Sperm morphology: Its relevance to compensable and uncompensable traits in semen.

The nature of subfertility due to the male or inseminate is as complex as that of the female. Fertilization failure, and failure in embryogenesis, are both of seminal origin. Males also differ in the number of sperms required to reach their maximum fertilization rate. Males requiring more sperm are considered to have compensable seminal deficiencies. These include a number of known viability and morphology traits (including both abnormal heads and tails) and unknown factors (functional or molecular traits) precluding sperm access to the ovum or ability of the sperm to engage the ovum sufficiently to initiate fertilization and the block to polyspermy. Differences in fertility among males or inseminates independent of sperm dosage are considered uncompensable. These seminal deficiencies are associated with fertilizing sperm that are incompetent to maintain the fertilization process or subsequent embryogenesis (once initiated), with most failures occurring prior to maternal recognition of pregnancy; these sperm would pre-empt fertilization by competent sperm. Evidence now exists supporting the concept that the uncompensable effect is due to chromatin aberrations in morphologically normal or near-normal fertilizing sperm present in abnormal ejaculates (elevated content of abnormal sperm). Thus, sperm morphology may be our best indication for the presence of an uncompensable deficiency, although we have yet to identify the incompetent fertilizing sperm clinically.