Teratozoospermism and Pregnancy

ben bunting BA(Hons) PgCert Sport & Exercise Nutriton  Written by Ben Bunting: BA(Hons), PGCert.


In this article, we'll discuss the causes and symptoms of teratozoospermia, the pathological changes that occur in affected sperms, and possible treatment options. We'll also cover the issue of intracytoplasmic sperm injection (ICSI), which often results in lower fertilization rates than with traditional methods.

What is Teratozoospermism?

Teratozoospermia is a condition where 96% or more of the sperm cells have abnormal morphology. Ideally, the sperm should have an ovoid head with a straight tail and a transparent nucleus. 

A sperm with a malformation called teratozoospermia is incapable of fertilizing an egg and resulting in infertility. This is a rare condition that affects approximately one in a million men. 

Because the human body has a very large compensatory capacity, treating teratozoospermia is possible in many cases. Some treatments involve modifying your lifestyle, such as switching from a sedentary to a more active one, eliminating stress, and eating nutritious foods and avoiding high inflammatory junk foods. The process will generally take about two to three months as the sperm takes two to three months to mature.

The most common treatment for teratozoospermia is sperm injection. This treatment involves the introduction of sperm from a healthy donor into the uterus of a woman. The success rate of this treatment is high. But it is not a guarantee, nor is it cheap.

Another fertility treatment for men with teratozoospermia is in vitro fertilization (IVF). This procedure involves the introduction of sperm into the egg via hormone injection. Then, the resulting embryo is implanted in the uterus. Some men with teratozoospermia may also benefit from intracytoplasmic sperm injection. In this procedure, a healthy sperm is microinjected into the ovum in order to fertilize the egg.

Some sperm cells are malformed and can be visible under a microscope. The sperm can be abnormal in length, size, or shape. Some of these conditions can be passed from father to son.

Pathological changes in teratozoospermia

Teratozoospermia is a condition where the morphology of sperm is abnormal. The defect usually occurs in the tail, midpiece, or head of the sperm. These changes cannot be detected by examining sperm tissue alone; a special dye test is required. Symptoms of teratozoospermia include male infertility and a failure to conceive.

A study aimed to determine the effects of teratozoospermia on the outcome of IVF and ICSI pregnancies. It found that infertile couples who knew about the risks, still had an increased likelihood of conceiving.

The study included 79 patients with teratozoospermia, 56 healthy donors, and a control group. Semen was analysed, and morphology was assessed according to WHO 2010 guidelines. Moreover, seminal ROS was measured by chemiluminescence assay. The cutoff value and area under curve (AUC) values were determined to determine sensitivity and specificity of the method.

Causes of teratozoospermia

Besides low sperm morphology, men also experience infertility due to problems with sperm quality, count, or motility. In this case, the male partner is unlikely to conceive unless the other partner has other infertility-related problems. The symptoms are similar to those of oligospermia and asthenospermia.

A person with teratozoospermia can still conceive naturally, but this is not always possible. Genetic disorders, chronic diseases, and lifestyle choices can all cause this problem. If this is the case, the couple may need to seek help from medical professionals, or undergo assisted reproductive technology procedures.

Other conditions can cause a low sperm count, such as anemia, or a chronic disease, such as prostate cancer. Untreated STDs can also cause obstructions that limit the sperm's ability to fertilize an egg. While it is difficult to predict the exact cause of teratozoospermia, it is possible to diagnose the issue and determine the best course of treatment.

A complete blood count can be performed to assess the health of the testicles and the health of the ejaculate. The blood test can reveal a range of conditions that may cause azoospermia, including teratozoospermia.

Treatment options for teratozoospermia

A test for teratozoospermia can be performed using a computer-aided semen analysis system (IMSI). The morphology of sperm cells can be assessed using a high-magnification lens. In this way, the specialist can determine which defects are present in a sperm cell.

Treatment for teratozoospermism and pregnancy depends on several factors, including severity, age, and duration of infertility. In the majority of cases, IVF with ICSI is recommended. While most cases do not result in miscarriage, spermatozoa containing genetic defects may increase the risk of miscarriage and even cause health issues to the newborn.

