One of the most important conditions for successful natural conception is a large number of healthy, morphologically correct sperm. A condition in which the number of pathological sperm exceeds the permissible norm is called teratozoospermia.

Types of disease

The reasons leading to changes in sperm morphology can be both diseases and lifestyle
Depending on the location of the pathology, the following types of teratozoospermia are distinguished:

1. Tail changes, which lead to difficulty in the movement of the cell along the female genital tract and thereby complicate its meeting with the egg:

• insufficient size;
• twist;
• plurality.

2. Head changes, which are considered the most severe pathologies, since they make it difficult for sperm to penetrate into the egg, the formation of a fertilized egg and increase the likelihood of miscarriages and frozen pregnancies:

• abnormal size (too big or small);
• irregular shape (circle or cone);
• increase in quantity;
• changes in the anterior part, called the acrosome;
• abnormalities of chromatin (DNA complex), which normally must be reliably protected to protect DNA from external influences during movement through the genital tract.

3. Cervical changes that affect the mobility of the tail:

• lack of symmetry when fastening;
• changes in the middle part (too thick or thin);
• obtuse angle.

Teratozoospermia index

Sperm defects are very often multiple in nature, which is why there is such a thing as the teratozoospermia index, sometimes called the multiple anomaly index. It is used to calculate the average number of abnormal changes per sperm. This is necessary in order to formulate a fertility prognosis.

If the teratozoospermia index is 1, this means that there is an average of 1 defect per cell. The norm is a value from 1 to 1.6.

Main reasons

Many reasons that can cause teratozoospermia can be grouped into several groups:

1. Diseases of the testicles and appendages of a different nature:

• infectious viral (orchitis, mumps, emididymitis, as well as sexually transmitted diseases);
• pathology of the circulatory system (varicocele);
• benign and malignant tumors.

2. Diseases of the vas deferens with or without obstruction (eg cysts).

3. Endocrine changes, including systemic diseases - for example, diabetes mellitus.

4. Genetic reasons.

5. External factors:

• intoxication of any nature (alcohol, chemical, nicotine and others);
• exposure to radiation;
• exposure to high temperatures;
• stress.

Thus, the reasons influencing the appearance of teratozoospermia are largely identical to those that determine the development of other sperm pathologies - oligozoospermia, pyospermia.

What tests should I take?

The most important analysis that will determine the presence of pathology is. The diagnosis of “teratozoospermia” is made if at least two spermograms confirm the presence of a large number of abnormal sperm. In this case, the interval between tests should be at least 2-3 weeks, and it is better to take them in different laboratories.

Acceptable norms for the content of abnormal sperm depend on the assessment methods used in a particular laboratory. So, if during a normal study under a microscope their proportion should not exceed 50%, then when using the Kruger method, a figure of 70% is allowed, and if strict Kruger criteria are applied - 85%.

In addition, before starting treatment for teratozoospermia in men, the doctor must establish the reasons that caused it. For this purpose, blood tests (biochemical, hormones, etc.), ultrasound and other studies are prescribed.

How to treat teratozoospermia

Folk remedies are an addition to drug and surgical treatment.

Is it possible to cure teratozoospermia? The answer largely depends on the reasons that caused its appearance and on the degree of development of the process. If we are talking about harmful external influences, poor diet and lifestyle, then treatment primarily consists of eliminating these factors.

In the presence of obstruction, surgical intervention is required, in case of infectious diseases - viral and antibacterial therapy, in case of endocrine diseases - regulation of hormonal levels. In addition, general strengthening agents and minerals are effective - folic acid, L-carnitine, iodomarin, selenium, zinc and others. Treatment with folk remedies as an additional treatment is also acceptable; The quality of the seed is increased by pumpkin juice, a mixture of dried fruits and nuts, and honey.

Is it possible to get pregnant naturally?

The likelihood of pregnancy occurring naturally depends largely on how many morphologically abnormal sperm are found in the ejaculate. However, it is important to remember that it is advisable to plan pregnancy only after complete recovery, since, as mentioned above, teratozoospermia contributes to the formation of fetal abnormalities, which lead to frozen pregnancies and miscarriages. If natural pregnancy does not occur, it is recommended to consider the possibility in which morphologically correct sperm are selected for fertilization.

The content of the article:

Andrologists and reproductive specialists know what “teratozoospermia” is. This is a condition in which the ejaculate has an increased (more than 50%) number of sperm with defective morphological properties, one of the common causes of male infertility.

