High rate of isolated teratospermia in a population of fertile men and the questionable clinical utility of sperm morphology

Abstract

ObjectiveTo better understand the impact of sperm morphology on fertility by assessing sperm morphology in a population of known fertile men. DesignProspective cohort study. SettingFertility center associated with university. Patient(s)Healthy men over 18 years of age were recruited to provide one semen sample prior to a vasectomy appointment scheduled between March 2020 through November 2022. Patients were included in the study if they had at least one biological child and no history of difficulty achieving pregnancy or fertility procedures. Intervention(s)None Main Outcome Measure(s)Sperm morphology Result(s)68 patients (mean age 36.7) were included. 38 patients (55.9%) had 3% or lower normal sperm morphology, including two patients who had 0% normal morphology. The most common morphologic abnormalities were head shape defects (n=59, 84.3%), followed by coiled tails (n=14, 20.3). Count, concentration, motility, and progressive motility were normal in more than 90% of patients. Conclusion(s)More than half of fertile male patients (55.9%) had lower than normal sperm morphology in our study. The results of our study further question the clinical relevance of sperm morphology on fertility outcomes and if the current approach in assessing morphology is too strict.