By Rebeca Reus BSc, MSc (embryologist).
Last Update: 06/28/2018

Male infertility is commonly caused by sperm disorders that affect sperm quality. Sperm abnormalities, whether they affect sperm count, morphology, motility or volume, can be diagnosed using a semen analysis. Asthenozoospermia, teratozoospermia, and azoospermia are some of the most frequent ones.

Causes

During spermatogenesis, that is, the sperm production process, the process can be compromised due to errors or defects at some point of the process, which leads to the production of sperm problems that can affect the morphology, count, and/or motility.

Any disorder that affects sperm quality can hinder or prevent egg fertilization. In other words, sperm quality is a determining factor when it comes to achieving a pregnancy successfully. For this reason, sperm disorders or abnormalities are considered a cause of male infertility.

The good news is that, thanks to Assisted Reproductive Technology (ART), men who are infertile due to sperm diseases can have biological children. Improvements achieved in ART, the sperm count and motility are not determining factors to achieve a pregnancy anymore.

Intracytoplasmic Sperm Injection (ICSI) has allowed thousands of infertile men due to the presence of a severe sperm disease to have children.

Sperm parameters taken into account to evaluate sperm quality are based on the guidelines provided by the World Health Organization (WHO) back in 2010. The test used to examine them is called semen analysis, also known as sperm test or seminogram.

In case all sperm parameters are normal, we talk about normozoospermia. In case a sperm abnormality is detected, the man will be diagnosed with any of the sperm disorders that we will explain in the following sections.

Abnormal sperm count

Low sperm count, that is, oligospermia is probably the most common sperm disorder. Nonetheless, depending on the grade of severity, there exist several types:

Oligozoospermia

Oligospermia or oligozoospermia is diagnosed when the sperm count is significantly low (below 15 million/ml). Only when the sperm count is above this value, samples are considered normal.

Check out this for information: What Is Oligospermia? – Low Sperm Count Causes & Treatment.

Cryptozoospermia

Cryptozoospermia refers to an extremely low sperm count. If the man’s ejaculate contains less than 100,000 sperm/ml, the sample will be diagnosed as cryptozoospermic.

Due to the reduced number of sperm in the ejaculate, finding spermatozoa is a challenging process. In fact, it is likely that sperm are found only by using the semen centrifugation method. In these cases, if the sample is diagnosed with azoospermia (zero sperm count), the specialist will mistakenly recommend a testicular biopsy.

Further reading: Cryptozoospermia – Definition, Causes, Treatment & Pregnancy.

Azoospermia

Azoospermia is a sperm disorder that is diagnosed when the sperm count is zero, which is to say, no sperm is found in the ejaculate. Azoospermia males can ejaculate, but when the semen is analyzed, no sperm are observed.

This disorder, depending on what causes it, can be:

Obstructive azoospermia
When the absence of sperm is associated with problems in the transport of sperm to the urethra.
Non-obstructive azoospermia
Also known as secretory azoospermia, it is defined as having sperm production issues.

In males who have had a vasectomy done, azoospermia should be diagnosed eventually as well.

Read this next: What Is Azoospermia or Zero Sperm Count? – Causes & Treatment.

Asthenozoospermia

Asthenozoospermia is the name of a sperm disorder that affects sperm motility. According to the WHO’s criteria, two types of motility should be taken into account when examining a sperm sample:

Total motility
Total amount of active spermatozoa.
Progressive motility
Total amount of active spermatozoa that are able to make forward progression.

For a sperm sample to be considered normal, at least 40% of sperm must be active, and 32% be able to make forward progression. If these requirements are not met, the man will be diagnosed with asthenozoospermia.

Based on the grade of severity, we can classify this disorder into three groups: severe, moderate, or mild asthenozoospermia.

More on this story: What Is Asthenozoospermia? – Definition, Causes & Treatment.

Teratozoospermia

Teratozoospermia or teratospermia is a sperm disease that affects sperm morphology. Normal sperm morphology has the following characteristics:

  • Oval-shaped head
  • Thick middle-piece or neck
  • Long, thin tail

For a man to have a normal sperm morphology, at least 4% of sperm must be free from abnormalities.

Inversely, if less than 4% of sperm in the ejaculate are normal in terms of morphology, the sample will be diagnosed with teratozoospermia—over 96% of the total sperm count are abnormal.

Recommended for you: What Is Teratozoospermia? – Causes, Pregnancy Rate & Treatment.

Hypospermia

Hypospermia is defined as having a sperm volume below 1.5 ml. According to the WHO’s reference values, sperm volume of a normal semen sample should be at least 1.5-6 ml.

Abnormal sperm volume can be due to abnormalities in the seminal vesicles or in the ejaculatory ducts, amongst other potential causes.

Similar post: What Is Hypospermia? – Causes, Symptoms, Fertility & Treatment.

Necrospermia

The term necrospermia refers to an elevated amount of dead sperm in the ejaculate. For a man not to be considered childless in spite of this disease, at least 58% of sperm present in the ejaculate must be live.

In short, if the number of dead sperm cells is 58% or more, necrospermia will be diagnosed.

