If a semen analysis report shows teratozoospermia, what does it mean?

In a semen analysis report, sometimes you find a word called teratozoospermia. What we essentially look at, is the volume, the count, the motility, and the quality of the sperm which is also known as morphology. When the morphology of the sperm is abnormal, then we say teratozoospermia. 

The sperm has 3 components, the head, the neck, and a tail. It is one of the smallest cells in the body which is exposed to different pH’s and external environments as it travels from the male body into the female body to meet the egg. So, it needs a robust quality to reach that point and fertilize the egg. In the sperm head abnormalities, we have the tip abnormality called abnormal acrosome which can be smaller or absent. we can have the whole head abnormality which is an elongated shape called pyriform or an irregular shape called amorphous form. 

The second part of the sperm is the neck which contains the energy packet that is the mitochondria that drive the sperm movement and it is called the energy pack. Neck abnormalities are short neck, bent neck, or an irregular neck which can also affect the pregnancy chances. The third part is tail abnormalities like the absence of a tail, a short tail, a coiled tail also known as head in coils. Quality assessment of the sperm is known as morphological assessment of the sperm which includes counting the head, the neck, the tail abnormalities of the total number of sperm that are present. 

The WHO cutoff level is one should have at least four percent normal forms to get a reasonable chance of pregnancy. 4% is the lowest level and if somebody has levels less than that, they need further evaluation in terms of health evaluation, male infection screening. The DNA fragmentation test and other sperm function tests are needed to understand why there is teratozoospermia. 

It is often an undiagnosed or misdiagnosed or incompletely diagnosed problem and most of the couples are labeled as unexplained infertility. If more attention is given to sperm morphology, the instance of unexplained infertility might significantly decrease. This teratozoospermia can give pregnancies but may not be within the given frame of time. The treatment modalities will depend on the severity of the problem and the co-existing health conditions. In conclusion, teratozoospermia or teratospermia is a quality issue of the sperm which requires proper interpretation.

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