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Updated: Jan 23, 2026

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Insight on multiple morphological abnormalities of sperm flagella in male infertility: what is new?

Wei-Li Wang1, Chao-Feng Tu1, Yue-Qiu Tan1,2,3

  • 1Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha 410078, China.

Asian Journal of Andrology
|June 19, 2019
PubMed

Insights

Multiple Morphological Abnormalities of the Sperm Flagella (MMAF) is a complex sperm disorder. This review clarifies MMAF definition, causes, genetics, and clinical implications for fertility treatments.

Area of Science:

  • Reproductive Biology
  • Human Genetics
  • Medical Science

Background:

  • Multiple Morphological Abnormalities of the Sperm Flagella (MMAF) is a specific asthenoteratozoospermia characterized by diverse flagellar defects.
  • While recognized since 2014, MMAF remains incompletely understood.
  • Distinguishing MMAF from similar sperm motility disorders is crucial for accurate diagnosis.

Purpose of the Study:

  • To systematically define MMAF and differentiate it from other conditions like primary mitochondrial sheath defects and primary ciliary dyskinesia.
  • To review current knowledge on the etiological mechanisms and genetic factors associated with MMAF.
  • To discuss the clinical significance of MMAF in the context of assisted reproductive technologies and genetic counseling.

Main Methods:

  • Systematic review of existing literature on MMAF.
  • Comparative analysis of MMAF with other asthenoteratozoospermia and asthenozoospermia conditions.
  • Synthesis of etiological, genetic, and clinical data.

Main Results:

  • MMAF presents with a spectrum of flagellar abnormalities including absent, short, bent, coiled, and irregular flagella.
  • Genetic underpinnings and etiological pathways of MMAF are being elucidated.
  • Understanding MMAF is vital for guiding intracytoplasmic sperm injection (ICSI) and genetic counseling.

Conclusions:

  • This review provides a foundational understanding of MMAF.
  • Further research is recommended to fully elucidate MMAF's mechanisms and clinical management.
  • Accurate diagnosis and genetic insights into MMAF improve reproductive outcomes.
Keywords:
asthenoteratozoospermiadisease-causing genesintracytoplasmic sperm injectionmale infertilitymultiple morphological abnormalities of the sperm flagella

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