Teratozoospermia and pregnancy

The chances of conceiving naturally for a teratozoospermic man are very low, if not nonexistent. In order to have biological offspring it is necessary to use assisted reproduction treatments.

The recommended techniques vary depending of the degree of affectation. Also, fertility and age of the woman are also taken into account, as the latter might be a limiting factor when attempting pregnancy.

Assisted reproduction treatments and teratozoospermia

Assisted reproduction treatments

Once the diagnosis of teratozoospermia is confirmed, the couple will start the treatment that meets their needs. The available options are:

  • Artificial insemination (IA): recommended in cases of mild teratozoospermia (3%-4% of the spermatozoa are normal), provided that the woman is younger than 35.
  • In vitro fertilisation (IVF): aimed at men with moderate teratozoospermia (1%-2% of spermatozoa are normal), mild teratozoospermic men whose partner is older than 35 or cases of multiple inseminations failures.
  • ICSI: to be used in cases of severe teratozoospermia (less than 1% of normal spermatozoa) or if the techniques mentioned above have not been successful.
  • IMSI: is a variation of ICSI with better sperm recruitment. In order to do so, a high-powered observation system allows the specialist to examine sperm in closer detail, identifying this with good morphologies and spotting abnormalities. Is the treatment of choice in cases of severe teratozoospermia or in a history of recurrent miscarriages.


  1. avatar

    My wife and I went through IVF and have a 9-month-old boy who is doing great. Recently, we shockingly found out she is 8 weeks pregnant naturally. My question is: I have severe Teratozoospermia and am wondering if there is any worry of our baby having serious abnormalities? Sorry if this appears to be an ignorant question.

    • avatar
      Sandra F.Fertility counselor

      Dear Bill,

      Although there are chances of developing some genetic disorder, it doesn’t always happen. Having abnormal sperm morphology can be due to two main causes: 1) genetic disorders, and 2) other factors related to spermatogenesis and not to genetics. Besides, the most probable is that the spermatozoon that fertilized was healthy, otherwise it would have been very difficult it could’ve done so.

      Now, the most important thing to do is performing regular medical check-ups throughout pregnancy. By doing this, it would be easier to foresee if the fetus is developing any genetic disorder.

      Best regards.

    • avatar

      Hi Bill, I was recently diagnosed with Terazoospermia 3% and would like to TTC naturally with my wife. However, we are trying to understand if there is any risk of problems with the fetus and/or the baby in case that the egg is fertilised by an abnormal spermatozoon. Can you please share your experience? Thanks!

  2. avatar
    Nova Rianti

    Thank you so much, your article has taught me so much about this abnormality. I need to know more about the possibilities of a men with moderate teratozoospermia reduced to mild teratozoospermia. If it is possible, how? Should he follow a special therapy or diet? I almost give up with this unexpected abnormality (it happens on my husband).

    • avatar
      Sandra F.Fertility counselor

      Hello Nova,

      there are plenty of methods for the management and treatment of teratozoospermia. Traditional Chinese Medication and Acupuncture, which focus is on the liver and kidney acupoints, is said to improve and help control the reproductive activities of men.

      Vitamin supplements and antioxidants are also said to guide motility of sperm, reinforce viability of the sperm cells, raise sperm count, etc. Taking Vitamin C, Vitamin A, L-Carnitine, selenium, and grapessed extract is also advisable in order to protect the sperm mainly from oxidative stress, free radicals, etc.

      Following a fertility diet is also recommendable, as they are designed to reduce damage to spermatozoa. Mussels, oysters, and fish are included within this diet, since they contain high amounts of proteins, fatty acids, and zinc, essential elements for the production of functional sperm.

      Doing regular sport and avoiding harmful products such as cigarettes, addictive drugs, steroids, and marijuana is also a must if you want to improve the quality of your semen sample.

      Hope this helps,


  3. avatar
    suresh reddi

    Respected madam,

    I’ve been diagnosed with severe oligoasthenotetraozoospermia. My chromosomal karyotype is normal male 46 XY and no deletion or translocation in chromosomes. Morphology is 1%. Do these conditions affect blastocyst formation in ICSI procedures or cause any genetical disorders in live birth rates? Please, reply and suggest valuable advice.

    Best regards,

    Suresh Reddi

    • avatar
      Sandra F.Fertility counselor

      Dear suresh,

      the fact that sperm concentration, motility, and morphology show very low values dies not mean your embryos will develop a chromosomal alteration. Given that your karyotype is a normal one, there is no genetic disorder likely to be inherited by the embryo. Thus, through ICSI, a fertility treatment that allows the selection of healthy sperms, creating good quality, able-to-develop embryos is possible.

