The ultrastructural abnormalities of human sperm flagella can cause sperm movement disorders. Dysplasia of the fibrous sheath (DFS) is an autosomal recessive genetic disease. The affected sperm in 95-100% of the patients display short, thick and irregular tails. Transmission electron microscopy can be used to confirm the diagnosis, which reveals gross abnormal flagella, with hypertrophy and hyperplasia of the fibrous sheath, without orderly disposition in longitudinal columns and transversal ribs. The axoneme shows variable distortion or almost complete obliteration. Microtubular doublets may exhibit partial or total lack of dynein arms. The genetic etiology of DFS is not yet clear. DFS does not affect the rates of fertilization and clinical pregnancy in ICSI, but due attention should be paid to the genetic risks in the offspring of the patient.