What is Teratozoospermia or Abnormal Sperm Morphology- Causes, Symptoms & Treatment

From hormonal disorders to disrupted functioning of the testes and ovaries, infertility is at the spike in the world. It is defined as a clinical condition in which women and men cannot achieve natural pregnancy without birth control after a year of intercourse. According to AIIMS, New Delhi, 10-15% of married couples are facing fertility issues. Infertility can be caused by several factors, with both men and women contributing to it.

According to experts, more than 30% of the cases are inclined to men’s infertility. Men’s fertility refers to issues with sperm count, sperm quality, and sperm motility like Teratozoospermia. Teratozoospermia, also defined as abnormal sperm morphology or Teratospermia, is, therefore, one of the prime issues contributing to the inefficiency of conceiving. It is a sperm disorder that affects the shape of sperm and is caused by a defect in the sperm’s head, neck, or tail, affecting their chances of egg fertilization.

What is Teratozoospermia?

teratozoospermia- Cause and Treatment

Teratozoospermia meaning, It is an abnormality in the morphology of sperm. The term “sperm morphology” describes the sperm’s shape and form. It is the term for any variation from the standard sperm shape and size. 

Teratozoospermia or Teratospermia is when sperm in a man’s semen is not well-formed or defective. When the abnormal shape of sperm reaches over 85% of deformation in semen samples, it is diagnosed as Teratozoospermia. It decreases the sperm’s capability to fertilize the egg or makes it difficult to swim to the egg inside a woman, leading to infertility.

(ASRM) American Society For Reproductive Medicine Research shows that normal sperm possess certain characteristics, such as,

  • A distinct, clean cap covers 40% to 70% of the sperm’s head
  • An oval-shaped head 5-6 micrometers long and 2.5-3.5 micrometers wide
  • A regular-looking midpiece and neck in a tail
  • No drops of fluid in the head

Teratozoospermia produces wonky-looking sperms that may have a round head, two heads, or two tails. Semen Analysis or Seminogram is done to check sperm morphology. It helps determine whether men’s sperms are damaged or not, highlighting the infertility issue.  

Importance Of Normal Sperm Morphology In Fertility And Reproduction

A healthy or normal sperm morphology falls typically within the 4–14% NF range, while the exact range may differ. A rating under 4% can indicate that getting pregnant will take longer than usual. Although low sperm counts are the main reason for infertility in males, the sperm’s shape could also be a factor. Since sperm requires a specific form to enter the egg’s outer layers, morphology might impact fertilization. Most males with poor morphology of sperm can still become parents, although getting pregnant might be more difficult or necessitate professional help from a fertility doctor.

For individuals who have problems with sperm morphology, in vitro fertilization (IVF) or intrauterine insemination (IUI) might be a possibility. Intracytoplasmic sperm injection (ICSI) could be done in addition to IVF to improve the likelihood. Several studies have discovered that consuming antioxidants in men’s fertility pills for three months or more can correct aberrant sperm morphology.

Types of Teratozoospermia

Defects in sperm cells can be found in any part of their bodies, in the head, tail, or midpiece. It can also be in all parts or combine any two types of abnormalities. 

types of teratozoospermia

Teratospermia is identified in different stages, depending on the percentage of abnormal and normal sperm in the semen sample. Sperm morphology determines the severity of Teratozoospermia:

  • Mild Teratospermia– The normal sperm morphology ranges between 10-14%.
  • Moderate Teratospermia– Sperm morphology ranges between 5-9%.
  • Severe Teratospermia– Here, the sperm morphology rate is less than 5%.

Apart from the range of sperm morphology, Teratozoospermia is categorized under two more different heads-

Astheno Teratozoospermia

Astheno Teratozoospermia is a clinically approved male infertility condition characterized by reduced sperm motility. It is often observed in men with PCD (Primary Ciliary Dyskinesia) or immotile ciliary syndrome.

Oligo Astheno Teratozoospermia

Oligo Astheno Teratozoospermia condition is a combination of Oligozoospermia (low sperm count), teratozoospermia, and asthenozoospermia. It is the most common cause of subfertility in males and is usually caused by medicines, genetics, infections, lifestyle choices, abnormal hormone levels, antibodies, and other factors.

What Causes Teratozoospermia?

Clinical experts have mentioned that the exact causes of Teratozoospermia or teratospermia are yet not identified and not determined. Psychological stress is therefore said to affect the morphology of the sperms. Some of the possible factors known for teratozoospermia are:


Aging is also linked with abnormal sperm morphology. With increasing age, the ability to produce good quality sperm diminishes in men, leading to structure and other related defects. National Institute of Health, USA studies shows, aging has a deleterious impact on semen parameters. Aging has also been linked to sperm viability, total sperm count, and reduced everyday sperm production. These changes are brought on by altered accessory gland activity and lead to reduced semen volume. Sperm morphological changes start to take place around 40.