      But in any case, the development os birth defects cannot be completely ruled out, since embryos could contain a chromosomal abnormality even though the father does not have any. A sperm FISH analysis allows us to study the chromosomes of the sperm. This could be an interesting option before resorting to IVF/ICSI and, if it showed an altered result, including PGD would be interesting as well.

      I hope I have been able to help,


  4. avatar

    It is characterised by having spermatozoa with abnormal composition and poor motility. The tail is a flagellum responsible for propelling the spermatozoon. Obviously, if the tail is underdeveloped or ill-shaped (the tail being spiral-like) the flagellum cannot develop its function, so the spermatozoon is not able to “run” or even stands motionless.

  5. avatar

    I lately went through a semen analysis, which detailed the following:

    Abnormal 60%
    Normal 40%

    1st hour Motility
    Motile 25%
    Sluggish Motile 15%
    non motile 60%

    Sperm Count: 100 million

    Quantity. 4 ml

    It’s been 4 months since I am in a relationship and we haven’t been able to conceive yet. Any suggestions?

    • avatar
      Sandra F.Fertility counselor

      Dear Zee,

      though it is still too early, as couples are advised to what for at least a whole year before starting fertility treatments, this semen analysis is showing you have asthenozoospermia, that is, your motility is below the levels considered to be normal. That’s the only altered value. However, since it’s a case of mild asthenozoospermia, my advice is that you continue TTC naturally during a few months and, if pregnancy does not occur after an entire year, then you should visit a fertility clinic in order to hive AIH a try.

      I hope I have been able to help,


  6. avatar

    My husband and I just found out that he has teratozoospermia. Can you please tell us how bad this is? Will we be able to conceive in spite of this? Will treatment work?

  7. avatar
    suresh reddi

    Respected madam,

    Thank you very much for your kind opinion on my case study. I did consult my fertility specialist to go for a FISH on sperm, but he suggested to screen for micro deletions on Y chromosome. Is these two tests are similar and is sperm DNA fragmentation test suggested by another expert relevant now. FISH is not being done on sperm in many labs of our place (Fructose in situ hybridisation test). Are the tests suggested by fertility experts good enough or inference from those tests derived will be the same as FISH? Kindly clear my doubts. Suggest which is more relevant, PGD on blastocyst or foetus? Please clarify. I will be highly pleased by your kind information.

    Thanks and best regards,

    Suresh Reddi

  8. avatar

    Dear Dr. Sandra,

    Do we have a study about incompatibility of sperm and egg?


    • avatar
      Sandra F.Fertility counselor

      Dear MM,

      When we talk about incompatibility between the egg and sperm, it’s not actually like that. In case there exists some incompatibility, it is generally the cervical mucus that is incompatible, not the egg. Even if the eggs a woman produces had antibodies against your sperm, it would be the female mucus that will kill the sperm.

      Be it as it may, the result of this incompatibility is that the sperm is never able to reach the egg, and therefore fertilization never takes place. A possible solution to this would be using condoms whenever you have intercourse for pregnancy. This way, when you have are actually trying to conceive, the female immunological response to the sperm won’t be that radical.

      I hope I have been able to help,


  9. avatar

    Hi dr Sandra, I have been trying to conceive for ten months back. My husband underwent a semen analysis and it shows: volume 2.5 ml, sperm count 68 million, pH 8, viscosity normal, total motility 20%, abnormal morphology 98%, normal morphology 2%. Also he had bilateral varicocele grade 2. Plz, give us some feedback… what’s the proper treatment to have a child?

    • avatar
      Sandra F.Fertility counselor

      Dear Hala,

      According to your SE results, you have asthenozoospermia and teratozoospermia, probably caused by varicocele. Depending on the severity degree, you could have surgery done or recover your normal values; if after surgery you don’t recover the normal values, you may consider turning to IVF to have a baby.


  10. avatar

    Hi … My husband’s semen analysis showed tarazoospermic index 2.41 sperm abnormal morphology index 2.37. I am 29 with regular periods and my husband is 31. We had 2 miscarriages previously for unknown reason both in 5th week. We are TTC from past 4 months and not successful. Should we opt for any further treatment? Please, advise.

  11. avatar

    Hi Sandra, my husband and I recently attended a fertility clinic. His results where normal with one exception. He has 100% Abnormal Morphology – head defect 86%, Neck, Mid-piece defect 9%, Tail defect 5%. I’m concerned that even ICSI may not work for us. I would value your expert opinion and advice.

  12. avatar

    Hi Sandra,

    I have teratozoozoospermic index of 2.65 as per WHO 2010.
    Can you please let me know if it will fall under severe mild normal?


