After a year of unsuccessful attempts to conceive, a couple should consider visiting an assited reproduction centre.
Therein both members will be evaluated, in order to check how fertile they are. The standard examamination a man will undergo is the seminogram, a comprehensive sperm analysis using a sample provided by him.
Since teratozoospermia is asymptomatic, it is necessary to observe the sperm in order to make a diagnosis. A seminogram covers basic parameters, namely:
- Semen volume
Sperm morphology analysis
A perfect shaped spermatozoon has an oval head, a defined midpiece and a thin and long tail, responsible for its movement.
WHO has established a strict criteria to evaluate sperm morphology. Each part is examined as follows:
- Head: the head has to be oval-shaped and regularly outlined. Two parts have to be clearly differentiated: the acromosome and the nucleus. The acrosome is distal and should stand out from the rest of the head with ease. There have to be less than 20% vacuoles.
- Midpiece: it has to be lineal. The midpiece has to attach the head by the axial side (opposite end of the acrosome). It is 1,5 times longer than the head. Midpieces are expected to have a proportional thickness between head and tail.
- Tail: the tail has to be the slimmer part of the spermatozoon, being 50 micras long.
According to WHO criteria,teratozoospermia can be diagnosed if only 4% of the sperm show normal morphology. There are other criteria, like Kruger’s, who states that rates below 15% are suboptimal and lead to a diagnosis of teratozoospermia.
Either system stresses the importance of having a high percentage of abnormal sperm; 96% for WHO against 85% in Kruger’s scale.