Causes and Treatment Options for Teratozoospermia

Reviewed By: Dr. S. Shashant, fertility specialist at Ferty9 Fertility Center, Secunderabad

Teratozoospermia is a medical condition that affects male fertility and is characterised by abnormal sperm morphology. This medical term may sound daunting, but understanding the causes, diagnosis, and available treatment options can help men with this condition navigate their fertility journey. In this comprehensive blog, let's delve into the details of teratozoospermia, exploring its impact on fertility and the various approaches to managing this condition.

What is Teratozoospermia all about?

Teratozoospermia is a condition where a significant percentage of a man's sperm exhibits abnormal shapes or morphology. The normal sperm should have a distinct head, midpiece, and tail, but in teratozoospermia, the sperm may have various deformities, such as:

Irregular or misshapen heads
Bent or coiled tails
Multiple tails
Presence of cytoplasmic droplets

These abnormalities can impair the sperm's ability to fertilise an egg, reducing fertility.

About Sperm

Sperm are the male fertility cells responsible for fertilising the female egg during conception. Each sperm cell has a distinct structure consisting of a head, midpiece, and tail. The head consists of the genetic material, the midpiece provides energy for the sperm's movement, and the tail propels the sperm forward.

For successful fertilisation, sperm must have the proper shape and function to navigate the female reproductive tract, bind to the egg, and penetrate the egg's outer layer. Abnormalities in sperm morphology can significantly impact their ability to perform these critical tasks.

Suggested Read: How to increase sperm count and motility

Teratozoospermia Causes

The causes of teratozoospermia can be diverse and may include:

Genetic factors:

Inherited / sporadic genetic disorders or chromosomal abnormalities
Genetic mutations that affect sperm development

Environmental factors:

Exposure to toxins and substances such as chemicals, heavy metals, or radiation
Excessive heat exposure, such as from hot tubs or saunas
Lifestyle factors, including smoking, alcohol consumption, and obesity

Medical conditions:

Varicocele-abnormal enlargement of veins in the scrotum
Infections or inflammation of the reproductive organs
Hormonal imbalances

Idiopathic (unknown) causes:

In some cases, the underlying cause of teratozoospermia may not be identified.

Understanding the specific cause of teratozoospermia is crucial for developing an effective treatment plan.

Diagnosis of Teratozoospermia

The diagnosis of teratozoospermia typically involves a comprehensive evaluation, including:

Physical assessment: The doctor may perform a physical examination to identify underlying medical conditions or anatomical abnormalities.
Medical history:The doctor will gather information about the individual's medical and reproductive history and potential risk factors.
Semen analysis: This primary diagnostic test assesses the following parameters:
1. Sperm concentration:It assesses the number of sperm cells per millilitre of semen.
2. Sperm motility: The capability of the sperm cells to move and swim effectively.
3. Sperm morphology: The structure and shape of the sperm cells.

During the semen analysis, trained professionals examine a semen sample under a microscope. Then, they evaluate the morphology of the sperm cells using strict criteria established by the WHO or other recognised guidelines. The WHO criteria is

Head Size and Shape:

The head should be oval-shaped.
The head length should be 5-6 μm.
The head width should be 2.5-3.5 μm.

The head should have a regular outline with no abnormalities such as vacuoles or irregularities.

Head Cap:

The presence of an acrosome covering at least 40-70% of the head.

Neck and Midpiece:

The neck and midpiece should be regular in size and shape, connecting the head to the tail.

Tail (Flagellum):

The tail should be straight and have a regular thickness.
The tail length should be at least 45 μm.

The total percentage of normal and abnormal sperm cells is calculated, and if the proportion of abnormally shaped sperm cells exceeds a certain threshold, teratozoospermia is diagnosed.

Additional Tests for Diagnosing Teratozoospermia

Depending on the findings, the doctor may conduct further tests, such as:

Hormonal evaluation: Measuring levels of male hormones like testosterone, follicle-stimulating hormone (FSH), and luteinising hormone (LH) can assess the proper functioning of the hypothalamic-pituitary-gonadal axis.
Imaging studies: Ultrasound or other imaging tests may help evaluate the structure and function of the male reproductive organs.

It is important to note that a single abnormal semen analysis is not necessarily indicative of a permanent condition. Multiple semen analyses may be required to confirm the diagnosis and rule out temporary factors affecting sperm quality.

