By Zaira Salvador BSc, MSc (embryologist).
Last Update: 11/28/2018

With teratozoospermia, achieving a natural pregnancy might be a challenge. In fact, in the most severe cases, fertilization and subsequent embryo development are almost impossible.

Teratozoospermic males, unfortunately, have no choice but to turn to assisted reproduction to have children.

The most adequate treatment option to conceive in spite of teratospermia depends on a variety of factors and not on the severity only. The remainder of the seminal parameters, along with age and health of the female partner, are limiting factors when it comes to achieve a pregnancy.

Natural pregnancy

Sperms with malformations can make the TTC journey more challenging due to any of the following reasons:

  • Amorphous sperm have trouble moving forward due to their abnormal shape. As a result, they cannot complete their journey towards the egg.
  • Head deformities can prevent the sperm cell from penetrating the egg and fertilizing it.
  • When teratozoospermia is due to genetic causes, the resulting embryo can carry DNA abnormalities that prevent normal embryo development.

The causes listed above can prevent or postpone natural pregnancy.

With mild teratozoospermia, normal sperm present in the semen could cause a natural pregnancy in the woman. Depending on parameters like sperm count and motility, the probability may be higher or lower.

Conversely, in cases of moderate or even severe teratospermia, especially if it is associated with other sperm disorders, including oligozoospermia or asthenozoospermia, the chances are that the couple has no alternative but to undergo fertility treatment to have a child.

Fertility treatments

When a man is diagnosed with teratozoospermia, based on the severity level and the results of the semen analysis report, the specialist will recommend the best treatment option to correct teratozoospermia and boost the success rates for the couple.

It should be noted that female fertility plays a major role when making this decision.

The following are the assisted reproductive technologies that a couple with teratozoospermia could undergo:

Intrauterine Insemination (IUI)

IUI is a simple technique whereby sperm are placed directly into the woman’s uterus or womb to cause a pregnancy. Before this, the sperm sample is processed through sperm capacitation technique and the woman undergoes ovarian stimulation.

This fertility treatment achieves satisfactory outcomes in cases of mild teratozoospermia (i.e. 3-4% of sperm are normal), provided that the sperm count and motility are normal.

For IUI to be possible, the total Motile Sperm Concentration (MSC) test should range between 2 and 3 million spermatozoa with progressive motility.

Furthermore, the woman should be aged between 35-36 years, have tubal patency, and do not have any significant fertility issue.

Check out this for information: What Is Artificial Insemination (AI)? – Process, Cost & Types.

In Vitro Fertilization (IVF)

IVF is one of the main fertility treatments available nowadays. Roughly, it involves retrieving multiple mature eggs from the woman through follicle puncture after she undergoes ovarian stimulation. The eggs collected are put in contact with a sample of sperm from the male partner in order to male fertilization possible.

IVF offers positive outcomes in cases of mild-to-moderate teratozoospermia (1-2% of sperm are normal) where the woman is 35 years old or more. It would be the option of choice after multiple failed IUI cycles, too.

There exists an alternative IVF procedure that requires a greater degree of human involvement, since the sperm cell is injected manually into the egg cell. It is known as Intracytoplasmic Sperm Injection (ICSI).

ICSI is mostly used in cases of severe teratozoospermia (the total normal sperm count is fewer than 1%), or when other techniques have failed.

However, most IVF procedures performed today use ICSI to create the embryos, as it reaches higher success rates than with conventional IVF.

You might also like: What Is ICSI Technique? – Process, Success Rates & Cost.

If you need to undergo IVF to become a mother, we recommend that you generate your Fertility Report now. 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.


IMSI or ultra-high magnification sperm selection is an improved version of ICSI. Thanks to it, the andrologist can select the best sperm cell more accurately, paying special attention to morphology.

To this end, ICSI is enhanced by digital imaging to achieve a magnification up to 6000x.

IMSI has many advantages for teratozoospermic males, since it allows sperms to be examined in detail, choosing the sperms with the best morphology.

Also, IMSI helps to diminish the miscarriage rates.

Read this next: IMSI Procedure in IVF – Differences with ICSI, Cost & Success Rates.

FAQs from users

What is the best treatment option to achieve pregnancy with teratozoospermia?

By Zaira Salvador BSc, MSc (embryologist).

Actually, the most adequate treatment option for couples with teratozoospermia depends on a number of factors, including the severity level, age of the women, duration of infertility…

The most advisable, however, is IVF with ICSI in most of the cases.

Do abnormal sperm cause miscarriage?

By Zaira Salvador BSc, MSc (embryologist).

The fact that a male has teratozoospermia does not translate into miscarriage if pregnancy has been achieved. Nonetheless, if teratozoospermia has a genetic origin and spermatozoa carry DNA mutations, it could increase the miscarriage rate or lead to the birth of a sick child.

Does teratozoospermia increase your chances of having a baby with Down syndrome?

By Zaira Salvador BSc, MSc (embryologist).

No, teratozoospermia is not associated directly with trisomy 21, that is, the chromosomal abnormality that causes Down syndrome. Nonetheless, sperm with an abnormal morphology can cause genetic alterations leading to implantation failure, increase the chances of miscarrying, or other pathologies.

By Zaira Salvador BSc, MSc (embryologist).

The truth is, the treatment in this case depends on how severe teratozoospermia is, as well as on the age of the woman. For instance, if it is a case of mild teratozoospermia, and the woman is younger than age 35 year, they could give IUI a try. But, if none of these requirements are met, the first option would be an In Vitro Fertilization (IVF).

Suggested for you

Males with mild teratozoospermia can try to improve their sperm quality with a natural treatment. See this for more: Treatment of Teratozoospermia – Can It Be Cured?

In case you are interested in learning about the different methods that can be used to detect teratozoospermia in males, we recommend that you visit this article: How Is Abnormal Sperm Morphology or Teratozoospermia Measured?

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French DB, Sabanegh ES Jr, Goldfarb J, Desai N. Does severe teratozoospermia affect blastocyst formation, live birth rate, and other clinical outcome parameters in ICSI cycles? Fertil Steril. 2010;93(4):1097-103.

Hotaling JM, Smith JF, Rosen M, Muller CH, Walsh TJ. The relationship between isolated teratozoospermia and clinical pregnancy after in vitro fertilization with or without intracytoplasmic sperm injection: a systematic review and meta-analysis. Fertil Steril. 2011;95(3):1141-5.

Lee RK, Hou JW, Ho HY, et al. Sperm morphology analysis using strict criteria as a prognostic factor in intrauterine insemination. Int J Androl. 2002; 25: 277-80.

Marchini M, Ruspa M, Baglioni A, Piffaretti-Yanez A, Campana A, Balerna M. Poor reproductive prognosis in severe teratozoospermia with a predominant sperm anomaly. Andrologia. 1989;21(5):468-75.

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Authors and contributors

 Zaira Salvador
BSc, MSc
Bachelor's Degree in Biotechnology from the Polytechnic University of Valencia (UPV). Embryologist specializing in Assisted Procreation, with a Master's Degree in Biotechnology of Human Assisted Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI). More information
License: 3185-CV
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    1. Pinky

      Good Day,

      Results for my husband;
      Tails 18%
      Neck 8%
      Cytoplasmic 2%
      Prog movement 1+ (Abnormal)
      Motility 10%
      Sperm count 4.3

      Is it possible that we can conceive naturally?

    2. Mona

      My husband sperms’ morphology is 100% abnormal. The doctors recommended us to do IVF. Pls let me know how it will be possible? I am worried about having an incomplete baby??