Your Sperm Shape Impacts Fertility
For most cases of male infertility, which affects about 1 in 10 adult men, sperm health is the primary cause. Sperm health is categorized by having an adequate sperm count, motility, and morphology. While sperm count and motility are well-known fertility markers, few individuals know about the impact of sperm morphology. A healthy sperm shape, known as sperm morphology, is necessary to swim properly and penetrate the egg. A normal sperm has an oval-shaped head, midpiece, and long, straight tail. Abnormal morphology can mean misshapen heads, bent tails, or irregular midpieces. Some severe cases need assisted reproductive technology (ART) such as intracytoplasmic sperm injection (ICSI) to improve pregnancy rates. ICSI success rates are the reason why this option is used for cases of poor sperm morphology.
Understanding ICSI for male infertility
Intracytoplasmic sperm injection is an effective strategy for severe male infertility. The procedure acts as an alternative form of in vitro fertilization (IVF), where egg and sperm are combined to create embryos to implant into a woman’s uterus. With conventional IVF, each embryo is created using a sample containing millions of active sperm that naturally attempt to fertilize an egg. With ICSI, however, a single healthy sperm is used to create an embryo. The fertility team carefully selects the best available sperm to inject directly into the egg, sometimes using assisted hatching to improve results. This technique is vital for men who have significantly low sperm counts or severely damaged sperm. Clinics may use ICSI in about 64% of IVF cases, with many due to poor sperm morphology.
Why ICSI helps sperm morphology
The shape of each sperm plays a crucial role in fertilizing eggs and achieving pregnancy. Sperm shape penetrates the egg's outer layers, whether in natural conception or IVF. Even in fertile men, most sperm can have abnormal shapes. When morphology falls below 4%, however, doctors consider this poor morphology, potentially contributing to fertility challenges. ICSI is designed to bypass sperm issues that cause severe male infertility. Using high magnification, fertility specialists can find and select the best sperm in each sample. Even when most sperm in a given sample are compromised, ICSI can locate the best, create viable embryos, and continue the IVF process. Only a single healthy sperm is needed among millions, making ICSI the most accurate option for severe infertility.
What are the success rates?
The good news is that ICSI has good success rates, even with poor sperm morphology. ICSI can produce similar success rates to conventional IVF. For men with severe morphology, the success rates may even be higher. While ICSI is useful for poor sperm morphology, other factors influence success rates. Egg quality, for instance, plays an equally important role in embryo development and IVF success. Other sperm markers, like motility and sperm count, also impact outcomes. Sperm DNA fragmentation, which isn't measured in standard semen analysis, may be more important than morphology for embryo development. Most of all, the expertise and care shown by the fertility clinic matter. Clinics with a history of ICSI and highly skilled embryologists can be a difference-maker.
Starting a family is possible with ICSI
Severely impaired sperm is the primary reason for male-factor infertility. Poor morphology can be overlooked as a factor, but sperm shape plays a crucial role in fertilization. IVF has addressed many sperm-related challenges, but ICSI goes a step further, using a single sperm. Success rates are as high as those of conventional IVF, which is especially promising news for men with morphology challenges. ICSI due to morphology can work, but may take multiple cycles. The key is working with an experienced fertility clinic, remaining patient through the process, and optimizing until success is achieved.
