Teratozoospermia is considered to be one of the most challenging phenomenon of male infertility at proper diagnosis and therapy. In this report, we described controversies regarding current methods of evaluation of sperm morphology and predictive value of this sperm feature in connection to assisted reproduction and/or functional sperm tests in vitro. It is indicated possible molecular background of teratozoospermia in respect to revealed chromosome aberrations and particular genes of which mutations may affect a sperm morphology and function. The own experience in research conducted in this field is also underlined.