  13. avatar

    Dear doctor,

    We have been trying to conceive for 6 months but no results. 2 months ago my husband did a semen analysis and motility came 48% (from which 35% progressive and 13% unprogressive. It also showed only 30% of normal forms and 70% abnormal. He went to an urologist whom diagnosed him with asthenozoospermia and said to take Orthomol Fertil plus for two months. He just finished them and I just finished my periods.

    Does he have to take another fertility test or continue with this kind of therapy or what do you suggest?

  14. avatar

    Dr. Sandra,

    I have recently been diagnosed with Teratozoospermia (0% Morphology). I am concerned whether or not this is caused by my genetics or my use of Anabolic Steroids? I have been told that AAS can definitely affect motility and count in a negative manner… But what about morphology? I am 25 years old and used AAS for 2 years cycling on and off. I have been off for 2 months now and was just diagnosed last week. I have no intention of using steroids again… But is it too late?

    P.S. My count was 9 million and my motility was 40%… My doctor said this was below average motility-wise and extremely low count-wise.

  15. avatar

    Hi, my husband’s semen analysis shows teratozoospermia with comment of lots of debris present. Morphology is3%, all the other parameters are within the normal range. It has been 3 years since we are trying for a baby and I took fertility treatments as well but all in vain. What are the other options left to conceive a child? I am 32 and my husband is 33. Shall we go for IVF? Or I should wait more…?

  16. avatar

    Thanks for providing detailed information.

    I am identified with severe oligo teratozoospermia with the following test results and I am 30 yrs old, my wife is just 23 yrs old.
    Would like to know if I can naturally conceive with medical treatments. Will homeopathy or acupuncture or the general medical treatments help me improve my sperm abnormality? If we are able to conceive naturally, will there be any birth defects?

    With IVF or other fertility treatments, is it guaranteed for a healthy child? Please advise. Thank you very much again for your help.
    fresh volume 3.5 ml
    concentration 2 milion per ml
    progressive motility 33%
    grade: 2
    total count 7 milion

    volume 1.0 ml
    concentration 1.2 milion per ml
    progressive motility 65%
    grade 2
    total count 1.2 milion
    tmf 0.7 milion
    krugers criteria 1%

    Severe oligo-teratozoospermia

  17. avatar
    Lysa Foehner

    Hi… my husband and I did IVF back in 2010 and it didn’t work… The dr told us there was no reason it shouldn’t have. I just recently obtained our records and found out that my husband has teratozoospermia and it also says that factors include tuboperitoneal disease, ovulatory dysfunction (makes no sense as I have regular cycles) and cervical factor. Does that mean we won’t be able to have a child?

  18. avatar


    I’m Liz, my age is 35 and my husband is also 35. Over the last 2 years we have been trying to conceive but we couldn’t. My physical condition is ok. But my husband has oligo-astheno-teratozoospermia and also varicocele. In this situation, which treatment will be better for us for having a child? Or is there any possibility to get pregnant in a normal way? Please help. Thanx for your cooperation.

  19. avatar

    Dear Dr. Sandra.

    I am 33 year old and my husband is 38 year old. We have been trying to conceive for the last 6 months with no success. Investigations done this week showed – Semen analysis of husband:

    Total sperm count- 171.6 millions/ejaculation
    Sperm count- 52 millions/ml
    Motile spermatozoa- 44%
    Progressive motility- 38%
    Non progressive motility- 06%
    Absolute sperm yield- 33 millions/ejaculation
    Sperm vitality- 48%
    Round cell- plenty/hpf

    Normal sperm- 2 %
    Head defects- 88%
    Neck defects- 67%
    Tail defects- 21%
    Teratozoospermia index- 1.8

    My HSG also shows – bilateral unhealthy tubes (visualised till fimbrial end with terminal dilatation and restricted spillage in both right and left tube).

    Other investigations of blood and hormone level tests, USG, TVS 3D have shown normal reports.
    Kindly suggest your valuable opinion on my case. Is IVF the only option left for us now? Should we go for IVF or ICSI ? Which procedure will give us greater chances for a healthy baby if any? Waiting eagerly for your reply.

    Thanks for going through.

  20. avatar

    May I have your email? I would like to send to u my latest sperm test. Married since 5 years and no children yet.

    • avatar
      Sandra F.Fertility counselor

      Hello anas,

      We do not analyze semen analyses through email, but you can get involved in our Forum, and raise any doubt or query you may have. Here’s the link: http://www.invitra.com/forums/forum/ask-the-specialist/

      Hoping to meet you there soon

      All the best

  21. avatar
    Peter John

    Hello doc. Sandra, with this analysis on my sperm, can I still get my wife into pregnancy?
    Ttl motility 69%
    Ttl Sperm count 101.4M
    Morphology 3%

    Thank you in advance.

