semen analysis - morphology

[woewoe148]

Hi, my busband as done a test on semen analysis recently. Everything was fine, except for the Morphology. The details are as follows:

Volume: 4.0 ml
Count: 105 million/ml
Motility: 95%
Morphology: 60% (The reference stated in the report is = or >70

I searched the Wikipedia and I am confused about two points. The quote is as below. My questions are

1) it appears that based on WHO, the reference point is 30%. But why is it that the standard stated on my hushand's report is 70.

2) Based on the Wikipedia, it appears that based on WHO, the reference is 30%. Based on another strict test, the % is 14%, i.e., Men with 14% normal forms are considered normal and okay. How come the stricter test's reference point is even less than that for WHO ? Did I misunderstand something ?

In anycase, does my husband's result (60%) show the low ability for fertile ?

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Morphology = shape of spermatozoa: Several techniques have been described to evaluate sperm morphology. Sperm are classified into normal-oval shaped, tapered, amorphous, duplicated and immature. Normal spermatozoid must have an oval form with smooth contour, acrosomal cap encompassing 40-70% of head, no abnormalities of midpiece, or tail and no cytoplasmic vacuoles of more than half of the sperm head. Head size is 5-6m M x 2.5-3.5m M. Any borderline sperm are counted as abnormal( amorphous, tapered,duplicated, immature, coiled tail, blunted tail, midpiece abnormalities). The predictive value of sperm morphology in determining pregnancy rates is low

a. WHO criteria: >30% normal forms ( 100 cells evaluated)
b.Strict criteria (higher predictive value in determining rates of pregnancy in IVF program) are based on the morphology of postcoital spermatozoa found at the level of the internal cervical os. 100 cells evaluated for only normal sperm (>14% normal forms). Men with fewer than 4% normal forms usually failed to fertilize without micromanipulation. Strict criteria for normal sperm morphology include:

Sperm head: Smooth oval configuration. Length-5-6 microns. Width:2.5-3.5 microns. Acrosome comprises 40-70% of the anterior sperm head
  Midpiece: Axially attached, 1.5 times the head length, £ 1m m in width
Tail: Straight, uniform, slightly thinner than the midpiece, uncoiled, ± 45m m long

[LandM2009]

I don't know anything about the WHO reference. There is the general SA then when they are concerned about morphology they will run the strict test. On the strict test anything under 4% they usually recommend IVF. Your husband's numbers do not sound bad if he has 60% normal forms.

[woewoe148]

Hi LandM2009, do you mean there are two readings from two different tests ? I was thinking there is only one reading for the test. For example, 25%. If you interpret this using the WHO refererence, this is no good (because  14%).

Is my above understanding correct ?

[LandM2009]

I was just thinking the same thing. My husband has 18% normal, but on a strict morphology test he is a 2%. Not good. If you are concerned you could have a strict test done.

[melon3]

Hi there,
            Im no medical expert but 60per cent sounds fine to me. My dh has only 4 per cent normal forms and we are seeing a specialist!