Are the causes of teratozoospermia reversible or not?

By (gynecologist), (embryologist), (embryologist) and (fertility counselor).
Last Update: 01/18/2024

Teratozoospermia or teratospermia is the medical term for the presence of an abnormal sperm morphology in the ejaculate of males.

This sperm disorder affects sperm quality, leading to male infertility or sterility, and reducing their chances of conceiving.

The particular causes of teratozoospermia are unknown in the vast majority of cases. However, there exist certain factors that can affect the semen by causing abnormal sperm morphology.

Defective spermatogenesis

Most experts agree that sperm morphology alterations occur during the final phase of sperm formation (i.e. spermatogenesis).

Spermatogenesis is the process whereby sperm production takes place. It occurs in the testicles and can take up to 3 months.

Particularly, spermiogenesis, which is the final stage of spermatogenesis, where sperm already contain all their genetic material, is the stage where sperm go through the maturation process, acquiring their characteristic morphology.

When sperms already have an oval-shaped head and the tail fully formed, they are released to the seminiferous tubules so they can continue their pathway.

In short, it is only natural that any kind of defect or abnormality that occurs during spermatogenesis causes sperm abnormalities in the head, neck, and/or tail.

Treatable teratozoospermia

Teratozoospermia can be reversible or irreversible depending on what is causing it.

As regards treatable or reversible teratozoospermia, the good news is that males affected by it can recover their fertility in a few months after having followed the appropriate treatment.

To check if it has been successful, one should repeat the semen analysis and compare it with the previous one.

The following are the most common causes of reversible teratospermia:


As surprising as it may seem, lifestyle affects sperm quality to a large extent.

Especially if one is stressed or anxious, sperm morphology can worsen, aside from other parameters such as sperm count and motility.

Alcohol, tobacco, and street drug use are associated with sperm disorders, too.

Continuous testicular exposure to heat affects spermatogenesis as well. For example, placing the laptop on your lap, wearing too tight clothes, or prolonged car driving can cause teratozoospermia.

Finally, eating habits and sports can influence male fertility as well.

Males who are currently trying to conceive with their partner should have healthy life habits, follow a balanced diet, practice sports on a regular basis, and avoid toxic substance use at all costs.

Seminal tract infections

Seminal tract infections are caused by invasive microorganisms, including bacteria and viruses, in the male reproductive tract.

Infectious agents can be present either in urine or sperm, causing sperm abnormalities, inflammations, and blockage in the seminal ducts.

Most common bacterial infections in the testes are chlamydia and gonorrhea. Fortunately, both can be overcome with antibiotics.

Get more info: Sperm Infections and Temporary Infertility.

Fever caused by the flu or any other condition may alter sperm production temporarily as well.

For more information on this topic, you can read more at the following link: Sperm Infections and Temporary Infertility.


Sex hormones like testosterone, LH, FSH, and inhibin have a very important role in regulating spermatogenesis.

Thus, any alteration in the adequate levels of these hormones due to the administration of medications can impact spermatogenesis negatively.

As explained above, if the spermiogenesis phase is altered, sperms will not mature as expected, causing teratozoospermia.

Untreatable teratozoospermia

In cases of teratozoospermia, if no improvement is seen in the second sperm analysis report after being treated, it might be a case of irreversible teratospermia.

If this were the case, the couple may have no alternative but to undergo fertility treatment if they wish to become parents. Unfortunately, achieving a natural pregnancy with untreatable teratospermia is highly unlikely.

Furthermore, there exist certain conditions or circumstances that can cause long-term or untreatable teratospermia. The following are the most remarkable ones:

Cancer treatments

Chemotherapy and radiotherapy can alter sperm stem cells and spermatogenesis at the same time, causing severe teratozoospermia along with other serious disorders.

For this reason, all men suffering from cancer should consider retaining their fertility through sperm freezing. This way, they can have children in the future, after having overcome the disease.

If you are considering freezing your sperm to have a child in the future, we recommend that you start by creating a Fertility Report. In 3 simple steps, it will show you a list of clinics that fit your preferences and meet our strict quality criteria. Moreover, you will receive a report via email with useful tips to visit a fertility clinic for the first time.

The male semen sample would then be thawed and used for artificial insemination (AI) or in vitro fertilisation (IVF) to achieve pregnancy.

Genetic abnormalities

One of the most complicated causes to detect. Normally, when the cause of teratozoospermia cannot be explained, it is attributed to genetic alterations.

Gene or chromosomal abnormalities in sperm are considered a serious defect, mainly because there is no possible way for them to be treated.

Teratozoospermia can be caused by diseases that affect the testes mainly, such as:

  • Trauma to the testicles, especially during childhood
  • Testicular varicocele
  • Meningitis
  • Diabetes mellitus

Aside from all this, age can affect sperm morphology as well. In particular, several studies have confirmed that, in males aged 45 or over, the rate of abnormal sperm in the semen increases.

FAQs from users

Can diabetes be a cause of teratozoospermia?

By Antonio Forgiarini M.D., M.Sc. (gynecologist).

