Fertilization with the ICSI method (intracytoplasmic sperm injection) offers higher success rates when one of the factors to address is teratozoospermia: we select a sperm with normal morphology and inject it directly into the egg, optimizing the chances of fertilization.
What is teratozoospermia and why is its diagnosis important?
Teratozoospermia is a medical term describing a high percentage of abnormally shaped sperm in semen. Teratozoospermia is defined when more than 96% of sperm have altered forms, reducing their motility and ability to penetrate the egg.
What causes can lead to teratozoospermia?
Semen quality can be affected by various factors:
- Diabetes mellitus
- Varicocele
- Vasectomy over 5 years ago
- Infections of the seminal tract
- Testicular problems or trauma
- Poor nutrition
- Smoking, alcohol, or drugs
- Exposure to insecticides and other toxins
- Advanced age (from 45 years, abnormal sperm increase)
- Cancer treatments (chemotherapy, radiotherapy)
- Recent fevers
- Excess heat (saunas, jacuzzis, vehicle seats)
How is teratozoospermia diagnosed and classified?
Diagnosis is made with a semen analysis after 3–7 days of abstinence:
- WHO: at least 4% normal sperm.
- Kruger: 4–15% normal = moderate teratozoospermia.
- Less than 4% normal = severe teratozoospermia.
Normal sperm have an oval head of 5–6 µm × 2.5–3.5 µm and a flagellum of ~50 µm.
What treatments exist to improve fertility?
- Artificial insemination: capacitated semen in the uterus. For moderate teratozoospermia and women under 35 years.
- In vitro fertilization (IVF): egg and sperm union in the lab. Recommended if the woman is over 35 years.
- ICSI: injection of a normal sperm into the egg. The option with the best rates in severe teratozoospermia.
A healthy lifestyle enhances semen quality: balanced diet, essential amino acids (L-Carnitine), and antioxidants. Avoid self-medication.
For more information on erectile dysfunction and fertility or male infertility and how to conceive a baby, visit our specialized articles.
FAQ on teratozoospermia and fertility
1. Can teratozoospermia be corrected with lifestyle changes?
In mild or moderate cases, improving habits (balanced diet, exercise, and reducing toxins) can increase the percentage of normal sperm. Antioxidants and L-Carnitine also help. If symptoms persist, consult a specialist.
2. Is ICSI safe for severe teratozoospermia?
ICSI manually selects a sperm with good morphology and injects it into the egg, achieving high fertilization and pregnancy rates. Before the procedure, the doctor will assess your history and semen quality.
3. When can improvement be seen after treatment?
The sperm production cycle lasts ~72 days, so changes in habits or treatments usually reflect in 2–3 months. Follow-up semen analyses help adjust the plan.
4. Does the man’s age influence the results?
Men over 45 years have more abnormal sperm and lower motility. When planning IVF or ICSI, male age is considered to optimize the protocol.
Sources consulted
- World Health Organization. (2021). WHO Laboratory Manual for the Examination and Processing of Human Semen (6th ed.).
- Cooper et al. (2010). WHO reference values for human semen characteristics. Human Reproduction Update, 16(3), 231–245.
- Carlsen et al. (1992). Evidence for decreasing quality of semen during past 50 years. BMJ, 305(6854), 609–613.
- MedlinePlus. (2022). Teratozoospermia.
We know this journey can be challenging. Stay hopeful and remember each case is unique. Consulting an assisted reproduction specialist will give you the personalized guidance you need to increase your chances of success.