Teratozoospermia: Types, Causes, Diagnosis, Available Treatments and How to get Pregnant

From age and lifestyle to ovarian and testicular dysfunction, infertility cases are increasing rapidly in India. According to a recent report from AIIMS (All India Institute of Medical Sciences), about 10-15% of couples in India suffer from infertility problems. 

Infertility refers to the inability of a couple to conceive after one year of unprotected sexual intercourse. Infertility can be caused by a variety of factors for both men and women. For women, infertility can be caused by problems with ovulation, poor egg health, hormonal imbalances, and abnormal reproductive structures. Male infertility, on the other hand, is associated with poor sperm production, sperm abnormalities, and obstructions that prevent sperm migration.

A new WHO report finds that almost 50% of infertility in India is caused by male factors. Sperm health problems among Indian men are on the rise. One such common sperm problem is teratozoospermia, which is discussed in this article today. We discuss its types, causes, diagnosis, available treatments, and how couples can use it to get pregnant. What is teratozoospermia?What is teratozoospermia?

A man’s sperm is considered healthy if:

The sperm head is exactly oval. Sperm has one long tail. Just below the sperm head is a thicker neck than the tail. The total length of the sperm is about 50 microns, with a head length of 5–6 microns and a width of 2.5–3.5 microns. Abnormal sperm morphology (shape or shape) is defined as teratozoospermia, also known as teratozoospermia. If a man’s sperm has a defective head, midsection, or tail, he may have this condition.

According to WHO, a man is classified as having teratozoospermia if his ejaculated semen contains more than 96% of his abnormal spermatozoa. On the other hand, according to the Kruger criteria, men with motile spermatozoa that are more than 85% abnormally shaped sperm are classified as having teratozoospermia. Men with this disorder are less able to fertilize a woman’s eggs, leading to infertility.

Types of teratozoospermia

When defining teratozoospermia, doctors usually begin by determining the type of sperm malformation: head, middle, or tail. And according to the severity of the condition, we classify the condition as follows:

  • Mild teratozoospermia: When semen analysis reveals 10-14% normal sperm count in ejaculated semen. Spontaneous conception is possible even in men with mild severity. 
  • Moderate teratozoospermia: When the normal percentage of sperm in semen is 5-9%. Men with moderately severe disease are very unlikely to conceive spontaneously, but may become pregnant with IVF-ICSI (intracytoplasmic sperm injection) treatment. 
  • Severe teratozoospermia: when the normal percentage of sperm in semen is less than 5%. Spontaneous conception is not possible in men with severe teratozoospermia. Treatments such as ICSI and advanced ICSI called IMSI (Intracytoplasmically Selected Sperm Injection) may help.

In addition to being classified according to the severity of the sperm abnormality, teratozoospermia is also classified into other types, including:

Astheno teratozoospermia

This condition is a combination of asthenozoospermia and teratozoospermia. A man’s chances of inducing pregnancy depend on sperm morphology, motility, and number. In this condition, male sperm motility and morphology are poor. There is no cure for asthenospermia teratozoospermia, but natural lifestyle changes can provide some relief. However, for pregnancy, ICSI and IMSI treatment is considered.

Oligoastheno teratozoospermia

This condition is a combination of oligozoospermia, asthenozoospermia, and teratozoospermia. Men with this condition have reduced sperm count, motility, and morphology. There is no cure for oligoasthenia teratozoospermia. IMSI is the treatment of choice when a child with this condition is likely to be born.

Causes of teratozoospermia

Although the exact cause of teratozoospermia or related disorders is still unknown, there are several factors that can affect sperm morphology.

  • Testicular infection, inflammation, damage. 
  • The veins in the scrotum (the bag that supports the testicles) swell. Also called varicocele. 
  • Genetic abnormality
  • Performing a vasectomy (an operation that sterilizes men). 
  • Exposure to radiation or toxins
  • Diabetes
  • Unhealthy habits such as poor diet, wearing tight clothing, smoking, drinking alcohol, and using recreational drugs. 

The good news is that some factors, such as testicular infections and inflammation, diabetes, and unhealthy habits, can be improved with the help of your doctor and habit changes. In such cases, the sperm morphology will eventually improve and the male may induce conception.