Teratozoospermia is diagnosed by analyzing the spermogram.

Why pathologically altered spermatozoa are present in semen is a different reason for each patient. The prognosis for pregnancy depends on the severity, the ability to eliminate the cause and a number of other factors. In some cases, teratozoospermia is considered idiopathic, i.e. Why this happens cannot be established. Teratozoospermia is popularly called “the disease of ugly sperm.”

Sometimes the disease does not manifest itself at all and is diagnosed when the partner does not become pregnant, or there are missed pregnancies and early miscarriages.
Note that defective forms of sperm are present in small quantities in the seminal fluid of an absolutely healthy man, and this is not considered a pathology.

Is it possible to get pregnant with teratozoospermia? Yes, some couples succeed, but without examination and treatment there is a certain risk.

Impaired morphology in teratozoospermia

Table. Classification of ejaculate indicators

Teratozoospermia and other pathologies

Structure of sperm

It is known that the sperm consists of a head, neck, body and tail. If deformation occurs in any of these parts, we are talking about a violation of morphology.

The worst prognosis for treatment and pregnancy is pathology of the head. Spermatozoa with a defective head can retain a very mobile tail, have rectilinear translational movements and retain the ability to fertilize, but the resulting zygote is either non-viable, or the pregnancy aborts on its own due to a genetic pathology or possible deformities of the embryo.

That is why trying to achieve an independent pregnancy, knowing that there are no normal forms of sperm in the seminal fluid, is a very risky undertaking. The combination of teratozoospermia with asthenospermia and oligospermia significantly reduces the onset of pregnancy.

In these cases, it is safer to resort to methods of assisted reproductive technologies, because repeated missed pregnancies and miscarriages can lead to infertility of the partner. For the same reasons, insemination for teratozoospremia is not the best choice.

We will talk about what is better for this pathology: IVF, ICSI or something else a little later.

So, what does more than 50% of sperm look like with teratozoospermia:

Violation of morphology is manifested in the following:

Anomalies in the structure of the head.
Decrease, enlargement, bifurcation, absence of acrosome, any abnormal shapes, presence of vacuoles, changes in chromatin.

Cervical changes.
A thickened or, conversely, too thin neck, curvature is the most favorable type of pathology; the chances of spontaneous pregnancy after appropriate treatment are quite high.

Tail pathology
Doubling, shortening, absence, broken tail, elongation, too pronounced tortuosity, uneven thickening lead to the fact that the sperm do not move towards the egg, but stand still or make atypical movements, sometimes in the opposite direction. After a certain time they die. Normally, the tail of male reproductive cells is straight.

What is the teratozoospermia index (ITI)

Otherwise – index of multiple defects, index of multiple anomalies.

To obtain a numerical value, all defects are summed up and divided by the number of morphologically altered sperm. The number is 1, when 1 male gamete has 1 defect, the index can be equal to 3, if one sperm has an anomaly in the development of the head, neck and tail. Normal values ​​are from 0 to 1.6.

Using ITZ, the fertilizing ability of sperm is predicted and management tactics are determined.

If the index is more than 1.6, they speak of impaired fertility.

Causes of teratozoospermia

Here we will rather talk about predisposing factors:

All types of sexually transmitted diseases,
Long-term diseases of the male reproductive organs, genitourinary tuberculosis.
Conditions requiring surgical correction: varicocele, cryptorchidism.
Genetic diseases characterized by abnormalities in the spermogram.
Exposure to X-rays and ionizing radiation.
Long-term intoxication of the body associated with abuse of alcohol, nicotine, and drugs.
Contact with harmful substances: aniline dyes, pesticides, heavy metal salts.
Environmental factor.
Viral lesions.
Tumor processes in the male genital organs.
Enzymopathies.

Frequent visits to saunas and baths, wearing tight underwear and trousers.
Taking certain medications that have a negative effect on spermatogenesis.
Taking courses of chemotherapy for tumors.
Hormonal imbalances, including due to the use of anabolic steroids.
Thyroid diseases.
Preference for unhealthy foods with a high content of preservatives and dyes.

Much depends on the compensatory capabilities of the body. For some patients, it is enough to remove themselves from stressful situations, stop drinking alcohol, and introduce foods enriched with vitamins (especially selenium and zinc) into the diet, and a spermogram records an increase in full-fledged forms of sperm.

The prognosis worsens when a couple has not only a male factor of infertility, but also a female one.

