Very often doctors talk about female infertility, ovarian dysfunction, problems with ovulation, however, the male factor is often excluded from the general equation, the purpose of which is pregnancy. Many mistakenly believe that spermatogenesis disorders are not so common, but according to statistics, 80% of spermatozoa in a healthy man are abnormal.
Of course, this is partly due to the high requirements for their quality, but these figures cannot but be alarming. On estet-portal.com read about the causes of changes in sperm morphology, as well as how this can affect male infertility.
Changes in the process of spermatogenesis: total transformation
In males, spermatid transformation is a key postmiotic event that contributes to major morphological reorganizations.
Spermatogenesis is accompanied by the reorganization of the nucleus, the development and positioning of the acrosome, the assembly of tail structures, and the reorganization of the cytoplasm.
As a result of changes during spermatogenesis, as shown by numerous studies, completely diverse spermatozoa are formed in their morphology, which raises the question - what is a normal spermatozoon?
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The answer is quite simple: a sperm cell that is able to penetrate the endocervical mucus is considered normal. Based on this statement, it was tracked which structure of spermatozoa is optimal for this task.
Sperm quality control: criteria for "ideal" spermatozoa
According to strict criteria, the percentage of "ideal sperm" in men is very low.
Thus, a normal spermatozoon should have:
• one smooth, well-defined oval head;
• one long curly tail;
• acrosomal region, which would include 40-70% of the head area without large vacuoles;
• The post-acrosomal region must not contain any vacuoles.
The presence of two tails or heads, curvature of the neck, changes in the shape and size of the spermatozoon head indicate a violation of the morphology of the spermatozoon.
Normally, in a healthy man, when assessed according to strict criteria, the number of "ideal" spermatozoa should be more than 16%. However, even more abnormal forms do not yet indicate male infertility.
Sperm quality score: objective data or waste of time
To monitor sperm quality, three different indicators have been proposed and defined:
• The Multiple Abnormality Index (MIA) is the average number of abnormalities per abnormal sperm cell;
• The Teratozoospermia Score (TTZR) is similar to IMA, but counts a maximum of four abnormalities per abnormal spermatozoon;
• The Sperm Deformation Index (SDI) is the number of abnormalities divided by the total number of spermatozoa.
Literature on the clinical significance of these parameters is very scarce. For example, HIRT has a low predictive value during the assessment of spontaneous fertility, as well as the results of the use of assisted reproductive technologies.
Men, even with significant morphological changes in spermatozoa, have high rates of spontaneous fertility.
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This suggests that the morphology of spermatozoa may be the cause of male infertility, however, most often these disorders are associated with genetic mutations that lead to almost total damage to spermatozoa. But in most cases, even if the morphology of spermatozoa is disturbed, there is a possibility of pregnancy.
Factors affecting spermatozoa morphology
Let's try to debunk the myths regarding which factors can influence the morphology of spermatozoa. Thus, studies show that smoking does not affect the structure of spermatozoa, but the use of marijuana can cause the formation of defects in their structure.
High temperature negatively affects the activity of spermatozoa, contributing to a decrease in their motility.
According to a recent study, patients with testicular cancer have an increase in several abnormalities: microcephalic spermatozoa, post-acrosomal abnormalities, acrosome defects, excess residual cytoplasm, and short tails. There is also a decrease in normal forms in patients with varicocele and urogenital infections.
Recently, scientists have argued that the structure of spermatozoa affects male fertility to a very small extent. Studies show that men with a complete absence of normal sperm morphology have high rates of spontaneous pregnancy without the use of assisted reproductive technologies.
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Evaluation of sperm morphology is an analytically unreliable method, which is associated with heterogeneity in the preparation and reading of smears, as well as lack of a uniform classification system. In this regard, a change in the morphology of spermatozoa does not always indicate the presence of male infertility, and sometimes a deeper and more detailed examination of the patient is necessary to search for its causes.
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