Treating Asthenozoospermia

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Treating Asthenozoospermia

Introduction
Symptoms
Risks
Causes
Biology
Diagnosis
Treatments
– Surgery
– Medication
– Supplements
– Environment
– Assisted Reproductive Technology

Updated: 18-Nov-2021

Introduction

Treating asthenozoospermia is a step-by-step process. The first step towards treatment is understanding and diagnosing the exact cause of asthenozoospermia in your individual case.

Asthenozoospermia (AZS), is defined as reduced or absent sperm motility (< 32%) in fresh ejaculate. It is one of the main causes of infertility in men and can occur in isolation or, like in the majority of cases, in conjunction with oligozoospermia (low sperm concentration) and teratozoospermia (abnormal morphology of the sperm cells).

Biologically asthenozoopsermia is associated with structural defects of the sperm flagellum (tail). The sperm flagellum is composed of a core axoneme (axial filament) and peri-axoneme structures surrounded by mitochondrial and fibrous sheaths.

Interestingly the sperm core ‘axoneme’ and ‘cilia’ of other cell types within the body, share similarities in their ultrastructure, that cases of asthenozoopsermia can occur as a result of primary ciliary dyskinesia or Kartagener’s syndrome.

However in the majority of cases asthenozoospermia is strictly due to morphological abnormalities of the sperm tail (absent, short, angulated or irregular).

Abnormal sperm motility (<25µm/s) alone doubles the level of DNA fragmentation.

Source: Zhang Z, et al. (2021)

In males diagnosed with asthenozoospermia, trying to conceive naturally, female partner progesterone levels may be a deciding factor. Progesterone receptors found on the outer membrane of sperm mitochondria show a clear pathway by which female progesterone levels can increase sperm ATP production and improve sperm motility.
Source: Tantibhedhyangkul J, et al. 2014

CAN ASTHENOZOOSPERMIA BE CURED

The success rate of curing asthenozoospermia depends strictly on the underlying cause. Anatomical and exogenous causes of asthenozoospermia can be treated successfully, however in cases of genetic or idiopathic (unknown) asthenozoospermia, there is no known cure.

Fortunately this does not mean your ability to successfully fertilize the embryo is nill, however the odds of successful fertilization, clinical pregnancy and live birth is significantly reduced.

A tailored fertility plan by your Doctor will minimize the overall time to conception.

IS IT POSSIBLE TO GET PREGNANT WITH ASTHENOZOOSPERMIA

Males with asthenozoospermia can still get their partner pregnant, however the actual chance of pregnancy per cycle varies significantly according to other sperm parameters, such as DNA fragmentation and lipid peroxidation, which is not assessed during the initial diagnosis of asthenozoospermia.

In this regard, the first step towards treatment is establishing the presence of any other abnormal sperm parameters followed by identifying the underlining cause/s of low sperm motility through a variety of tests.

Symptoms of Asthenozoospermia

The symptoms of low sperm motility are similar to men diagnosed with oligospermia or azoospermia. The primary symptom is the inability to conceive a child despite 1 year of frequent and unprotected intercourse.

Other symptoms may include

  • Erectile dysfunction or low sex drive
  • Pain or swelling in testicles
  • Changes in body hair indicating hormonal abnormality

Risks associated with Asthenozoospermia

Men suffering from abnormal sperm parameters are susceptible to further issues such as

  • Stress, loss of self-esteem and relationship issues due to difficulties trying to conceive
  • Increased risk of cancer

CANCER

Several studies to date have found an association between abnormal semen analysis, including poor motility, and a higher risk of cancer. Although the exact reason for this link has yet to be identified infertile men should consult their Doctor to discuss long-term monitoring strategies.
Source: Hanson H A, et al. (2016); Eisenberg M L, et al. (2015); Jacobsen R, et al. (2000)

Causes of Asthenozoospermia

Some of the possible reasons for low sperm motility are;

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