Diagnostic measures

Diagnosis of teratozoospermia occurs according to the general principle of diagnosing male infertility and includes the following measures:

UAC, TAM, blood sugar.
spermogram for teratozoospermia with determination of ITZ,
hormonal profile,
MAP test,
special examinations before IVF (EMIS, DNA fragmentation, etc.),
sperm biochemistry,
Ultrasound of the scrotum with Doppler, TRUS,
testing for STIs, preferably PCR diagnostics,
sowing biomaterial for flora,
examination for tuberculosis, HIV, syphilis,
MRI, CT, testicular biopsy if necessary.
Consultation with a geneticist and special screenings are required.

The examination regimen is selected individually; additional tests may be performed, this is especially true for couples who are included in the IVF protocol.

Treatment of teratozoospermia

The scheme directly depends on the reason. If teratozoospermia is accompanied by varicocele or cryptorchidism, surgical intervention is performed.

With a confirmed genetic pathology, if there are no normal forms of sperm in the ejaculate, they will most likely be offered to use donor sperm.

All inflammatory diseases are treated with antibiotics taking into account sensitivity, immunomodulators, drugs that stimulate spermatogenesis and local therapy.

Hormonal disorders will require consultation with an andrologist - endocrinologist.

When the cause of teratozoospermia is not clear, multivitamin complexes with minerals and drugs that stimulate spermatogenesis are used.

Most commonly prescribed drugs:

Spermactin,
Iodomarin,
Vitamins E, A and C,
Folic acid,
Gerimaks with ginseng,
Tykveol,
Verona,
Carniton,
Zinc and Selenium - containing complexes, etc.

Very good reviews on forums from the use of beekeeping products, especially royal jelly and bee bread, to normalize the qualitative and quantitative composition of sperm. Seafood, nuts, dried apricots, raisins, dates, lemons, celery are healthy. As for protein products, it is useful to include lean meats, poultry, fish, milk and lactic acid products, eggs, and cheese in your diet.
You can try herbal medicine.

A decoction of elecampane root helps improve spermatogenesis.

What assisted reproductive technologies are best used for teratozoospermia?

Teratozoospermia and IVF

If after treatment the morphology shows less than 4% of normal sperm according to Kruger, and sometimes even 1%, you should not hope for an independent resolution of the situation.
In WHO-approved standards for assessing sperm quality and quantity, preference is given to the Kruger assessment. Normal is a reference concept; it is believed that normal sperm should be from 30 to 85%. If the number of complete gametes is less than 4% in vitro, the likelihood of fertilization is reduced. This indicator is taken into account before the planned IVF.

ICSI MAX

ICSI is an intracytoplasmic (intracellular) injection of sperm into an egg. If there is a risk that fertilization will not occur in vitro, the ICSI MAX method is used for teratozoospermia.

There are absolute and relative indications for this technique.

Absolute:

The number of motile sperm is critically low,
the prevalence of morphologically altered forms,
the presence of only immature germ cells, but there is a possibility of obtaining normal sperm using TESA during puncture of the testicle or epididymis, or isolating normal forms of sperm from urine when sperm is thrown into the bladder,
after cryo-freezing there is a deterioration in morphology,
a history of several failed IVF attempts with no penetration of the egg,
immunological infertility with the death of male gametes in the female genital tract.

Relative:

Borderline state of ejaculate, when all indicators are at the lower limits of the norm.
Infertility is idiopathic (with an unknown cause).
A large number of oocytes obtained after stimulation. This occurs with polycystic changes in the ovaries, and the quality of female germ cells suffers.
After stimulation, few oocytes were obtained. Since quite aggressive drugs are used to avoid a repeat stimulation procedure, the likelihood of pregnancy with ICSI MAX increases.
Age factor.
Combined infertility.

MAX - what is it?

Literally, the abbreviation stands for “microscopic analysis of sperm quality,” i.e. differentiation of high-quality male gametes from unsuitable ones occurs.

If the sperm does not have morphological abnormalities, the likelihood that it has the correct set of chromosomes is much higher.

Cell evaluation is performed using state-of-the-art optical equipment. The process takes place in 3 stages:

1. All defective gametes with inappropriate shapes and sizes are rejected in transmitted light.
2. The structures of the head are analyzed, acrosomal pathologies are excluded, and chromatin is assessed. The study is carried out using phase contrast.
3. Using modulation contrast, the content of the sperm head is assessed.

Everything together leads to the fact that even cytological pathologies are cut off, and the sperm selected for ICSI are of the highest quality.

