In the natural selection process, a spermatozoa with normal DNA is needed to achieve normal fertilization. Lack of fertilization, implantation or miscarriage will most likely occur if the spermatozoa that penetrates the egg (oocyte) is deficient in DNA.
Routine semen analysis (SA) provides the number, rate and quality of motility. We recommend infertility patients have SA performed in a laboratory specialized in Andrology and/or Reproductive Endocrinology which focuses on sperm shape, also called “morphology.” Normal morphology corresponds with DNA integrity. Any lab can give a good estimation of sperm count and motility but the normal morphology is harder to evaluate and needs well-trained eyes.
There are several known methods to check sperm morphology. The gold-standard method used by IVF and Andrology units around the world is the “Kruger Strict Morphology.” The sperm is stained with the Papanicolaou stain like the PAP smears. It requires more time, attention and training from the technician. This may surprise you, but as a rule, in any man, there is a relatively small number of sperm with normal DNA.
Our lab in Augusta, Georgia uses a very strict variation of the Kruger technique. We consider a morphology rate as normal if it is superior or equal to five percent. If it falls below three precent, the chances for natural conception or artificial insemination are compromised and are practically nil. In such cases, IVF/ICSI is strongly advised.