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3.5 Minute

27-07-2024 Team Medicover Fertility

Understand Sperm Morphology

Q: Can An Abnormal Sperm Fertilize An Egg?

It’s possible for an abnormally shaped sperm to fertilize an egg. Having abnormal sperm morphology doesn’t mean that a man would be completely unable to impregnate a female; it might just take a longer time. The genetic material in that abnormal sperm may still be healthy.

Q: Does Sperm Quality Affect A Baby?

A sperm with chromosomal abnormalities might cause a miscarriage. Sperm quality is good in younger men, but it deteriorates with age. Hence, the chances of a baby being born with genetic defects increase in older men.

Q: Can Unhealthy Sperm Cause Pregnancy?

Unhealthy sperm, where the head is defective with altered genetic material, may not cause pregnancy. Instead, it may cause early miscarriage due to an abnormality in a chromosome.

Q: Can You Get Pregnant If A Man Has Low Sperm Count?

Low sperm count, also known as oligospermia, is a common cause of subfertility or infertility in couples. The normal sperm count range varies from 15 million to 200 million sperm per milliliter. A sperm count below 15 million per milliliter is considered low.

Q: What Is Sperm Morphology Normal Values?

A healthy or normal sperm morphology value can range from 4 to 14%. Fertility success is good when the sperm is in this range.

Q: Can 0% Sperm Morphology Be Improved Or How To Correct Sperm Morphology?

In couples with infertility, abnormal strict morphology of 0% normal forms of sperm is a criterion to proceed rapidly towards in vitro fertilization. Sperm quality may be increased by a good diet, and proper intake of vitamin supplements and antioxidants.

Q: How Bad Is 1% Sperm Morphology?

According to strict morphology or Kruger morphology, a score of 0 to 3% is considered abnormal, which means a very severe impairment or inability to fertilize an egg.

Q: What are the foods to improve sperm morphology?

To improve sperm morphology, consume foods rich in antioxidants, vitamins, and minerals. Include nuts, seeds, leafy greens, citrus fruits, berries, fish, eggs, and whole grains. Avoid processed foods, reduce alcohol, and stay hydrated for optimal results.

Q: What is sperm morphology range?

Sperm morphology refers to the size and shape of sperm. A normal morphology range is typically considered 4% or more of sperm with normal shape according to the Kruger strict criteria. Values below this may indicate fertility issues, and further evaluation by a specialist is recommended.

Q: What are the causes of abnormal sperm morphology?

Abnormal sperm morphology can be caused by genetic factors, hormonal imbalances, exposure to toxins or radiation, infections, varicocele, smoking, excessive alcohol consumption, drug use, poor diet, obesity, and stress. Environmental and lifestyle factors also play a role.

Sperm morphology is primarily investigated to check male fertility status along with sperm count and motility.

A semen analysis test evaluates the shape and size of sperm, providing insight into proper sperm development (spermatogenesis) in the testicles.

Men with defects in sperm maturation often have problems with sperm shape, affecting fertility.

Importance of Sperm Morphology

Morphology Assessment: Looks at the shape and appearance of the sperm head, midsection, and tail.
Sperm Head: Carries genetic information and affects the ability to dissolve the egg’s outer surface.
Mid-piece: Contains enzymes and mitochondria for energy.
Tail: Made of protein fibers, aiding in forward movement.

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Importance of Morphology

Fertility Evaluation: Part of semen analysis to evaluate male infertility.
Normal Values: Results are reported as the percentage of normal-shaped sperm.
Diagnosis: Relies on standardized analysis of semen parameters (morphology, motility, count).

Sperm Morphology Test

Sperm morphology can be seen in a semen analysis test, also known as the sperm count test. A semen analysis test analyses the health and viability of a man’s sperm. For a semen analysis test, we need a fresh semen sample from a patient.

Semen is the fluid containing sperm (plus other sugar and protein substances and secretions from other male accessory glands) that is released during ejaculation, and its main function is to fertilise a female ova or egg.

From that semen sample, a drop of semen is taken in a clean, dry glass slide, and it is then dried, stained and observed under a microscope to determine the percentage of normal sperm in the total sample taken.

A man should at least, give two semen samples a few days apart to get an accurate result of semen analysis, which determines the sperm quality.

Normal sperm morphology range varies between 4 to 14 percent. The fertility rate is considered good when normal sperm morphology is in this range. A sperm morphology, lower than 4 percent means it will take longer time to impregnate a female.

