Poor reproductive prognosis in severe teratozoospermia with a predominant sperm anomaly.

A retrospective examination of the semen analyses performed in our clinic from January 1979 to September 1986 revealed that approximately 15% of the patients were affected by severe teratozoospermia (greater than 80% abnormal forms and greater than 5 x 10(6) sperm/ml). In approximately 8% of these cases, a single predominant anomaly (same defect in greater than 50% of the sperm) was reported and confirmed by subsequent analyses (n = 37). The types of monomorphic teratozoospermia encountered in this study included round head (n = 6), amorphous head (n = 16), small head (n = 6), tapering head (n = 2), pin head (n = 1) and midpiece anomaly (n = 6). The clinical data suggest that familial genetic factors are probably involved in round head-monomorphic teratozoospermia, whereas testicular factors may be associated with amorphous head-monomorphic teratozoospermia. No matter what type of monomorphic teratozoospermia, the data in vivo (no pregnancies recorded in the follow-up period ranging from 2-8 years) and in vitro (negative SPAs) suggest a poor prognosis for the couples affected by this syndrome.