Asthenospermia refers to a sperm abnormality affecting sperm motility. Less mobile, spermatozoa see their fertilizing power altered, with an impact on the fertility of man. The couple may then have difficulty conceiving.
Definition of Asthenospermia ?
Asthenospermia, or Ashtenzozoospermia, is a sperm abnormality characterized by insufficient motility of spermatozoa. It can alter the fertility of the man and reduce the chances of pregnancy of the couple because if they are not mobile enough, the sperm cannot migrate from the vagina to the trunk to fertilize the acolyte.
Asthenospermia can be isolated or associated with other sperm abnormalities. In the case of OATS, or oligo-astheno-teratozoospermia, it is associated with an oligospermia (sperm concentration lower than the normal values) and a teratozoospermia (an excessive proportion of spermatozoa of abnormal forms). The impact on human fertility will be even greater.
The causes of Asthenospermia
As with all sperm abnormalities, the causes of oligospermia can be numerous:
- An infection, a fever;
- Hormonal insufficiency;
- The presence of anti-sperm antibodies;
- Exposure to toxic substances (alcohol, tobacco, drugs, pollutants …);
- A genetic anomaly;
- A varicocele;
- Nutritional deficiency;
- General disease (kidneys, liver)
- Treatment (chemotherapy, radiotherapy, certain drugs)
Symptoms of Asthenospermia
Asthenospermia is not symptomatic, if not difficult to conceive.
Diagnosis of Asthenospermia
Asthenospermia is diagnosed by spermogram, a biological analysis of sperm systematically performed in humans during the infertility assessment of the couple. During this examination, different sperm parameters are evaluated, including sperm motility. This is the percentage of sperm capable of progressing from the vagina to the trunk to fertilize the acolyte. To evaluate this parameter, the biologists control, on a drop of sperm arranged between two blades, the percentage of spermatozoa capable of rapidly crossing the field of the microscope in a straight line. They study this mobility at two moments:
- Within 30 minutes to one hour after ejaculation for so-called primary mobility;
- Three hours after ejaculation for so-called secondary mobility.
The mobility of spermatozoa is then classified into 4 grades:
- A: normal, rapid and progressive mobility;
- B: decreased mobility, slow or weakly progressive;
- C: movements on the spot, not progressive;
- D: immobile spermatozoa.
According to the threshold values defined by the WHO (1), a normal sperm must contain at least 32% spermatozoa with progressive mobility (a + b) or more than 40% with normal mobility (a). Below this threshold, we talk about asthenospermia.
To confirm the diagnosis, a second or third spermogram should be performed at 3-month intervals (the duration of a spermatogenic cycle being 74 days) to confirm the diagnosis, because many parameters (infection, fever, fatigue, stress, exposure to toxins, etc.) can influence spermatogenesis and transiently alter sperm quality.
Other examinations complete the diagnosis:
a spermocytogram, an examination consisting in studying under the microscope the shape of the spermatozoa in order to detect any morphological abnormalities. In the case of asthenospermia in this case, an abnormality in the flagellum can alter the motility of the spermatozoon;
spermoculture to detect sperm infection that could alter spermatogenesis;
a migration-survival test (TMS), consisting in selecting the better spermatozoa by centrifugation and evaluating the percentage of spermatozoa capable of fertilizing the acolyte.
Treatment and prevention to have a child
Management depends on the degree of asthenospermia, other spermatic abnormalities that may be associated, particularly with regard to the morphology of the spermatozoa, and the results of the various examinations, the origin of asthenospermia (if found), the age of the patient.
In mild to moderate asthenospermia, treatment may be attempted to improve sperm quality. Supplementation with anti-oxidants that could promote the increase in the number and mobility of sperm, decreasing the oxidative stress, enemy of spermatozoa. An Iranian study (2) has shown that supplementation with Q-10 coenzyme, an antioxidant, improves the concentration and mobility of spermatozoa.
When it is not possible to treat the cause of asthenospermia or when treatments do not work, different MPA techniques may be proposed to the couple depending on the situation:
- In vitro fertilization (IVF);
- In vitro fertilization with microinjection (IVF-ICSI).