Sperm malformation

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Sperm malformation (also called teratozoospermia) means that a man’s sperm cells have abnormal shapes or structures. Normally, sperm should have an oval head, intact midpiece, and a long straight tail that allows it to swim effectively. When sperm are malformed, fertility can be reduced because they may not be able to swim properly or fertilize an egg.

Types of sperm malformations
Head abnormalities
Large head / Small head – irregular size makes it difficult to penetrate the egg.
Double head – two heads attached, usually non-functional.
Pinhead sperm – head too small, often lacking genetic material.
Round head (globozoospermia) – head lacks acrosome, so sperm cannot break into the egg.
Amorphous head – irregular, misshaped head.
Vacuoled head – head has empty spaces, affecting DNA quality.

Midpiece abnormalities
Thickened midpiece – may contain excess cytoplasm.
Bent midpiece – affects motility.
Irregular mitochondria distribution* – lowers energy supply.

Tail abnormalities
Short tail – reduces motility.
Coiled tail – sperm cannot swim forward.
Double tail – ineffective swimming.
Absent tail – completely immotile.

 Causes of sperm malformation
- Genetic defects
- Infections (e.g., STIs)
- Varicocele (enlarged veins in scrotum)
- Exposure to heat, toxins, radiation, smoking, alcohol
- Hormonal imbalances
- Nutritional deficiencies

 Effects
- Reduced motility
- Lower ability to fertilize the egg
- Possible infertility if severe

👉 In many men, a few abnormal sperm are normal. Concern arises when more than 96% of sperm are malformed.

A Semen Fluid Analysis (SFA) laboratory report is used to assess male fertility and reproductive health. It provides detailed information about the physical, chemical, and microscopic properties of semen.

Here are the key features usually found in a standard SFA report:
1. Patient Information
Name, age, ID number
Date & time of collection
Duration of abstinence (usually 2–7 days)
Method of collection (masturbation, condom, withdrawal, etc.)

2. Macroscopic (Physical) Examination
Volume: (normal: ≥1.5 mL)
Color & Appearance: normally greyish-white, opalescent (yellowish, reddish, or clear may indicate pathology)
Viscosity: normal vs. increased thickness
Liquefaction time: normally within 60 minutes
pH: normal 7.2 – 8.0

3. Microscopic Examination
Sperm Concentration (Count): normal ≥15 million sperm/mL
Total Sperm Number: ≥39 million per ejaculate
Motility:
Progressive motility (PR)
Non-progressive motility (NP)
Immotile sperm
(Normal: ≥40% motile or ≥32% progressively motile)
Morphology: percentage of sperm with normal shape (≥4% by strict WHO criteria)
Vitality (Live–Dead Test): percentage of live sperm (normal ≥58%)
Agglutination: clumping of sperm (may indicate antibodies or infection)
Round Cells / WBCs: leukocytes <1 million/mL (higher suggests infections 

4. Biochemical Tests (if performed)
Fructose test: indicates seminal vesicle function
Zinc, Citric acid, Acid phosphatase: indicators of prostate function
Alpha-glucosidase: epididymal function

5. Additional Findings
Presence of pus cells (pyospermia)
Red blood cells (hematospermia)
Crystals or debris

6. Interpretation / Conclusion
Normal Semen Parameters (Normozoospermia)
Oligozoospermia (low count)
Asthenozoospermia (low motility)
Teratozoospermia (abnormal morphology)
Azoospermia (no sperm)
Necrozoospermia (all dead sperm)
Aspermia (no ejaculate)

In summary, a semen fluid analysis report contains patient details, macroscopic parameters, microscopic parameters, biochemical markers, and interpretation according to WHO reference values.

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