What is PIXIE

The technique is similar to ICSI; the selected sperm undergoes additional testing for maturity using hyaluronic acid.

Let us note that even with the most high-tech microscopes it is impossible to give a visual assessment of the maturity of the germ cell.

IMSI

Before artificial insemination, the sperm is examined at a powerful magnification of 6000 times, while with simple ICSI it is only 400 times.

Morphological parameters are assessed. In prognostic terms, tail pathology is considered more favorable than the presence of vacuoles in the head. If all gametes with pathology are visualized, it is appropriate to perform MCOME

MSOME– a method for studying the morphological characteristics of sperm, which has been used for several decades.

There is a classification based on morphology:

1. Spermatozoa are not suitable for pregnancy.
2. Sperm that promote spontaneous abortion.
3. Sperm with a high probability of developing abnormalities.
4. Spermatozoa without morphological pathology.

MCOME allows you to select the best genetic material, which increases the chances of a successful pregnancy with male factor infertility.

Let's sum it up

Unfortunately, some couples have to go through many trials to become parents. You can't stop on the way to your goal. Medicine does not stand still; there are successes with teratozoospermia after conservative therapy. If the long-awaited pregnancy does not occur, you can use assisted reproductive technologies. How exactly artificial insemination will be carried out for you will be decided by a whole team of specialists - reproductologists.

Teratozoospermia - what is it, this is a question often asked by couples who have been diagnosed with this. There are many married couples in the world whose main dream is to have a child. And even for several years a woman cannot get pregnant. The reason that the desired pregnancy does not occur may be pathology or disorders in the female reproductive system.

A disease such as teratozoospermia can lead to infertility in men. This pathology differs in that in men more than 50% of sperm are determined to have an irregular structure.

When teratozoospermia is diagnosed, the sperm has a deformed shape. Taking into account medical research, over the past decade, sperm concentrations have dropped significantly in men of reproductive age, which suggests that men’s reproductive health has deteriorated significantly.

The diagnosis of teratozoospermia is the most common cause of male infertility men. In some cases, this disease does not interfere with pregnancy. If the ejaculate, which has an abnormal structure, was able to fertilize the egg, then this can lead to possible complications in the perinatal development of the embryo, frozen pregnancy or miscarriage in the early stages.

Spermogram is a way to determine the presence of certain abnormalities in male reproductive function. With this diagnosis, it is unlikely to become pregnant naturally; as a rule, artificial insemination or in vitro fertilization is used. This means for those who want to get pregnant that pregnancy and teratozoospermia are incompatible.

Causes of teratozoospermia

Define specific causes of the disease It is not yet possible, but doctors point to a direct connection between the onset of the disease, lifestyle and past illnesses. There are other causes of teratozoospermia:

Teratozoospermia must be treated, since pathological changes in the body can provoke other, more significant complications. The most basic and most common cause of this disease are disorders in the hormonal system. As a rule, they appear as a result of the use of hormonal drugs (for example, for gaining muscle mass or treatment). Another common cause is viral infections. Among them, genital herpes most often leads to the occurrence of pathology.

Not uncommon cause of the disease are inflammatory diseases of the genitourinary system. Emotional overstrain and stress predispose to the appearance of pathology. Is it possible to cure teratozoospermia? To get rid of the cause that caused the disease, various medical methods are used, and treatment with folk methods is also used. Most often, such a disease can be treated only with an integrated approach.

Features of abnormal changes in sperm

Teratozoospermia is one of the forms of male infertility, is a direct provoking factor for the presence of the main number of pathological sperm in the semen analysis. For example, a spermogram determines the presence of sperm with a pathological structure of the neck, head or tail. During a normal analysis, the number of these cells is no more than 50% of the total number, but with this disease these disorders are much greater, and this negatively affects the reproductive function of the male body.

This disorder is triggered by frequent stress, poor lifestyle, excessive body weight, negative environmental environment, bad habits and other negative factors.

Types of pathologies in spermatogenesis

After carefully studying this disease, doctors have identified several types of pathologies in spermatogenesis:

Teratozoospermia- This is the most common cause of infertility in men. With such a diagnosis, fertilization of the egg very rarely occurs. During sexual intercourse, it is recommended to use contraceptives to protect against conception with poor quality sperm and the development of an intrauterine fetus with pathologies.

