Sperm Morphology After a Vasectomy Reversal 2023: Facts vs. Fiction
This article about sperm morphology is written by Matthew Marks, MS, TS (ABB), Arizona Andrology Lab and Cryobank’s andrologist and lab supervisor.
Bottom Line: Morphology is usually not important when it comes to natural conception (1).
Morphology is the term in laboratory measurement to describe how normal or abnormal the sperm look. To understand better, the percent of normal semen morphology (normal appearing sperm) in a normal human male is basically 5% or better. In other words, a normal healthy male can be putting out 95% abnormal, funny looking sperm and still have what is considered a “normal” semen analysis.
To make morphology even more confusing, there is very little consistency to the subjective morphology count. This means that what one lab tech can label as 3% normal another can describe as 14 % normal and both are considered acceptable variation. Plus, one tech might describe sperm anywhere from 0% normal to 14% normal from day to day, specimen to specimen.
Interestingly, when scientists analyze the DNA in sperm, some normal appearing sperm have abnormal DNA and some abnormal looking sperm have normal DNA, so using sperm appearance alone is not very useful or predictive for natural conception.
Women are all about quality and so put out one perfect egg each month. Men are just the opposite and are all about quantity, continuously making and putting out millions upon millions of sperm, mostly abnormal. Just as with salmon swimming upstream, we also know that only the healthiest of the healthy sperm will actually make it all the way up to the egg through all of the amazing filters in the female reproductive tract to result in a beautiful, healthy child.
The only time we worry about morphology with natural conception is with the morphology rate is consistently extremely low, such as 2 or 3% or less when associated and with possible issues with conception. Then we look for possible lifestyle causes for the low morphology (2) such as exposure to heat (yes, no hot baths, hot tubs, Jacuzzi’s or hot saunas) for 3 months before, excessive alcohol, tobacco, marijuana or exposure to many medications, drugs, some supplements, chemicals, toxic radiation or electromagnetic fields (3).
This is why couples are encouraged to follow a healthy lifestyle (4), exercise in moderation, maintain a healthy weight and keep cell phones away from his front pants pockets. Just the same, it is smart for all men to avoid laptops on their lap because of the heat and electromagnetic fields.
Antioxidant rich diets, high with colorful fresh fruits and vegetables, nuts and some vitamins and supplements have been shown reduce the oxidative stress and improve morphology over time (5).
Morphology is generally not an issue when it comes to natural conception and making babies the way they were designed, such as after a vasectomy reversal or even with IUI. The opposite is true when it comes to making the child using in-vitro fertilization (IVF) with ICSI (6), where morphology is important for IVF success rates.
In the assisted reproductive technique of IVF, the female fertility doctors (reproductive endocrinologists, also called REI) need just a few high quality perfect sperm and so morphology definitely can influence the success and outcomes of offspring conceived with in-vitro fertilization (IVF).
Misinformation about sperm.
Over the years we have heard from a number of patients around the country who were cautioned by their doctor that sperm after vasectomy reversals are always “abnormal,” have bad morphology and therefore vas reversals can not work. This is not true. There are many doctors that talk about “bad sperm” after a reverse vasectomy, when experts in male fertility have many couples with thousands of healthy babies after vas reversals.
The truth is that morphology is really irrelevant and the majority of correctly perform vas reversals are successful and the offspring are as normal as those conceived with natural conception. It is smart to stay on a healthy lifestyle, eat lots of colorful fresh fruits, berries, nuts and vegetables, take your Fish Oil, Vitamin D, Vitamins E and C (7) and don’t worry if your morphology is 5% or better!
For more information about sperm morphology or to ask questions about vasectomy reversals, please contact ICVR today! At that time, we can also set up a no cost office, Zoom, phone, Skype or Face Time consultation.
This page was reviewed, edited and updated June 13, 2023 by Sheldon Marks, MD.
References:
1.Shabtaie SA, Gerkowicz SA, Kohn TP, Ramasamy R. Role of Abnormal Sperm Morphology in Predicting Pregnancy Outcomes. Curr Urol Rep. 2016 Sept;17(9):67.
2.Sharma R, Biedenharn KR, Fedor JM, Argawal A. Lifestyle factors and reproductive health: taking control of fertility. Reprod Biol Endocrinol. 2013 Jul 16;11:66.
3.Kesari KK, Agarwal A, Henkel R. Radiations and male fertility. Reprod Biol Endocrinol. 2018 Dec 9;16(1):118.
4.Pacey AA, Povey AC, Clyma JA, McNamee R, Moore HD, Baillie H, Cherry NM; Participating Centres of Chaps-UK. Modifiable and non-modifiable risk factors for poor sperm morphology. Hum Reprod. 2014 Aug;29(8):1629-36.
5. Bisht S, Dada R. Oxidative stress: Major executioner in disease pathology, role in sperm DNA damage and preventive strategies. Front Biosci (Schol Ed). 2017 Jun 1; 9:420-447.
6.Ombelet W, Dhont N, Thijssen A, Bosmans E, Kruger T. Semen quality and prediction of IUI success in male subfertility: a systematic review. Reprod Biomed Online. 2014 Mar;28(3):300-9.
7.Showell MG, Mackenzie-Proctor R, Brown J, Yazdani A, Stankiewicz MT, Hart RJ. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2014;(12):CD007411.