Symptoms and diagnosis of teratozoospermia

The disease has no noticeable side effects and patients learn about it during fertility tests. The only indication of this condition is the experience of male infertility.

On the other hand, when it comes to diagnosing teratozoospermia, it can be detected by a semen analysis test. For this test, sperm (mature sperm cells) are analyzed under a microscope. A urologist stains a man’s semen sample with methylene blue and analyzes the sperm morphology to see if the man has morphological abnormalities.

Teratozoospermia and pregnancy rate

Fertility rates for teratozoospermia vary depending on the severity of the condition, other sperm health parameters such as sperm count and motility, and whether the person or partner has other fertility problems.

Men with mild teratozoospermia, healthy sperm count and motility, and otherwise healthy fertility are very likely to conceive a child naturally or with little medical help. higher. However, women with moderate to severe teratozoospermia, low sperm count, poor sperm motility, and other fertility problems have very low pregnancy rates.

Frankly, there are no specific pregnancy rates for patients with teratozoospermia or other sperm-related fertility problems. The less serious the problem, the more likely a man will have children. However, ART such as IVF-ICSI and IVF-ICSI have also been shown to be highly effective in cases of moderate to severe teratozoospermia.

To find out what is best for you, you should always consult a fertility specialist, properly diagnose and evaluate your medical history, and then find a solution. But yes, pregnancy is possible even with teratozoospermia.

Treatment of teratozoospermia

Teratozoospermia is caused by controllable factors such as inflammation, infections, diabetes, and unhealthy habits, and is very likely to be treated. On the other hand, if teratozoospermia is hereditary or is the result of irreversible injury, surgery, or disease, it is very unlikely to be treated. Well, the good news is that as long as the sperm count and motility are normal, or at least good enough for conception, there are few options that can help a man with teratozoospermia produce a genetic child. is.

Natural treatment for teratozoospermia

A man’s sperm health obviously depends on the specific hormones that the brain and testicles produce to form the sperm. What men do, how they eat, and how they move all affect their ability to produce these hormones.

If you do everything right, your sperm count, motility and morphology will ultimately improve. Start quitting unhealthy habits such as unhealthy eating, smoking, drinking alcohol, recreational drugs, and wearing tight clothing. Then, you can add certain male fertility supplements such as omega-3 fatty acids, L-carnitine, antioxidants, and vitamin E to your diet. You can also start weight training to boost your testosterone levels.

Pregnancy with teratozoospermia

If you have teratozoospermia and are unable to conceive naturally, assisted reproductive technology (ART) can help.


IUI, also known as intrauterine insemination, is her first-line ART approach that collects, cleanses, and concentrates sperm and transfers the healthiest sperm into a woman’s ovaries at the time of ovulation. If the man has mild to moderate teratozoospermia and you and your partner have no other fertility problems, an IUI can be an effective option to achieve pregnancy.


ICSI (Intracytoplasmic Sperm Injection) is an evolution of her traditional IVF procedure. This involves injecting a single, healthy, normal, live sperm into the cytoplasm of a woman’s mature egg to initiate fertilization. For moderate to severe teratozoospermia, ICSI is an effective treatment option to promote pregnancy.


IMSI (Morphologically Selected Intracytoplasmic Sperm Injection) is a further development of the IVF-ICSI procedure. This procedure is similar to ICSI, but requires a more detailed analysis of the sperm prior to injection. The morphology of the collected sperm is determined using a high-magnification device, and only single sperm cells without morphological abnormalities are transplanted. IMSI is best for severe teratozoospermia. 


Talk to your doctor about teratozoospermia

You may father a genetic child with teratozoospermia. By properly diagnosing the condition and determining its severity, the condition can be treated and improved. Effective treatments are available to help men with teratozoospermia to conceive, including IUI, IVF-ICSI, and IVF-IMSI.

You are not alone. More than 50% of infertility in India is male infertility. Men tend to experience declines in sperm count, sperm quality, and motility throughout their lives. it is normal. You can then conceive a child with proper fertility support. All you need is the help of a good fertility specialist.

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