Treatment of teratozoospermia with medical means

If one is installed, then the treatment of the disease occurs in a comprehensive manner: medication and folk remedies. This pathological phenomenon is treated taking into account the cause that provoked the disease. If these are inflammatory processes, then the correct anti-inflammatory treatment is developed. When it is prolonged stress, it is advised to consult a psychotherapist. But medications that are not affected by the original cause of the disease are also recommended. Among them are products that contain zinc, selenium, folic acid - Verona, Tribestan, Spermaktin. These are complexes of minerals and vitamins designed to increase ejaculate mobility and secretion.

If you start competently and timely treatment, then in almost all cases, sperm examination returns to normal. But there are exceptions when it is impossible to eliminate this disease, among which are:

In these situations, doctors offer the only option for a woman to get pregnant - to do IVF in the laboratory. Using this method, the chances of fertilization increase.

To determine an accurate diagnosis, a spermogram is performed. Doctors advise to conduct this examination twice in different institutions, this will make it possible to exclude the presence of errors in the results. The teratozoospermia index must be more than 1.6. Only after a doctor's examination can this diagnosis be established. Specialists are making every effort to get rid of the cause that caused the formation of pathological changes in the spermatozoon. In addition to the above remedies, the use of apitherapy is recommended.

Moreover, for the entire period of treatment, a man needs a complete rejection of alcohol and smoking. It is necessary to avoid emotional tension and stress as much as possible.

Treatment of teratozoospermia using traditional methods

If such a diagnosis as teratozoospermia, then treatment with folk methods is a great addition to the main complex of drug therapy. These methods can bring great benefits and are safe for the body. The traditional method of treatment has almost no contraindications or side effects. With the help of folic acid, it becomes quite possible to naturally conceive a healthy child. Folic acid is taken at the stage of pregnancy planning, both future fathers and mothers. This remedy improves sperm quality in men and helps women bear a healthy child.

You can replace regular tea with currant custard leaf. In currant leaves contains a high content of folic acid and other vitamins, especially vitamin C. This infusion is taken several times daily. The duration of treatment is approximately one month. Then you can re-take tests to determine the quality of sperm.

Excellent help in the fight Plants with this disease include birch, dandelion and nettle. A decoction is made from them; you can also use plantain seeds in addition. It must be consumed before meals, several times daily. The duration of treatment is 14 days.

Used for treatment pumpkin juice and pumpkin. The juice should be taken in the morning and evening, one glass at a time. You can use canned juice, cooked in a juicer, or fresh. Pumpkin is steamed in pieces or consumed as a puree as a dessert. Treatment with traditional methods is only a complement to drug therapy. And it should not be considered as an independent method of treatment.

We must not forget that only a doctor can establish a diagnosis after a series of examinations. There is no need to carry out any independent treatment or self-diagnose yourself after unsuccessful attempts to conceive a child.

To return quantity normal and healthy sperm complex treatment is used. In which a natural vitamin mixture is also used, for example, honey, nuts, dried fruits, lemon. These products strengthen the immune system, positively affecting the reproductive functions of both women and men. It is necessary to lead a healthy lifestyle and give up bad habits. If the cause of the disease is not determined, or treatment of the disease does not lead to positive development, then the doctor advises the couple to seek help from in vitro fertilization in a laboratory setting. This method has become very popular today.

Teratozoospermia is a diagnosis in men that is very multifaceted. With 60% of pathological sperm, some already make such a diagnosis, but this is completely different from, for example, 95%. A lot also depends on the shape. When the neck is irregular, then this is one thing, but when the head is irregular, then it is completely different. My husband has tertozoospermia of 58%, the doctor told him that with this spermogram you can get pregnant, but you need to eliminate the pathologies of the head, everything else is not very important.

Lera, Tula

Only 10% of us are healthy, while almost half of the abnormal ones have pathology of the head. With these indicators, I myself became pregnant, but at 10 weeks there was a frozen pregnancy. For now, we are undergoing standard treatment - proper nutrition, peace of mind and vitamins.

Natasha, Perm

We did examinations both in Russia and abroad, the result was almost the same - teratozoospermia and 3% of healthy people. They didn’t take anything global - I started wearing loose underpants, took vitamins and also changed jobs, in the end I got pregnant and gave birth normally.

The number of married couples who are unable to conceive a child is growing every day. This phenomenon is facilitated by many different factors, both external (ecology, harmful conditions at work, stress, decreased material security, etc.) and internal (pathological disorders in the body of a man and woman planning a child). Male infertility is being diagnosed more and more often. One of its causes is teratozoospermia - a condition in which the number of pathological forms of sperm in the ejaculate (sperm released during one ejaculation) exceeds 50%.