Moreover normal sperm count to get pregnant is between 15 million to 200 million sperm per milliliter.

W.H.O. 2010 cutoff parameters for a normal sperm count

Parameter	Lower Reference Limit
Semen Volume (ml)	1.5
Sperm Concentration (10^6/ml)	15
Total Sperm Number (10^6/ejaculate)	39
Progressive Motility (PR, %)	32
Total Motility (PR + NP, %)	40
Vitality (live sperms, %)	58
Sperm Morphology (NF, %)	4
pH*	>=/=7.2
Leucocyte* (10^6/ml)	<1
MAR/Immunobead Test* (%)	<50

*Parameters agreed on consensus

Cutoff Parameters for a Normal Sperm Count

Normal Sperm Morphology

Normal sperm has an oval head with a long tail. It should be free from any defect to fall under the category of normal sperm morphology.

The normal morphology of sperm says that the head should be smooth and between 2.5 to 3.5 micrometres wide and 5 to 6 micrometres long.
An acrosome tip that takes 40 to 70 percent space of the head of the sperm. The acrosome is a unique membranous organelle located over the anterior part of the sperm nucleus that contains enzymes which helps to penetrate an egg’s membrane.
The head should not have a large fluid-filled vacuole, also should not contain more than two small vacuoles and should not occupy more than 20 percent of the total head.The area between the head and the tail known as the midpiece should be thinner than the head.

A straight non-defective tail that is 45 micrometres long and should be thinner than the head and the midpiece.

With Strict criteria or Kruger’s criteria, a score of 4 to 14% sperm of normal morphology are considered sufficient to achieve a pregnancy.

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Abnormal Sperm Morphology

Teratozoospermia, teratospermia or abnormal sperm morphology is a semen alteration in which a large percentage of sperm have an abnormal shape.

Abnormal Sperm Have Large Or Deformed Heads
Head Defects Of Sperm
The Midpiece May Be Defective
Midpiece Defects Of Sperm
Crooked Or Double Tails
Tail Defects Of Sperm

And at times large vacuoles may be present.

Defects	Explanation
Head Defects	Includes large, small, tapered (elongated), pyriform (pear shaped), round, and amorphous (constricted) heads, vacuolated, heads with small cap area (< 40% of the head area) and double heads, as well as combination of these. Globozoospermia, where the head appears small and round due to the failure of the acrosome to develop.
Midpiece Defects	Includes bent neck, asymmetrical insertion of the midpiece into the head, irregular midsection, an abnormally thin and thick midsection, cytoplasmic droplet as well as a combination of these.
Tail Defects	Includes short, multiple, hairpin, broken or bent tails, coiled tails and terminal droplet, as well as a combination of these.

Traditionally, teratozoospermia was diagnosed if 14% of the sperm had a normal shape. According to W.H.O. guidelines 2010, the reference value was updated.
A man should have 5% of properly shaped sperm, to be within normal limits. By current standards, if a man is diagnosed with teratozoospermia, 96% of his sperm need to be morphologically abnormal.
Strict morphology or Kruger morphology score 0 to 3% is considered abnormal, which means a very severe impairment or inability to fertilise.

Abnormal Sperm Morphology and Male Infertility

A man needs 4 to 14% of normal sperm to be fertile. While abnormal sperm morphology affects fertility, factors like sperm count, concentration, semen volume, viability, and motility are also crucial.

Healthy Genetic Material: Abnormally shaped sperm usually carry healthy genetic material. A 2017 study found men with 0% normal sperm still had near-normal fertility rates.
Pregnancy Possibility: Men with abnormal sperm can still achieve pregnancy, though it may take longer. Assisted reproductive technologies like IVF with ICSI can help. ICSI involves directly injecting sperm into an egg and can be used even with low morphology.
IUI Option: If sperm concentration and motility are good, IUI can be considered before ICSI-IVF.

How to Increase Sperm Morphology

Lifestyle Changes: Improve sperm quality by losing weight, exercising, avoiding heavy drinking, smoking, and wearing loose cotton shorts.
Diet and Supplements: Consume foods rich in Vitamin B12 (seafood, fish, meats, poultry, dairy) and other supplements.
Freezing Sperm: For those delaying family planning, freezing sperm when young can preserve quality.

Frequently Asked Questions