When treating fertility patients in clinic I often get asked about semen analysis results, sperm morphology and what they mean so I thought I would write a high-level blog on the subject.
Morphology refers to the shape and size of the sperm. It refers to the number of sperm which are shaped perfectly normal, as shown in the diagram below. It is one factor that is examined as part of a semen analysis test to evaluate male fertility.
Along with Morphology testing, a semen analysis test will also assess sperm volume, sperm number, sperm concentration, vitality (% alive) and movement (motility).
According to WHO criteria, a morphologically normal spermatozoon has an oval head and an acrosome covering 40%–70% of the head area. A normal spermatozoon has no neck, midpiece, tail abnormalities nor cytoplasmic droplets larger than 50% of the sperm head.
Sperm Morphology criteria
There are several types of guidelines that you may see used for sperm morphology on a semen analysis report, and the report will generally state which of these criteria they are using. The two most commonly used are the World Health Organization guidelines (third edition) and the Kruger strict criteria.
The Kruger criteria were developed in 1986 by a physician named Thinus Kruger and were based upon the evaluation of sperm that had successfully migrated to the cervix following natural intercourse. The original 1986 guidelines used a figure of 14 percent or greater normal forms as the cutoff for “normal” morphology. However, the strictness of the guidelines has changed over the years. [Kruger TF. FertSteril 1986].
World Health Organisation Guidelines
Since 1980, the World Health Organization (WHO) has issued guidelines for what it considered “normal” semen morphologies. Over the decades, the criteria for what the WHO considers normal has gotten progressively more rigorous.
1st Edition (1980) 80.5%
2nd Edition (1987) 50%
3rd Edition (1992) 30%
4th Edition (1999) 14%
5th and 6th Editions (2010 and 2021) 4%
Most fertility-specific labs now use 4 percent or more as their definition of “normal” (as do the latest WHO guidelines).
Can sperm shape be corrected?
A male is always producing new sperm. Changes to a man’s diet and lifestyle can affect the health of future sperm, for example, exercising regularly, losing weight, if needed, avoiding hot tubs, decreasing stress, reducing caffeine intake, wearing loose cotton boxer shorts, eating food or supplements rich in antioxidants every day.
It takes approximately 3 months (120 days) to make and transit the new sperm, so any changes in diet or lifestyle will take this amount of time or longer before improvements are seen. It should be noted though that sperm production will start to decline after the age of 40 so age can play a part in sperm reduction and increases morphology issues.
Can acupuncture help male infertility?
Acupuncture can be used to help improve male sperm parameters. Acupuncture has been shown to increase sperm count and motility, and can increase the percentage of normal-form sperm. A study conducted by Feng et al in 2022, The efficacy and mechanism of acupuncture in the treatment of male infertility: A literature review, showed that acupuncture can effectively treat male infertility.
For more information regarding male fertility acupuncture, call YOLO Acupuncture on 07769 906962.