Normal spermogram

A spermogram is an analysis of the ejaculate (the fluid released during ejaculation) in order to determine its main characteristics. The analysis allows us to identify the presence of inflammatory diseases of the male reproductive system or male infertility. A single spermogram analysis is not always enough to determine the cause of the disease, but it is the simplest and most accessible method that allows you to detect the problem.

A spermogram determines the number of sperm, their structure, the percentage of young forms of sperm, the number of leukocytes or other cells that may be present in the ejaculate. In addition to the number and percentage of cells, it is mandatory to determine the general characteristics of sperm: volume, appearance, color, viscosity, liquefaction period and pH.

In addition to the above characteristics, if necessary, the biochemical composition is determined: the amount of fructose, alpha-glucosidase, zinc, L-carnitine.

According to the standards of the World Health Organization, which were published in 2010, the standard spermogram is:

Total volume of ejaculate – from 1.5 ml and above
Total number of sperm – from 39 million and above
In one milliliter the sperm concentration is 15 million or more
Overall sperm motility is 40% and above
Spermatozoa with progressive movement of 32% and above
Viable organisms from 58% and above
Morphologically normal forms from 4% and above.

Preparation for the delivery of ejaculate analysis for spermogram

Compliance with certain rules plays a very important role in obtaining correct spermogram results:

1. Diet. During the week before the spermogram, it is recommended to exclude fried, fatty foods and coffee from the diet. After all, their use can reduce the normal activity of sperm and the total amount of sperm in the ejaculate. You also need to make sure you take enough fortified foods (fruits, vegetables, herbs, dairy products, meat and fish).
2. Abstinence from sexual intercourse. Two days before taking a spermogram, it is recommended to exclude sexual intercourse, but please note that the period of abstinence should not exceed one week. With a long absence of sexual intercourse, a large number of immobile and old forms of sperm accumulate in the ejaculate, which have already lost the ability to fertilize.
3. Refusal to drink alcohol. Experts recommend that a week before taking a spermogram, you should stop taking alcohol or drugs, as this leads to a change in the structure of the germ cells and significantly reduces their activity. Consequently, the spermogram results will be underestimated.
4. Inflammatory diseases of the reproductive system in men, they are a contraindication for taking a spermogram, since the results will be erroneous. This means that you must first undergo a course of treatment, and then, in case of recovery, take a spermogram. The recommended period for taking a spermogram after recovery is 7 days, because during this time the drugs are completely removed from the man’s body and the normal functioning of the reproductive system is restored.
5. If you have colds or other respiratory infections, which were accompanied by a significant rise in temperature, treatment is carried out, and only after 7-10 days a spermogram is taken. This is due to the fact that when a man’s body temperature rises above 37°C, the process of sperm maturation and the condition of seminal fluid are disrupted. The normal temperature for sperm maturation is 34.6-35.6°C.
6. It is necessary to avoid visiting a sauna or bathhouse. before taking the analysis.
7. Significant physical activity should be avoided on the body because they lead to the accumulation of lactic acid in muscles and tissues, which can affect the results of spermograms.
8. It is recommended to avoid stress on the eve of the test, because they disrupt the hormonal balance of the whole body.
9. Cancel prostate massage session before taking a spermogram if it is prescribed to the patient.
10. Immediately on the day of the test, the patient should be well rested, After all, you need a normal erection.

The procedure for collecting ejaculate can be carried out both in hospital and at home. The latter option is more acceptable, but experts recommend the first. This is due to the fact that when performing the procedure at home, the reliability of the results decreases. It is also worth noting that ejaculation should occur as a result of masturbation, because when using the method of interrupting sexual intercourse, secretions from the female genital organs may be detected in the ejaculate, which distorts the result.

Teratozoospermia in spermogram

In cases where more than 50% of pathological forms of sperm are detected in the spermogram, they speak of teratozoospermia. Depending on what part of the sperm is damaged (changed), There are several forms of it:

Changes in the sperm head: too small or large, the presence of two or more heads in one sperm, altered shape of the head, disturbances in its chromatin or acrosome.
Changes in the tail of the sperm: two or more in one sperm, too short or curled.
Changes in the sperm neck: improper attachment, thickening or thinning of its middle part, obtuse angle of the neck.

Teratozoospermia: an accurate indicator of pathology

To more accurately determine the number of pathological forms of sperm in the ejaculate, the ITZ indicator is used - the teratozoospermia index. This index is calculated by dividing the total number of sperm defects by the number of all pathological forms in the ejaculate. The ITZ will be equal to one in the case when one sperm has only one defect. Therefore, ITS is 2.0 or 3.0 when the sperm has two or three pathologies in its structure.

