Teratozoospermia: causes, diagnosis, and treatments

Infertility is a problem that many couples face, and in nearly half of the cases, the difficulty in conceiving a child is related to the man's health. Teratozoospermia is one of the most common causes of male infertility. It is characterized by a decrease in the quality of sperm and their ability to fertilize. The main diagnostic method for this condition is to perform a sperm analysis.

What is teratozoospermia?

Teratozoospermia is a pathology of spermatogenesis in which more than 30% of sperm have an abnormal shape. These cells cannot fully participate in the fertilization process, negatively affecting the possibility of conception.

Abnormal sperm may exhibit the following structural modifications:

1. Head anomalies: the head of the sperm may be too small or too large, bifurcated, globular, conical, have an altered acrosome, etc. These morphological changes prevent the sperm from penetrating the ovum and fertilizing it.
2. Tail anomalies: the tail may be short, thickened, broken, bifurcated, or twisted. Due to these anomalies, sperm lose their motility, significantly reducing the chances of fertilization.
3. Midpiece anomalies: changes in the midpiece of the sperm, such as asymmetry, thickness anomalies, or abnormal angle of attachment to the tail, also impair its motility and the possibility of effective conception.

Teratozoospermia Index

The teratozoospermia index is used to assess sperm quality and determine its fertilization capacity. This index reflects the presence of multiple morphological defects in the sperm. If a sperm presents only one defect (for example, head, midpiece, or tail anomalies), the index is 1. If there are two defects, the index is 2, and if there are three defects, the index is 3 (for example, if there are head, midpiece, and tail anomalies).

An index of teratozoospermia between 0 and 1.6 is considered normal, as within this range, the number of morphologically normal sperm is sufficient to allow for successful fertilization. An index above 1.6 indicates impaired fertility and a decreased ability for the man to conceive a child.

Causes and treatment of teratozoospermia

The morphological anomalies of sperm are associated with disorders of the spermatogenesis process, which can be caused by various factors. The main causes of the development of teratozoospermia are as follows:

• Sexually transmitted infections: various infections can negatively affect sperm formation, leading to the appearance of abnormal cells.
• Varicocele: this is an enlargement of the veins in the testicle, which hinders blood circulation and affects spermatogenesis.
• Inflammatory processes: inflammations of the male genital tract, such as epididymitis, also contribute to the development of sperm anomalies.
• Hormonal disorders: changes in hormone levels can lead to the formation of abnormal sperm.
• Influence of unfavorable external factors: exposure to toxins, radiation, high temperatures, and other environmental factors.
• Harmful habits: smoking, excessive alcohol consumption, and an unhealthy lifestyle negatively affect the spermatogenesis process.

The treatment of teratozoospermia depends on the cause of the disorder. An individualized approach to treatment is particularly important, as each cause requires specific approaches and therapeutic methods. Accurate diagnosis allows for the selection of the best treatment strategy, significantly increasing the chances of success. Treatment is prescribed by specialists, such as a gynecologist specializing in reproduction, a urologist, or an andrologist, after a comprehensive examination and analysis of the sperm analysis.

The treatment plan for teratozoospermia is chosen individually. In cases of hormonal disorders or infectious-inflammatory diseases, medication may be prescribed. In cases of pathologies such as varicocele or cryptorchidism, the problem may be resolved surgically. If teratozoospermia is due to genetic disorders, treatment may include the use of donor sperm within the framework of an in vitro fertilization (IVF) program or sperm donation.