One would first try to use the patient's own sperm before switching to a sperm donor.
Teratozoospermia is diagnosed when, in a seminogram, there are less than 4% of spermatozoa with normal forms in the ejaculate, according to the WHO (World Health Organization) and it is considered as a possible cause of infertility in a couple. Generally, teratozoospermia is accompanied by other alterations in the seminogram, affecting concentration (oligotherotherozoopermia), motility (asthenotherotherozoospermia) and other combinations.
Morphological abnormalities of the spermatozoa can occur in the head, midpiece or tail. The head contains the genetic material and should be oval; the midpiece contains the mitochondria and is observed as a slight thickening between the head and tail; finally, the tail is a single elongated flagellum that allows movement of the sperm.
Any alteration in any of these components would result in an abnormal spermatozoon, which could hinder or prevent it from reaching the egg for fertilization.
The cause of teratozoospermia is not known exactly, but it is known that it can be affected by factors such as inadequate lifestyle habits (smoking, alcohol, poor diet, etc.), as well as varicocele, diabetes mellitus, chemotherapy, radiotherapy and vasectomy.
After the first diagnosis of teratozoospermia, it is advisable to improve lifestyle habits as much as possible and to repeat the semen analysis after a few months. After a second diagnosis, if the problem persists or if there are other abnormalities in the semen analysis, the treatment of choice is ICSI (intracytoplasmic sperm injection). This technique makes it possible to observe the spermatozoa under the microscope and select those with the best morphology for microinjection of the egg.
In case of severe teratozoospermia or if pregnancy is not achieved by ICSI with the patient's own sperm, donor sperm can be used.