Test Catalog

Test ID: MSTC    
Strict Criteria Sperm Morphology for Infertility Diagnosis and Treatment, Semen

Useful For Suggests clinical disorders or settings where the test may be helpful

Diagnosing male infertility


Selecting the most cost-effective therapy for treating male-factor infertility


Quantifying the number of germinal and WBCs per mL of semen

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Infertility affects 1 out of 6 couples of child-bearing age. Approximately 40% of infertility has a female-factor cause and 40% a male-factor cause. The remaining 20% of infertility is due to a combination of male- and female-factor disorders or is unexplained.


Abnormalities in sperm morphology are related to: defects in sperm transport, sperm capacitation, the acrosome reaction, binding/penetration of the zona pellucida, and fusion with the oocyte vitelline membrane. All of these steps are essential to normal fertility.


Strict criteria sperm morphology testing also greatly assists with selecting the most cost-effective in vitro sperm processing and insemination treatment for the couple's IVF cycle. Sperm with severe head abnormalities are unlikely to bind to the zona pellucida. These patients may require intracytoplasmic sperm injection in association with their IVF cycle to ensure optimal levels of fertilization are achieved. This, in turn, provides the patient with the best chance of pregnancy.


Multiple semen analyses are usually conducted over the course of the spermatogenic cycle (approximately 70 days).

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Normal forms

> or =4.0%

Germinal cells/mL

<4 x 10(6) (normal)

> or =4 x 10(6) (Elevated germinal cells in semen are of unknown clinical significance)


<1 x 10(6) (normal)

> or =1 x 10(6) (Elevated white blood cells in semen are of questionable clinical significance)

Interpretation Provides information to assist in interpretation of the test results

Categorizing sperm according to strict criteria based on measurements of head and tail sizes and shapes. Sperm with abnormalities in head/tail size/shape may not be capable of completing critical steps in sperm transport and fertilization.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Conventional semen analysis (FER / Semen Analysis) should be performed in conjunction with each strict criteria sperm morphology.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Kruger Morphology Conference, Boston, MA, October 9, 1993

2. The World Health Organization Laboratory Manual for the examination of human semen and sperm-cervical mucus interaction. Fifth Edition. Cambridge University Press, 2010