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One of the biggest problems I see today is the increasing number of men being diagnosed with teratozoospermia, which simply means that a high proportion of their sperm are reported to have an abnormal shape. On paper, this sounds alarming. In reality, many of these diagnoses are based on poorly performed semen analyses. Unfortunately, this often leads to unnecessary anxiety, incorrect treatment, and expensive IVF procedures that may never have been needed.What Is Teratozoospermia?
Sperm morphology refers to the shape and structure of sperm. When a semen report states that a man has teratozoospermia, it means that a large percentage of his sperm have been classified as abnormal in appearance. Many patients immediately panic. They assume this means they will be unable to father a child or that they are at risk of having an abnormal baby. Neither assumption is necessarily true.Measuring Sperm Morphology Is Much Harder Than It Looks
Many people believe semen analysis is a simple laboratory test. It isn’t. Assessing sperm morphology correctly is one of the most technically demanding parts of semen analysis. The WHO Laboratory Manual for the Examination and Processing of Human Semen provides detailed instructions on how this should be done. The sperm sample must first be specially stained. The laboratory technician must then examine the shape of at least 100 individual sperm under high magnification using strict, standardized criteria. Every sperm has to be evaluated carefully before the final morphology percentage is calculated. This process is slow. It requires experience. It demands attention to detail. Unfortunately, many laboratories simply don’t do it properly.The Shortcut That Creates a Misdiagnosis
Instead of following international guidelines, some laboratories take shortcuts. They examine only a few sperm. They don’t stain the sample correctly. They rely on subjective impressions instead of standardized criteria. Then they issue a report stating that 97%, 98%, or even 99% of the sperm are abnormal. The patient is labelled as having teratozoospermia. The laboratory report looks scientific. The diagnosis often isn’t.The Domino Effect
Once that report reaches the doctor, a chain of unnecessary events may begin. The doctor concludes that male-factor infertility is the cause of the couple’s infertility. The patient is prescribed vitamins, antioxidants, hormones, or other medications that have little evidence of improving sperm morphology. Or, if the clinic has an IVF laboratory, the couple may be advised to undergo ICSI instead of conventional IVF. Sometimes they are even pushed directly towards IVF without first questioning whether the laboratory diagnosis itself was correct. A poor-quality laboratory report can therefore lead to months of unnecessary treatment and considerable emotional and financial expense.Don’t Accept a Single Number
One of the biggest warning signs is a report that simply states: “97% abnormal forms.” That number alone is meaningless. A good laboratory should be able to explain:- How the morphology assessment was performed.
- Which staining method was used.
- Which strict criteria were applied.
- What types of abnormalities were observed.
- How many sperm were actually examined.