Genetic Factors

Genetic factors may contribute to Teratozoospermia. Besides, Teratozoospermia inherited genetically is persistent and cannot be curable. In these situations, artificial insemination techniques similar to ICSI or IVF could be utilized to make the female partner pregnant.

Environmental Factors

Negative environmental such as exposure to toxins or radiation influences significantly impact the quality of sperm, which eventually results in male infertility by increasing aberrant sperm morphology, total sperm count, viability, motility, and lowering sperm concentration. But, since each of these risk variables is reversible and adjustable, most Teratozoospermia causes could be prevented by altering the lifestyle and preventing excessive radiation or toxins.

Medical Conditions

A few medical conditions such as varicocele or infections may cause Teratozoospermia, such as issues in testicles (may be due to injury or infection), cancer treatments including chemotherapy or radiation therapy, vasectomy, varicocele, etc.

Other possible factors are known for teratozoospermia

Genetic traitsInfections or chronic diseasesDrug use
Testicular traumaObesityUnbalanced diet

Symptoms Of Teratozoospermia

Teratozoospermia does not cause pain for the male affected. As a result, a seminogram is required to identify this seminal change. An expert will inspect the spermatozoa shape in the andrology lab as part of this examination.

Difficulty Conceiving

Although most aberrant spermatozoa cannot enter an egg, infertility could be a symptom of teratozoospermia. Although the causes are unclear, it is recognized that several things, including testicular issues, could impact sperm quality.

Abnormal Semen Analysis Results

Abnormal semen analysis or semen morphology is usually Teratozoospermia, the spermatozoa’s high percentage appearance.

Diagnosis of Teratozoospermia/Teratospermia

Semen Analysis

The seminogram, a thorough sperm study, is the primary screening for males. The semen specimen that the male supplied is used for this analysis, which is then examined under a microscope to look for any irregularities. A screening for semen analysis can identify teratozoospermia; for a specimen to consider normal, WHO states that for a normal morphology, there should be a minimum of 4% sperms. The specimen exhibits moderate teratozoospermia if 4 to 15% are normal sperm, according to Kruger parameters. The presence of normal sperm below 4% in the sample signifies acute teratozoospermia. Teratozoospermia pregnancy rate- In-vitro fertilization (IVF) outcomes are inversely correlated with aberrant sperm morphology in early investigations, with fertilization rates varying from 45% to 75% in males with teratospermia and 77% to 92% in males with normal sperm morphology.

Other tests, such as Hormonal Assays or Genetic Testing

Hormonal assay for Teratozoospermia analysis: Hormone levels differs significantly between sub-fertile and normal stallions, making hormonal analysis less useful for diagnostics.

Treatments for Teratozoospermia

Diagram of normal human sperm

A man diagnosed with teratozoospermia can still achieve natural pregnancy until all the other semen parameters, including sperm count and sperm motility, are normal. Moreover, if a man cannot achieve pregnancy naturally, they can follow a series of medical tips to improve the morphology index of their sperm.

On the other hand, if teratozoospermia is due to a genetic origin and congenital (present from birth), finding an ideal treatment will help them with the desired results.

Natural Treatment

One of the predictable reasons identified for teratospermia is lifestyle factors. Men diagnosed with it must adopt a healthy lifestyle, changing or quitting their unhealthy habits, including cigarette smoking and alcoholic drinks.

Switching to a balanced diet with food rich in antioxidants, and amino acids, including L-carnitine, will help boost sperm quality, increasing their effectiveness in swimming to the egg and fertilizing it.

Medical Treatment For Infections Or Varicocele Repair Surgery

Teratozoospermia treatment for subfertile individuals with clinically evident varicocele or isolated teratozoospermia may include varicocelectomy. Patients must be aware that the operation only benefits a few people since it does not work for many people.

However, teratospermia treatment is available but it is incurable when it is genetically transmitted or inherited. It is especially challenging to treat sperm morphological problems brought on by radiation treatment for cancer or chemotherapy. Therefore, sperm freezing before treatment is considered when prospective fertility is sought.

The best part is that with quick action, the illness could be treated or teratozoospermia treatment when certain other circumstances have brought it on.

