Diagnosis of teratozoospermia

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.

Diagnosing the condition

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
  • Vitality
  • Concentration
  • Motility
  • Morphology

Semiogram as a diagnostic mean

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.


  1. avatar

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  2. avatar


    I’m 46 y.o male and have been trying with my wife for more than a year to have a child. A basic semen analysis shows that I have severe asthenoteratozoospermia:

    Motility: 5%
    Morphology: 0% (Head piece defect 78%, Mid piece defect 21%, Tail defect 1%)

    My wife is a year younger than me and I know that also reduces our probability of success. Thus so far she’s healthy and her reproductive system is normal when she had a check a few months ago.

    Is there any chance that I could father through non-assisted means a healthy child without genetic defects?

    What options do we have?

    Would be grateful for your advice.


  3. avatar

    Hi there! Not understanding my partner’s… head defects 48%, neck 37% and tail 15%. Does this indicate good or not? Been trying for a year now.

    • avatar
      Andrea A.Assisted Reproduction Specialist

      Dear Sarah,
      One of the parameters that are analysed in a spermiogram is the morphology. Depending on the percentage of normal spermatozoa the diagnosis will be normal semen analysis or teratozoospermia. Usually, on the medical report it is also analysed which kind of abnormalities can be found among the abnormal spermatozoa: head defects, middle piece defects, neck defects or tail defects.

      In your case you have to check if those percentages that you explain refer to the totality of the spermatozoa in the sample or just to those that have an abnormality. By this I mean that 48%, 37% and 15% sum up 100%, and it would be the same result if this 100% refers to the whole sample or just to the fraction of abnormal spermatozoa.

      I hope I have been able to help.
      Best regards.

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