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Last updated: Apr 28, 2022
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Sperm morphology: what is it, and how does it affect fertility?

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Medically Reviewed by Raagini Yedidi, MD

Written by Gina Allegretti, MD


If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Sperm morphology is one of the contributing factors to male fertility and refers to the shape of a sperm cell’s head, neck, and tail. This article discusses sperm morphology’s role in fertility, what it means if you have abnormal sperm morphology, and how to improve the shape of your sperm.  

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What is sperm morphology?

Sperm morphology refers to the shape of individual sperm. 

A sperm is made of different parts: a head, neck, and tail. Each part has its own “ideal” shape, and an abnormality in shape can happen in any part of the sperm. According to the World Health Organization (WHO), when less than 30% of the sperm in a sample have normal morphology, it’s called teratozoospermia (Seracevic, 2009). 

Normal sperm morphology vs. abnormal sperm morphology 

A sperm with normal morphology has these characteristics (WHO, 2010):

  • It should have a smooth, oval-shaped head that contains genetic material (DNA). 
  • It should have a slender neck that extends from the head. 
  • It should have a single tail (flagellum) that’s thinner than the neck and is about 10 times as long as the sperm head. That’s about 5060 micrometers long. That’s a lot smaller than it sounds. For reference, it’s shorter than the thickness of a piece of paper. 

Abnormal sperm are missing some of these characteristics. For example, an abnormal sperm may have a double tail or a misshapen head. It’s perfectly normal to have some abnormal sperm. What matters is that you have enough sperm with normal morphology so that one is able to swim to and fertilize an egg. 

Sperm morphology range

Important ranges to be aware of when considering sperm morphology are as follows (WHO, 2010; Cooper, 2010):

  • Over 14% of sperm with normal morphology: high probability of fertility
  • 4–14% of sperm with normal morphology: slightly decreased fertility
  • Less than 4% of sperm with normal morphology: If the sperm morphology is 03%, it’s considered very low, and is likely to contribute to male factor infertility 

How does sperm morphology affect fertility? 

Abnormally-shaped sperm can affect fertility in many ways. 

For example, if a sperm’s tail is abnormal, it may not be as able to propel itself towards an egg. If the head, neck, or DNA are abnormal, the sperm might not be able to fuse with the egg (acrosome reaction) and fertilize it (Abu Hassan Abu, 2012). 

Abnormal DNA may lead to increased sperm death (apoptosis). It has also been linked to decreased overall semen quality and could decrease the likelihood of fertilization occurring (Agarwal, 2014). 

Other sperm parameters

Morphology is not the only factor that can impact semen quality. Male fertility also depends on other characteristics, including (Wang, 2014): 

  • Sperm count: The total number of sperm 
  • Sperm motility: The ability of sperm to move forward
  • Sperm vitality: The amount of live sperm 
  • Semen volume: The amount of semen in an ejaculate

Sperm morphology testing

A healthcare provider or technician can perform a semen analysis in a laboratory. This is a test that looks at different parameters of your sperm. They can check sperm morphology from a semen sample by examining the sperm under a microscope to visualize their size and shape. They can also analyze samples using specialized machines (Wang, 2014; Kruger, 1995).

It’s not always convenient or comfortable to go to a healthcare facility for a sperm analysis, but there’s good news—sperm test kits let you check your sperm from the comfort of your home. 

Studies suggest that some of these test kits are helpful and accurate screening tools to detect sperm abnormalities, though you should always follow up with a healthcare provider if you have an abnormal result (Schaff, 2017; Yu, 2018). 

How to improve sperm morphology

If you’ve been diagnosed with abnormal sperm morphology, there may be things you can do to help improve it. For example: 

  • Stop smoking: Cigarette smoking can damage sperm shape and motility, so cutting back on tobacco may improve your sperm quality (Mohamad Al-Ali, 2017). 
  • Cut back on alcohol: Alcohol can harm sperm morphology and motility and decrease semen volume, so decreasing alcohol intake may improve these parameters (Finelli, 2021). 
  • Move your cell phone: Radiation from cellular phones can damage sperm DNA and cause abnormal morphology. Keeping your phone away from your pelvis might be safer for your sperm (Hassanzadeh-Taheri, 2022).   
  • Reduce excess weight: Losing weight (when appropriate) may improve sperm motility and morphology, though the evidence for this is inconclusive (Håkonsen, 2011).  
  • Exercise: Some studies suggest that regular physical activity is linked to better sperm morphology, though the data is not conclusive (Vaamonde, 2012; Gaskins, 2015).  
  • Take nutritional supplements: There’s some evidence that nutritional supplements, like Vitamin E and selenium, may improve semen quality and sperm morphology, though not all experts agree (Liu, 2017Moslemi, 2011). 

How to get pregnant with abnormal sperm morphology

Not all people with abnormal sperm morphology will experience infertility, and some people with abnormal sperm morphology can conceive without intervention. 

If you do experience infertility, there are several assisted reproductive technologies (ARTs) that may help, including: 

  • IVF (in vitro fertilization): With IVF, a healthcare provider combines a sperm and egg outside the body before inserting the fertilized egg into a uterus.  
  • ICSI (Intracytoplasmic sperm injection): With ICSI, a healthcare professional identifies a healthy sperm and uses a tiny needle to inject the single sperm directly into an egg, which can then be implanted into a uterus (O’Neill, 2018). 
  • IUI (intrauterine insemination): With IUI, a healthcare provider injects sperm directly into the uterus, so it doesn’t need to travel far to reach an egg. Studies show that this procedure may be effective in people with teratozoospermia (Francavilla, 2009). 

If you’ve been told that you have abnormal sperm morphology, remember that while sperm morphology contributes to fertility, abnormal sperm morphology doesn’t always mean you can’t fertilize an egg. 

There are things you can do to improve your sperm morphology and ARTs that can help if you experience infertility. Your healthcare provider can advise you on the best treatment options. 


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