Fertility Treatments

IUI (Intrauterine Insemination)

To all males suffering from teratospermia, IUI is the first choice of medical treatment. However, if a man is diagnosed with mild teratozoospermia and the partner is perfectly healthy, then direct injection of men’s semen near the egg will help facilitate the fertilization process.


In cases with moderate to severe teratozoospermia, normal and healthy-looking sperms are selected after an inspection under the microscope and injected directly into the egg for fertilization through ICSI or IVF Procedure.

IMSI (Intracytoplasmic Morphologically Selected Sperm Injection):

IMSI is an advanced technology considered more effective than ICSI for teratospermia. This technology provides a better view of the sperm, allowing sexologists to pick the best quality and place them in the egg for fertilization.

Prevention Strategies for Abnormal Sperm Morphology

The initial step in addressing teratozoospermia will be changing one’s lifestyle to one that is healthful. By eating a diet full of fruits, teratozoospermia could be naturally treated. Often, getting rid of harmful sources such as alcohol and tobacco is a highly effective remedy. Besides, routine medical checkups and following the doctor’s advice may help you prevent the disorder.


You may have infertility when you and your spouse have issues getting pregnant. A clinician specializing in fertility issues could advise and perform specific tests to assess your fertility and figure out what’s wrong. Many occurrences of infertility are caused by problems with men’s factor infertility, sperm, and among the most frequent diagnosis is teratozoospermia. To begin or expand a family, several couples with this illness must consider medical interventions and infertility treatments.

FAQs Related to Teratozoospermia

1. Can IVF show successful results with Teratozoospermia?

IVF is a lab-based procedure where the semen sample is collected and analyzed. As a result, the best healthy sperm is picked for the fertilization process, increasing the chances for positive results.

2. How to treat abnormal sperm morphology naturally?

Consuming healthy food rich in antioxidants, nutrients, and vitamins and quitting unhealthy habits will help elevate sperm quality, increasing the chances of conceiving naturally.

3. Is achieving natural pregnancy possible with Teratozoospermia?

If all the other factors, including the partner’s age, reproductive health, and semen analysis, are positively ranked, then a married couple can conceive naturally.

4. Can abnormal sperm morphology lead to miscarriage?

They’re very few chances for miscarriage in teratozoospermia. If the sperm contains genetic disorders, it will not be able to fertilize the egg. Once the egg is fertilized and the embryo is attached to the womb, the involvement of genetic sperm disorders is eliminated from the reproductive process.

5. What are the risks associated with Teratozoospermia?

The absence of healthy sperm, with a smooth overhead, oval head, and a complete proportion, is the principal risk factor for Teratozoospermia. Infertility may result from sperm with morphological abnormalities that hinder fertilization. But, this risk could be avoided entirely with the proper care and treatment.

6. Is there a link between Teratozoospermia and male infertility?

Men with Teratospermia, a disorder, create sperms that have an odd appearance. The condition subsequently impacts their prospects of fertilizing the eggs.

7. What specialists treat Teratozoospermia?

Fertility specialists can help treat Teratospermia.

8. What happens if Teratozoospermia is left untreated?

When untreated, Teratospermia may lead to infertility and other specific issues. 

9. Are there any home remedies for Teratozoospermia?

Berries include antioxidant pigments while absorbing oxygen-free radicals such as blackberries, raspberries, strawberries, and blueberries. To safeguard or enhance sperm quality, it is a good idea to include berries in your regimen. Additionally, in situations of teratozoospermia, asthenospermia, and oligospermia, acupuncture may enhance sperm quality. However, you must see a specialist to get effective remedies since home remedies may not be effective.

Picture of Dr Namita Kotia

Dr Namita Kotia

Dr. Namita Kotia (IVF specialist in Jaipur) attained her Master’s in Obstetrics and Gynecology from S.N. Medical College, Jodhpur affiliated to University of Rajasthan in 1997. She has more than 10 years experience in field of Assisted Reproductive Technology (ART).Presently at Aastha Fertility Care Dr. Namita along with her team is providing complete infertility work up and treatment options under one roof. Her aim is to provide proper guidance and treatment to Infertile couples at AFFORDABLE RATES.She is life member of Indian Academy of Human Reproduction (IAHR), Indian Society for Assisted Reproduction (ISAR), Federation of Obstetrics and Gynecology Society of India (FOGSI) and Jaipur Obstetrics Gynecology Society (JOGS). She has a number of publications in various journals and presentations at state and National level conferences to her credit.Dr. Namita is also recipient of best paper presentation viz “Diagnosis of Congenital Mullerian anomalies by three dimensional Transvaginal Sonography” awarded at “Kishori” Conference in Jodhpur (2000).

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