Here are three studies showing the low significance of morphology if the range if even 3% or greater normal forms. Hopes this helps some people out. I have read the full studies, but just posted the abstracts or conclusions for simplicity.
"Prospective and retrospective studies were conducted to evaluate sperm morphology using strict criteria for predicting fertilization capacity in males. Severely impaired male fertility potential was measured by a result of <4% (denotes percentage sperm having normal morphology) and scores of > 14% indicated normal fertilization potential. There were no statistically significant differences found in pregnancy rates in partners of men with normal morphology of <4% vs. those with 14% or greater (x2 analysis): the prospective study showed a 41 % pregnancy rate in <4% group vs. 29% rate in > 14%
group @ - 0.44 NS); the retrospective analysis showed a 50% pregnancy rate in the group with <4% morphology scores vs. 67% in > 14% group @ - 0.45 NS). When only the men with normal motile
density (> 10 x 106/ml) were evaluated, a statistical difference was found in the retrospective study between the group with morphology results > 14% (93%)
vs. the group <4% (40%). However, the 56% success rate in the men with < 10 x 106/ml sperm and normal morphology <4% reduces the significance of the diagnosis of sperm morphology using the new strict criteria."
Source: EVALUATION OF SPERM MORPHOLOGY USING
KRUGER’S STRICT CRITERIA
J. H. CHECK, H. G. ADELSON, B. R. SCHUBERT,
and A. BOLLENDORF
(Done in 1996)
__________________
This is another study classifying the minimum as 3%. (I'm a university student so have access to library database to read the studies)
In this study, the semen analysis results of a fertile population were compared with those from a subfertile population, in order to establish normal cut-off values for the standard semen parameters with the aid of receiver operating characteristic (ROC) curve analysis. The fertile group comprised healthy males (n = 107) without any history of fertility problems, the partners of whom had had a spontaneous pregnancy within one year of unprotected intercourse and were pregnant at the time of the male's inclusion into the study. A total of 103 males from couples attending the infertility clinic, and with an initial sperm count of <20×106/ml were recruited to form the subfertile population. The best discriminating parameter between the two populations was sperm morphology evaluated according to WHO criteria at a cut-off point of 31% normal spermatozoa. The other cut-off values were at 8% for the acrosome index, 45% for motility, and 4% normal spermatozoa for strict criteria. Recalculating the ROC curve cut-off values based on an assumed 50% prevalence of subfertility in an assisted reproductive setting, the cut-off points were reduced to 21% and 3% normal spermatozoa for WHO and strict criteria respectively. For motility, the new cut-off value was at 20% motile spermatozoa, for motility quality at 3.5 (on a scale of 1–6), the acrosome index at 3% normal acrosomes, and the teratozoospermia index at 2.09.
(Done in 2000)
Roelof Menkveld1, Wai Yee Wong2,3, Carl J. Lombard4, Alex M.M. Wetzels2, Chris M.G. Thomas2,5, Hans M.W.M. Merkus2 and Régine P.M. Steegers-Theunissen2,3,6
____________
Study of Sperm Morphology in Fertile Pakistani Men
Mohammad Owais Ahmad, Saadat Ali Khan, M. Amjad Hameed**, Umar Ali Khan**
Departments of Physiology *Foundation University Medical College and **Islamic International Medical College, Rawlapindi. Pakistan
Pak J Physiol 2007;3(2)
Background: The aim of this study was to determine the sperm morphology of proven fertile
males and to compare the same with that of infertile males. Method: This study was carried out at
International Medical College Rawalpindi and its attached Railway hospital and Islamabad Clinic
Serving Infertile Couples Islamabad, from June 2005 to July 2006. 50 healthy fertile males were
selected and their semen morphology was determined according to Tygerberg’s strict criteria,
while another 50 infertile males were recruited as controls Results: Proven fertile group showed
significantly higher morphologically normal forms of sperms (3.04 ± 1.63) than the infertile
group (0.92+-0.72). Conclusion: Sperm morphology assessed by strict criteria is of value in the in-vivo situation to identify a group with greater chance of having an infertility problem and strict criteria sperm morphology analysis should be used to minimize variations in intra and inter-individual and inter-laboratory sperm morphology assessment.
Conclusion: Around 3% normal morphology was the average for the fertile group. The range found in the fertile men was only 0-8%. The maximum morph found was 8%. CRAZY!
________
WEBSITE WITH MORPH AND CONCENTRATION SPECIFIC INFO:
Chart comparing monthly probability of natural conception in comparison to sperm morphology. First chart I've seen with this info. https://metrovanurology.com/content...ability of Pregnancy Using the Semen Analysis
Figure: Morphology and Pregnancy. The main thing to note is that there is a gradual but small decreae in the probability of conception as morphology declines. It should be noted that the effect of morphology on the probability of conception is relatively minor compared to that of concentration. Modified from Bonde et al. Relation between semen quality and fertility: a population-based study of 430 first pregnancy planners. Lancet 1998. Specifically, the old WHO morphology criteria have been changed to the Kruger Strict criteria for illustrative purposes.
"Very commonly, the only 'abnormality' on a semen analysis report will be the morphology - the concentration and all other parameters will be 'within reference range'. This is known as isolated teratospermia. Most patients are alarmed at this. While a decrease in morphology can be associated with a decreased probability of conception, this is one instance in which there is probably no effect on the chances of conception and the morphology can be safely ignored." -Quoted from website.
