The clinical value of morphological rating of human spermatozoa.

The clinical fertility of 1,077 men whose semen had been analyzed between 1950 and 1952, in terms of types of abnormal spermatozoa morphology according to the Hammen system with 14 types, was studied 20 years later by means of a questionnaire (785 replies i.e., 72.9%). There was a significant difference (P less than or equal to 0.01) between couples who obtained living children and the couples who did not, expressed as the mean percentages of spermatozoa with narrow heads, round heads, amorphous heads, irregular heads, abortive forms, double forms, staining abnormalities and vacuoles. The same tendency was found for piriform heads, small heads, belted heads and various rare heads. Giant head showed no difference, and pinhead was not represented. Piriform heads and narrow heads increased significantly more than the other types (P less than or equal to 0.01) with increasing total number of abnormal spermatozoa. There was no relation between any abnormal type and abortions and otherwise abnormal pregnancies. Detection of types of abnormal spermatozoa morphology does not seem to improve semen analysis in terms of predicting chance of pregnancy, and we prefer to use the percentage of morphologically normal spermatozoa, the inverse expression of abnormal spermatozoal morphology as a total, for routine semen analysis.