Teratospermia is the presence of large numbers of sperm with an abnormal appearance in a man’s semen. When more than 40% of the sperm have malformations, it can interfere with fertility, and the man may have trouble getting his partner pregnant. There are several treatment options, depending on the underlying cause. A fertility specialist can meet with patients to discuss the best approach to treatment, given the situation and the end goals.
A doctor can diagnose this condition by examining a sample under the microscope. The malformed sperm will be readily visible, and the doctor can determine their concentrations. When only a handful of sperm have an unusual appearance, it may not represent a serious obstacle to fertility. The doctor can also conduct some other tests to assess semen quality, such as evaluating sperm motility to see if the sperm can successfully reach an egg. The patient may have a combination of issues, not just teratospermia, that make achieving a pregnancy difficult.
Sometimes the cause of teratospermia is an underlying disease like Celiac disease. Metabolic and hormonal imbalances are common culprits, as they can interfere with the process of sperm maturation, and may create abnormalities like unusually large or small heads or malformed tails. The doctor may recommend some tests to learn more about the situation, in addition to reviewing the patient’s chart for any signs in his medical history that might provide clues. In other cases, it may be difficult to determine why the sperm are malformed.
Medications may help with teratospermia. Anti-estrogens are one line of treatment a doctor may consider to see if it is possible to encourage the sperm to follow a normal course of maturation. In other cases, the doctor may recommend the use of assisted reproduction. It may be possible to take a sperm sample, select viable sperm, and manually implant it into the egg. The egg should fertilize and develop normally.
Patients with this condition can discuss it with a doctor and their partners to decide how they want to proceed. Usually teratospermia is not associated with genetic abnormalities. The problem lies solely with the shape of the sperm, not the DNA they contain. The doctor can perform some tests to determine if there are separate concerns about congenital conditions, such as pre-implantation genetic diagnosis, where fertilized embryos are evaluated for common genetic diseases. This testing can allow the doctor to avoid implanting an embryo that will not survive a full pregnancy.