In the IVF clinic in Vladimir, you can take a spermogram, determine the ITD and carry out the IVF procedure.

Causes of teratozoospermia

There are several leading etiological factors that cause teratozoospermia in men. These include:

1. Hormonal disorders. These disorders can occur due to malfunctions of the endocrine system in a man, or in the case of taking hormonal drugs. Hormonal drugs are used for therapeutic purposes or to improve physical performance (gaining muscle mass, professional sports). But despite this, hormonal causes are not the leading causes of teratozoospermia.
2. Viral infectious diseases of the genitourinary system in men. Mumps (mumps) suffered in childhood, which caused orchitis - inflammation of the testicles is often the cause of male infertility. In addition to mumps, there are a large number of other diseases that lead to teratozoospermia, including herpes viral infections. Their number is growing every day.
3. Inflammatory diseases of the male reproductive system, both acute and chronic.
4. Hereditary diseases, which are most often transmitted through the male line. Therefore, if there was infertility in the male family, then the likelihood of infertility in male descendants is much higher than in others.
5. Exposure to harmful environmental factors, including radiation exposure of varying degrees, can cause the appearance of such pathological changes as teratozoospermia.
6. Bad habits. Smoking, drinking alcohol or using drugs negatively affects the functioning of the genital organs, disrupting the process of spermatogenesis (the formation and maturation of sperm, as well as the formation of seminal fluid). If a married couple is planning a child, it is recommended that both spouses give up bad habits within a few months.
7. Diseases of internal organs, which are accompanied by impaired enzyme metabolism.
8. Stress. It has long been established that prolonged nervous tension and constant stress negatively affect the functioning of all organs and systems of the human body. The male reproductive system is no exception.

Teratozoospermia and the possibility of pregnancy

In order to determine the likelihood of becoming pregnant if a man has teratozoospermia, it is necessary to take a spermogram several times. The higher the percentage of sperm with pathological changes, the less likely it is to conceive.

It is very important to identify the cause of teratozoospermia and undergo a course of treatment.

In some cases, in severe forms of teratozoospermia, in vitro fertilization (IVF) is necessary.

Teratozoospermia: treatment

The features and effectiveness of treatment directly depend on the factors that led to its occurrence. In the case where teratozoospermia occurs due to an inflammatory disease of the genital organs, treatment begins with the elimination of inflammatory processes. If the cause of the problem is nervous stress or exposure to external factors, then measures are taken to reduce them as much as possible and the tests are repeated after some time.

Regardless of the cause of teratozoospermia, all patients are prescribed medications that improve sperm production. These include: selenium, zinc, folic acid, verona, spermactin, tribestan, etc.

Prognostically unfavorable in the treatment of male infertility, including teratozoospermia, are advanced cases of diseases of the male genital organs, leading to atrophy of testicular tissue, or serious injuries.

Many married couples having difficulty conceiving begin to undergo various tests. Quite often, especially in recent years, the problem is found in men. One of the diseases leading to male infertility is teratozoospermia.

Some doctors, upon seeing a confirmed diagnosis, immediately recommend turning to assisted reproduction methods, in particular, in vitro fertilization and its varieties. However, before you decide to take extreme measures, it is worth learning more about this insidious disease. How are teratozoospermia and pregnancy related? Let's find out in this article.

Definition of disease

Teratozoospermia is a lesion of spermatozoa, which consists of a violation of their morphological structure. Often referred to colloquially as “ugly sperm disease.” Spermatozoa containing various genetic errors are not able to form a full-fledged, viable embryo.

Irregular shape of the tail, head, neck or all together also interferes with the normal process of movement towards the egg. Instead of smoothly sliding in a straight line, defective sperm move in different directions, backwards, or even remain in place. Most often, teratozoospermia and pregnancy are mutually exclusive concepts.

What is the danger?

The disease can create many obstacles that prevent a woman from becoming pregnant and carrying a child:

• impossibility of pregnancy;
• cessation of embryonic activity in the early stages;
• pathologies of fetal development leading to natural or forced termination of pregnancy;
• extremely high risk of embryo rejection and miscarriage.

Factors for making a conclusion about the presence of a disease

Let's look at how teratozoospermia and pregnancy are related.

