From the Guidelines
Astheno teratozoospermia is a male fertility condition characterized by reduced sperm motility and abnormal sperm morphology, and treatment typically involves lifestyle modifications and medical interventions, with the goal of improving sperm parameters and overall fertility potential, as recommended by the most recent guidelines 1.
Definition and Diagnosis
Astheno teratozoospermia is defined as a condition where a man's semen contains a high percentage of sperm with reduced motility (asthenozoospermia) and abnormal morphology (teratozoospermia) 1. The diagnosis of astheno teratozoospermia is typically made through a semen analysis, which evaluates various parameters of the semen, including sperm concentration, motility, and morphology, with reference limits established by the World Health Organization, as outlined in the 2024 AUA/ASRM guideline 1.
Treatment and Management
Treatment of astheno teratozoospermia typically involves a combination of lifestyle modifications and medical interventions, with the goal of improving sperm parameters and overall fertility potential. Lifestyle modifications may include quitting smoking, limiting alcohol consumption, maintaining a healthy weight, avoiding excessive heat exposure to the testicles, and consuming a balanced diet rich in antioxidants 1. Medical treatments may include clomiphene citrate (25-50mg daily) or human chorionic gonadotropin (HCG) injections to boost testosterone and sperm production, as well as treating underlying conditions such as varicocele through surgery, as recommended by the 2021 AUA/ASRM guideline 1.
Assisted Reproductive Technologies
If lifestyle modifications and medical interventions are unsuccessful, assisted reproductive technologies (ART) such as intrauterine insemination (IUI) or in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) may be necessary, as recommended by the 2021 AUA/ASRM guideline 1. IUI involves processing a semen specimen and placing the low volume washed semen into the uterine cavity at the time of ovulation, while IVF with ICSI involves fertilizing an egg with a single sperm in a laboratory, and then transferring the resulting embryo to the uterus.
Key Considerations
Key considerations in the treatment and management of astheno teratozoospermia include the importance of addressing underlying medical conditions, such as varicocele or hypogonadotropic hypogonadism, and the potential benefits and limitations of ART, as outlined in the 2024 AUA/ASRM guideline 1. Additionally, the use of antioxidant supplements and other nutraceuticals may be beneficial in improving sperm parameters, although the evidence for their effectiveness is limited, as noted in the 2021 AUA/ASRM guideline 1.
From the Research
Definition and Causes of Astheno Teratozoospermia
- Astheno teratozoospermia, also known as oligo-astheno-teratozoospermia (OAT), is a condition characterized by low sperm count, poor sperm motility, and abnormal sperm shape 2.
- The causes of astheno teratozoospermia can be genetic, with mutations in genes involved in flagellar assembly and motile regulation contributing to the condition 3.
- Other factors, such as deficiencies in certain proteins, like ORP4, can also lead to astheno teratozoospermia 4.
Treatment and Management of Astheno Teratozoospermia
- Treatment strategies for astheno teratozoospermia may include individualized homeopathy, which has shown positive effects in some cases 2.
- Dietary supplementation with a multi-micronutrient formula, including l-carnitine, l-arginine, and other nutrients, has also been shown to improve sperm quality and increase pregnancy rates in men with idiopathic male subfertility involving oligo-, astheno-, and teratozoospermia 5.
- Understanding the cellular and molecular pathways contributing to sperm motility reduction is crucial for developing effective treatment strategies for astheno teratozoospermia 6.