Current Urology Reports

, 20:43 | Cite as

Sperm Morphology: History, Challenges, and Impact on Natural and Assisted Fertility

  • Rachel B. DanisEmail author
  • Mary K. Samplaski
Men's Health (A Dabaja, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Men’s Health


Purpose of Review

The classification of morphologically normal sperm has been progressively redefined. Concurrently, our understanding of the significance of sperm morphology in relation to male factor infertility has evolved. In this review, we will discuss the evolution of sperm morphology assessment and factors that contribute to its measurement variability. We will examine the impact of sperm morphology on natural pregnancy, IUI, IVF, and ICSI outcomes.

Recent Findings

There is a lack of consensus on sperm morphology classification, technique, and inter-observer grading variability. Current evidence suggests sperm morphology has low predictive value for pregnancy success, for both natural and assisted reproduction. Additionally, the threshold for what is considered an adequate percentage of morphologically normal sperm has changed over time. These variables have called into question the relevance of this variable in predicting fertility outcomes.


Our understanding of the impact of sperm morphology on reproductive outcomes continues to evolve and seems to play less of a role than initially thought.


Sperm morphology Semen analysis Teratozoospermia Infertility Assisted reproductive technology Male factor 


Compliance with Ethical Standards

Conflict of Interest

Rachel B. Danis and Mary K. Samplaski each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Reproductive EndocrinologyUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.Institute of UrologyUniversity of Southern CaliforniaLos AngelesUSA

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