It should be taken into account that in any portion of male semen submitted for examination to compile a spermogram, there will certainly be a certain number of abnormal sperm. This is a normal situation; moreover, this state of affairs is necessary for productive fertilization of the partner.

A huge number of sperm simultaneously moving towards the meeting place with the egg is dangerous because they will interfere with each other, crowding and preventing anyone from getting to the desired point. Morphologically erroneous cells can account for up to half of the total number. The diagnosis of “teratozoospermia” is made when less than 50% of spermatozoa have the correct structure.

Therefore, teratozoospermia and pregnancy cannot exist together.

Morphological abnormalities during the development of the disease

A normal sperm has strictly defined sizes and shapes of its constituent parts. The following disorders are considered pathological:

• Changes in the structure of the head - an increase or decrease in volume, bifurcation, absence of an acrosome - one of the chromosomes, determination of the presence of vacuole cells in the head, unnatural shapes.
• A curved, too thin or thick neck is considered the mildest form of teratozoospermia, in which a natural pregnancy and bearing a healthy fetus is possible.
• A tail that twists in the wrong direction, is elongated or shortened, especially if it is forked or too twisted, does not allow the sperm to reach the final goal, carrying out a chaotic or reverse movement.

Causes of the problem

Many people are interested in the question: “Teratozoospermia, what is it?”

The modern world is creating more and more risk factors that provoke the appearance of male infertility. The following reasons most often correspond to the development of teratozoospermia:

• abuse of drinks containing caffeine, substances that stimulate the release of energy;
• drinking alcohol, drugs, smoking;
• constant overheating of the groin area - baths, hot baths, laptop placed on the knees;
• long-term eating disorders - fasting or overeating, large amounts of fatty, sweet foods, smoked foods, marinades, salt;
• daily wearing of too tight underwear and clothes, which causes a decrease in blood supply to the testicles and a lack of oxygen in the cells;
• external factors - polluted habitat, radiation exposure;
• a sedentary lifestyle, especially complicated by excess weight;
• work associated with constant heavy physical labor or daily stress, an overly busy schedule, lack of rest and sleep;
• hereditary disorders caused by a genetic malfunction that has become established in the offspring;
• diseases of the endocrine system, problems with the functioning of the thyroid gland;
• diseases of the urinary system and genital organs of various etiologies - viral or bacterial, varicose veins of the testicles (varicocele), prostatitis, orchitis, urethritis, neoplasms, both benign and malignant.

In these cases, teratozoospermia is possible. The reasons for the occurrence may be other.

Most of the causes of the disease are provoked by the man himself, refusing to take care of his health. Unfortunately, in Russia there is still a widespread opinion that the inability to have children is solely the fault of the woman.

Reproductive capabilities

What treatment can be given if teratozoospermia is diagnosed? Who did it help? Reviews can be found further in the article.

The conclusion about the presence of teratozoospermia is not always a verdict meaning a man’s infertility. The number of remaining healthy sperm, the degree of damage to the abnormal ones, as well as other spermogram indicators should be taken into account. It is advisable to perform the analysis in as much detail as possible, in this case the field for the final conclusion will expand.

If there are 50-80% of morphologically healthy cells, the probability of pregnancy naturally remains quite high, but it may take more time for conception to occur. However, within 2-3 years the couple usually has a healthy baby. It is worth considering that this is a fairly average indicator, the period often increases, sometimes decreases.

Teratozoospermia and IVF

If the disease has affected more than 80-90% of sperm, the method of alternative fertilization - IVF - is usually recommended. The advantages lie in the selection of only healthy male germ cells and their guaranteed connection with female eggs in an environment as close to natural as possible. After a successful manipulation, several embryos are transferred to the woman’s uterus, where further gestation occurs.

ICSI is a much more effective procedure. The technique is indicated for severe male infertility, including when there is teratozoospermia. Treatment and pregnancy are interconnected.

ICSI is successfully carried out even if only one normal sperm is found in the ejaculate, which is quite rare. The difference from IVF is only in the method of fertilization of the egg - in this case, the sperm is injected with a thin needle to precisely end up in the right place.

There are cases when, with a relatively normal number of healthy sperm, pregnancy does not occur. This may be due to the structural features of the woman’s body, for example, with the curvature of the uterus. In such situations, an artificial insemination procedure is often sufficient, in which a portion of ejaculate, specially treated with drugs that improve its quality, is introduced into the uterine cavity during the ovulation cycle - egg maturation.

Treatment effectiveness

How effective is treatment for a diagnosis of teratozoospermia? Who did it help?