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, talks to us about this issue in the following video:

Yes, sometimes it could, especially when we cannot treat properly the diabetes, so we have higher levels of glucemia in the blood during long time, so it can cause some hormonal alteration and could be a cause of teratozoospermia.

Does poor sperm vitality correlate with abnormal sperm morphology?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Yes, teratozoospermia can affect both live and dead sperm.

Dead sperm do not have an abnormal morphology in all cases. Sometimes, they are confused with immotile sperm, and performing a dye test is necessary to determine whether they are actually viable or not.

Can leukocytospermia cause teratozoospermia and male infertility?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Leukocytospermia or pyospermia is defined as having white blood cells in the semen, with a concentration that is above 1 million per milliliter. The cause of this sperm disorder is an infection in the seminal tract, which should be treated with antibiotics, as it can affect spermatogenesis (sperm production process), and lead to oligospermia or teratozoospermia.

Are teratozoospermia and asthenozoospermia caused by the same factors?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

In most of the cases, asthenozoospermia and teratozoospermia have the same causes. Both sperm parameters appear altered in the semen analysis, which is known as asthenoteratozoospermia. Nonetheless, they do not go hand in hand in all cases.

Does alcohol consumption cause teratozoospermia?

By Marta Barranquero Gómez B.Sc., M.Sc. (embryologist).

Yes, it is possible. Drinking alcohol can cause alterations in sperm quality. Studies have concluded that alcohol causes a reduction in the concentration of sperm in the ejaculate, as well as alterations in sperm formation. Alcohol could therefore be a reversible cause of teratozoospermia.

Suggested for you

The most important test to detect teratozoospermia in males is the semen analysis (SA). You may also enjoy some further information reading this: What Is a Semen Analysis Report?

Also, we have made reference to sperm freezing as an option for fertility preservation in males with cancer. If you want to delve deeper into it, we recommend that you have a look at this: What Is the Process of Freezing Sperm?

We make a great effort to provide you with the highest quality information.

🙏 Please share this article if you liked it. 💜💜 You help us continue!


Aly JM, Polotsky AJ. Paternal Diet and Obesity: Effects on Reproduction. Semin Reprod Med. 2017;35(4):313-317.

Asare-Anane H, Bannison SB, Ofori EK, Ateko RO, Bawah AT, Amanquah SD, Oppong SY, Gandau BB, Ziem JB. Tobacco smoking is associated with decreased semen quality. Reprod Health. 2016;13(1):90 (View)

Chemes HE. Phenotypic varieties of sperm pathology: Genetic abnormalities or environmental influences can result in different patterns of abnormal spermatozoa. Anim Reprod Sci. 2018;194:41-56 (View)

Choe JH, Seo JT. Is Varicocelectomy Useful for Subfertile Men with Isolated Teratozoospermia? Urology. 2015 Dec;86(6):1123-8.

De Braekeleer M, Nguyen MH, Morel F, Perrin A. Genetic aspects of monomorphic teratozoospermia: a review. J Assist Reprod Genet. 2015;32(4):615-23 (View)

Oumaima A, Tesnim A, Zohra H, Amira S, Ines Z, Sana C, Intissar G, Lobna E, Ali J, Meriem M. Investigation on the origin of sperm morphological defects: oxidative attacks, chromatin immaturity, and DNA fragmentation. Environ Sci Pollut Res Int. 2018;25(14):13775-13786.

Ray PF, Toure A, Metzler-Guillemain C, Mitchell MJ, Arnoult C, Coutton C. Genetic abnormalities leading to qualitative defects of sperm morphology or function. Clin Genet. 2017;91(2):217-232 (View)

FAQs from users: 'Can diabetes be a cause of teratozoospermia?', 'Does poor sperm vitality correlate with abnormal sperm morphology?', 'Can leukocytospermia cause teratozoospermia and male infertility?', 'Are teratozoospermia and asthenozoospermia caused by the same factors?' and 'Does alcohol consumption cause teratozoospermia?'.

Read more

Authors and contributors

 Antonio Forgiarini
Antonio Forgiarini
M.D., M.Sc.
Bachelor's Degree in Medicine from the Università degli Studi di Roma “Tor Vergata”, with specialty in Obstetrics and Gynecology at University Clinical Hospital of Valencia, Spain. Master's Degree in Human Reproduction, and currently works as an OB/GYN specialized in Assisted Procreation at fertility clinics Millet and IMER Valencia. More information about Antonio Forgiarini
License: 464621719
 Marta Barranquero Gómez
Marta Barranquero Gómez
B.Sc., M.Sc.
Graduated in Biochemistry and Biomedical Sciences by the University of Valencia (UV) and specialized in Assisted Reproduction by the University of Alcalá de Henares (UAH) in collaboration with Ginefiv and in Clinical Genetics by the University of Alcalá de Henares (UAH). More information about Marta Barranquero Gómez
License: 3316-CV
 Zaira Salvador
Zaira Salvador
B.Sc., M.Sc.
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV
Adapted into english by:
 Sandra Fernández
Sandra Fernández
B.A., M.A.
Fertility Counselor
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

Find the latest news on assisted reproduction in our channels.