Related content: What Causes Necrospermia? – Symptoms, Diagnosis & Treatment.

Combined disorders

Oftentimes, samples are not only diagnosed with a single sperm disorders, but with a combination of two or more. Most common combinations include:

Oligoasthenozoospermia

Oligoasthenozoospermia is caused by issues related to low sperm count and poor sperm motility.

In such cases, the sperm concentration is below 15 million sperm per milliliter, along with a percentage of progressive motility that is under 32%.

More: Oligoasthenozoospermia – Definition, Causes, Symptoms & Treatment.

Oligoasthenoteratozoospermia

Oligoasthenoteratozoospermia (OAT) is diagnosed when:

  • Low sperm count (less than 15 million/ml)
  • Poor motility (less than 32% are able to make forward progression)
  • Abnormal morphology (less than 4% have a normal morphology)

You may like: What Is Oligoasthenoteratospermia (OAT)? – Causes & Treatment.

Treatment

Sperm quality is a determining factor when it comes to referring a patient to a particular fertility treatment. Thus, depending on the quality, and as long as no other fertility issues are present, the treatment of choice may be:

Intrauterine Insemination (IUI)
When sperm quality is good because all parameters explained above are normal but pregnancy is not achieved naturally, this is the technique of choice.
In Vitro Fertilization (IVF)
In those cases where sperm quality is altered, IVF will be the first choice. In patients with severe sperm disorders, IVF with ICSI will be necessary.
Testicular biopsy
When azoospermia is diagnosed, your doctor will recommend a testicular biopsy to determine if sperm production is taking place, or if donor sperm is needed.

In any case, one should note that each case should be treated individually, since there are many factors that may have an influence, including medical history of the couple or female fertility.

Whether you need to undergo IUI or IVF to become a mother, we recommend that you use "The Calculator". 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.

Also, the report will inform you about the promotions or special prices that the clinics selected offer so you can benefit from them as well.

FAQs from users

Can you test your sperm count at home?

By Rebeca Reus BSc, MSc (embryologist).

Yes, although not so accurately as andrology labs. There exists a sperm test called SpermCheck Fertility that works similarly to a pregnancy test. It uses colored lines to indicate if your sperm count is normal or not.

How can you know if your sperm is infertile?

By Rebeca Reus BSc, MSc (embryologist).

The most basic test to evaluate if a man’s sperm is fertile or not is a semen analysis. Other tests to check fertility in men include:

  • Physical exam
  • Hormone evaluation
  • Genetic testing
  • Analysis of anti-sperm antibodies

Read more: Male Fertility Testing – How Do You Know if You Are Infertile?

What does healthy sperm look like?

By Rebeca Reus BSc, MSc (embryologist).

Not exactly. Apparently, a man’s ejaculate is healthy if it’s white or light grey in color. Yellowish or greenish discoloration may indicate the presence of an infection. Other factors that contribute to healthy sperm include following a balanced diet, doing exercise, wearing lose underwear, not having unhealthy or toxic habits, etc.

In any case, ejaculate may have all these characteristics but still be unhealthy due to the presence of genetic diseases, low sperm count, abnormal morphology, etc. The best way one can get accurate information about sperm quality is via a semen analysis.

Can jelly-like sperm stop pregnancy?

By Rebeca Reus BSc, MSc (embryologist).

Ejaculating jelly-like semen is actually quite normal, and in fact it can increase your chances of conceiving. A jelly-like appearance indicates that the semen contains fructose, a type of simple sugar that keeps the sperm viable after ejaculation. Semen consistency can be normal yet not have viable sperms, though.

Is thick sperm more fertile?

By Rebeca Reus BSc, MSc (embryologist).

Normal sperm is thick and gelatinous (jelly-like). It is a natural feature of sperm that enables it to stick to the cervix of the female.

Suggested for you

As we have seen through this post, a semen analysis is a fundamental test when a man wants to have his fertility checked. If you liked this post, you may want to go through this: Sperm Test Results Explained – Interpretation & Normal Values.

If you are interested in learning about the characteristics of sperm cells, you may also enjoy some further information reading this: What’s the Function of a Sperm Cell? – Definition & Structure.

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Authors and contributors

 Rebeca Reus
BSc, MSc
Embryologist
Degree in Human Biology (Biochemistry) from the Pompeu Fabra University (UPF). Official Master's Degree in Clinical Analysis Laboratory from the UPF and Master’s Degree about the Theoretical Basis and Laboratory Procedures in Assisted Reproduction from the University of Valencia (UV). More information
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One comment

    1. Suresh Reddi

      Respected madam,

      I have been diagnosed with Severe OAT (15 sperm/ml, volume 1.7 ml, normal pH) and viscosity – 3% normal viable sperms. My karyotype is normal male 46XY. Should I go for a sperm DNA fragmentation test to rule out any alterations or sperm chromosomal abnormalities, which may lead to the development of genetical disorders in the newborn? What is a FISH test and when should it be done? Is it done on sperm, blood, blastocyst or fetus to know any alterations? We have decided to go for ICSI with donor oocytes.

      Kindly clear my doubts and give your valuable advice to proceed.

      Best regards,

      Suresh Reddi.