  22. avatar
    Louisa L H

    Hello Dr Sandra,
    Here is my husband’s semen analysis:

    Total motility (%) 46
    1.Progressive % (PR)
    a. Rapid 27
    b. Slow 16
    2. Non-progressive% (NP) 3
    Normal morphology(%) 2

    Reference (WHO, 2010)

    Classification: Teratozoospermia

    I want to ask for the result for total motility, is the above data within the normal range? However, sperm morphology shows teratozoospermia. Does that mean even if the sperms are rapid and progressive they are not in a good morphology to fertilize an egg? Should I still try IUI instead of IVF?

    Thank you for your answer.

  23. avatar


    I would like to inform you that I have teratozoospermia according to the following:

    Abnormal: 98%
    Count: 153 million/mm
    Motility: 66%
    Progressive: 37%

    I’ve taken antioxidants, vitamins, omega 3, Orthomol Fertil plus, proxeed & I did tried surgery last year.

    My age is 38 & my wife is 28 years old.

    Thanks for your advise. Should I undergo IVF or Artificial insemination?

  24. avatar

    Doctor, my husband has severe teratozoospermia with the following properties:

    Viscosity/liquefaction: >30 minutes
    Morphology : pin heads
    colour : Pale
    RBCS : 07

  25. avatar

    Doctor, my husband has severe teratozoospermia with the following properties:

    Viscosity/liquefaction: >30 minutes
    Morphology : pin heads
    colour : Pale
    RBCS : 07
    Density/sperm count >95×10

    What are the chances that we can have a child normally?

  26. avatar

    I have been diagnosed with teratozoospermia within the P pattern. I would like to know what does this mean and if there are any remedies

    • avatar
      Sandra F.Fertility counselor

      Hello Raj,

      “P-pattern” means “poor prognosis”, so it means that you have less than 5% normal forms.

  27. avatar

    Hi madam, my husband have teratozoospermia and normal forms 1% and head defects 79%, neck mid defects 16%, cytoplasmic droplets 4% tail defects 0% and agglutination null. Leukocytes <1M/ml post wash, motility 99%. Can we go for ayurveda or medical treatment? Will it be possible?

  28. avatar

    Hi Sandra,

    November of 2016, I was diagnosed with varicocele in which we thought was causing me to have Teratozoospermia. I went through an operation after a month and had my semen analysed this March, although total sperm count is just 25 million and volume is just 1 ml. Morphology showed 9% on normal forms and was classified as Normozoospermia. We continue to TTC for 3 more months but still unsuccessful. The other day, I went thought another sperm analysis and now morphology shows 3% of normal forms and classified to have Teratozoospermia again. I’m 36 and wife is turning 38 this year so time is really of the essence here. Do we still have a fighting chance to conceive naturally? Any advise on what method or practice? Thanks in advance.

    • avatar
      Andrea A.Assisted Reproduction Specialist

      Dear Karl,
      In your case it seems that morphology alterations where caused by varicocele. Since morphology has gone again under 4%, it might be caused by the reappearance of varicocele or by other cause such as stress. In any case, since you have been already quite a long time TTC and your morphology shows 3% of normal forms, the recommendation would be to contact a fertility specialist. The doctor will recommend you which is the most appropriate treatment in your case. Probably, since your sperm analysis is not too altered,they will choose the treatment based on your wife’s fertility.
      I hope I have been able to help.
      Best regards,

  29. avatar
    Christina Milton

    My Husband was diagnosed with teraozoospermia a year ago he had 61 millon sperm count with 3% normal morphology is this bad? I have PCOS I have 3 children from a previous marriage and would like for me and my current spouse to be able to have a child of our own A.I is a option however IVF is to costly for our family.

    • avatar
      Andrea A.Assisted Reproduction Specialist

      Dear Christina,
      Since you do not talk about motility I will assume that i was within the normal range. As regards the remaining parameters, a low normal morphology percentage might lead into fertility problems trying to conceive naturally. If that is the case, assisted reproduction is advisable. Especially taking into account that you have PCOs, which will also cause some trouble when searching for pregnancy.

      Because of the high concentration that you indicate, the semen sample will probably be enough for an own AI. Anyway, the fertility specialist should also run some tests on you in order to establish the right treatment.

      I hope I have been able to help.

  30. avatar

    Hello, Doc. I recently took a sperm test and was diagnosed with Teratozoospermia. The other values were above the recommended. Normal forms were 2% while abnormal forms were 98%. Can we still have a child through the normal process? In case we decide to do ICSI, what is the success rate?

  31. avatar

    Hi Doctor. My husband had a semen analysis with the results of low count- 6 million, low morphology- 1, but a high motility 68%. We have been TTC for 3 months. How long should we try before getting help? What are the odds we’ll be able to conceive naturally? Also, if we conceive naturally, will our child have any problems because his morphology is so low? Thanks!

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