Effects of Teratozoospermia on Fertility

Teratozoospermia can have a significant impact on a couple's ability to conceive naturally. The abnormal shape and structure of the sperm cells can impair their ability to fertilise the egg, leading to reduced fertility or infertility. The specific effects of teratozoospermia on fertility include:

Impaired motility:Abnormally shaped sperm cells may have difficulty swimming effectively, reducing their ability to reach and penetrate the egg.
Reduced fertilisation potential: Even if the sperm cells reach the egg, their abnormal shape or structure may prevent them from successfully binding to and fertilising the egg.
Increased risk of genetic abnormalities: Sperm cells with structural defects may carry genetic abnormalities, which can increase the possibility of miscarriage, birth defects, or genetic disorders in the offspring.
Reduced implantation rates: Teratozoospermia may contribute to lower implantation and success rates in assisted reproductive technologies (ART), such as in vitro fertilisation (IVF).

Treatment Options For Teratozoospermia

The treatment approach for teratozoospermia depends on the underlying causative source and the severity of the condition. The following are some common treatment options.

1. Lifestyle modifications: Changing lifestyle choices may improve sperm quality and teratozoospermia condition. These include:

Quitting smoking
Reducing alcohol consumption
Maintaining a healthy weight
Avoiding exposure to toxins or excessive heat

2. Medication: Depending on the underlying cause, doctors may prescribe medicines, such as:

Hormonal therapies to address underlying hormonal imbalances
Anti-inflammatory medications to treat infections or inflammation
Antioxidant supplements to improve sperm quality

3. Surgery: In severe cases, doctors may suggest surgical intervention to treat underlying causes, such as:

Varicocele repair to address abnormal vein enlargement
Microsurgical sperm extraction (MESA) or testicular sperm extraction (TESE) to retrieve sperm for assisted reproductive techniques

4. Assisted reproductive techniques (ART): When the condition does not improve with conservative and surgical interventions, doctors may recommend ART for successful pregnancies.

The doctor will work closely with the couple to customise the most appropriate treatment plan based on the individual's specific circumstances and the severity of the teratozoospermia.

Lifestyle Recommendations for Teratozoospermia

In addition to medical treatments, specific lifestyle alterations can also enhance sperm quality and overall fertility in men with teratozoospermia. Some recommended lifestyle adjustments include:

Maintain a healthy weight: Being overweight or obese can affect sperm quality and increase the chance of teratozoospermia. Maintaining a healthy BMI (body mass index) through a balanced meal and regular exercise can improve overall reproductive health.
Quit smoking and avoid excessive alcohol consumption: Tobacco and excessive alcohol intake have been linked with decreased sperm quality and increased risk of abnormal sperm morphology. Limiting alcohol consumption and quitting smoking can positively affect sperm health.
Manage stress levels: Chronic stress can disrupt hormonal balance and affect sperm production and quality. Stress-reducing activities like exercise, meditation, or counselling may help improve sperm health.
Avoid exposure to environmental toxins: Certain environmental factors, such as pesticides, heavy metals, and radiation, can contribute to sperm abnormalities. Minimising exposure to these toxins can help protect sperm health.
Maintain proper scrotal temperature: Elevated scrotal temperatures can adversely affect sperm production and quality. Avoiding prolonged exposure to heat sources, such as hot tubs, saunas, or tight-fitting clothing, can help maintain optimal scrotal temperature.
Supplement with antioxidants: Antioxidants like vitamin C, vitamin E, and zinc may help protect sperm cells from oxidative stress and improve sperm quality. However, consulting with a medical professional before taking any supplements is essential.
If an underlying systemic condition, such as hormonal imbalances, varicocele (enlarged veins in the scrotum), or genetic disorders, is the root cause of teratozoospermia. In that case, it's important to remember that treating the underlying condition may improve sperm quality.

These lifestyle changes can help improve sperm health and increase the chances of successful conception.

Conclusion

Teratozoospermia is a condition that can significantly impact male fertility. By understanding the causes, diagnosis, and available treatment options, men with teratozoospermia and their partners can take proactive measures to address this condition and improve their chances of a successful pregnancy.

If you or your partner are struggling with fertility issues related to teratozoospermia, don't hesitate to consult with a fertility specialist. They can provide personalised guidance and develop a comprehensive treatment plan to help you on your journey to parenthood. Schedule an appointment today with a fertility expert and take your first step towards overcoming this challenge.

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Causes and Treatment Options for Teratozoospermia

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