Invasive procedures

Couples faced with this condition can undergo in vitro fertilization or intrauterine insemination (IUI), in which sperm are deposited at the top of the uterus when a woman ovulates. This procedure enables the healthiest sperm to be selected and increases the likelihood of a successful pregnancy. For severe cases, sperm donation may be necessary.

In vitro fertilization, or IVF, is another treatment option for teratozoospermians. This lab-based procedure uses a sample of the man's sperm to fertilize the eggs in the woman's womb.

Depending on the severity of the condition, intracytoplasmic sperm injection (ICSI) may be performed. This procedure enables doctors to choose the healthiest sperm for fertilization. It is also a good option for women who have failed multiple Intrauterine insemination (IUI) cycles. That said, ICSI isn't fail safe.

Lifestyle changes

A healthy lifestyle is essential for treating teratozoospermia. Lifestyle changes, including regular exercise and a balanced diet, will help improve sperm quality. Vitamin supplements, omega-3 fatty acids, and antioxidants will help sperm become more viable. These treatments can also improve sperm motility and count.


Antiestrogens have long been used to treat idiopathic male infertility, but previous reviews found that they did not improve pregnancy outcomes. A new meta-analysis involving eleven randomized trials found that antiestrogens were associated with a statistically significant increase in pregnancy outcomes, an increase in sperm motility, and a significant increase in sperm concentration. The study also found that antiestrogens increased pregnancy rates in men who were given antiestrogens alongside clomiphene 25-50 mg.

➡️READ: Natural treatments for male infertility

In men with azoospermia, the condition is characterized by a lack of sperm in the ejaculate. This condition is caused by various factors, including congenital abnormalities of the reproductive tract, post-testicular cancer treatment, and severe sexual dysfunction.

Testicular sperm extraction (TESE) is not recommended for routine treatment in patients with oligoasthenoteratozoospermia (OAT), particularly if the spermatozoa contain high DNA fragmentation. However, it may be considered in high-risk cases when previous IVF treatments failed or the sperm were cryptozoospermic.

ICSI results in lower fertilization rate in teratozoospermia

ICSI is an in vitro fertilization procedure in which the spermatozoon is directly injected into the oocyte. This enhances the chances of fertilization and enables the embryo to develop normally. ICSI also allows researchers to investigate the role of ooplasm maturity in the outcome of ART.

ICSI has advantages, including the fact that it is more successful than conventional insemination. This procedure can fertilize oocytes with damaged or absent ZP. ICSI can also be used to treat oocytes with structural abnormalities. When performed properly, ICSI can result in a normal blastocyst and fair chances of pregnancy.

There are a few reasons why ICSI results in lower fertilization rate in couples with isolated teratozoospermia. The first is the fact that morphology is a significant parameter in sperm. Couples with morphologically normal sperms have a higher rate of successful conception. A decrease in this factor also impacts the risk of total fertilization failure. 

Another factor that negatively impacts the success rate of ICSI is the high rate of double-stranded DNA breaks. These breakages can lead to poor fertilization. When the single-stranded DNA is intact, ICSI results are not affected.

ICSI can be used as a treatment for teratozoospermia if it is the only viable option for fertility in this disorder. Despite the lower fertility rate, it can lead to a healthy pregnancy.


Teratozoospermia is a condition that can affect male fertility. It can also affect sexual health and intimacy. It can also cause feelings of shame for the male. Teratozoospermia is not a life-threatening condition and treatments are available. 

Treatment options for teratozoospermia include artificial insemination, IVF, and surrogacy. Although none of these treatments are 100% effective, they are often the first choice for couples with this condition. 

Teratozoospermia is a common cause of male infertility. Over 85 percent of male sperm has abnormal morphology. Ideally, a spermatozoon should have an acrosome, an oval head measuring between five and six millimeters, and a flagellum.

Infertility is usually a problem that can be fixed with a few lifestyle changes and medications. The good news is that with the right treatment, a large proportion of these abnormal sperms can be normal.

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