Oligozoospermia is defined as the presence of a low number of spermatozoa in the ejaculate (less than 15 mill/ml according to WHO); asthenozoospermia as the presence of a reduced number of progressive motile spermatozoa (less than 30% according to WHO); and teratozoospermia as the presence of a number of spermatozoa with a normal morphology of less than 5%. Thus, oligoastenothermia will be the sum of the three, that is, semen with less than 15 million spermatozoa per milliliter, 30% progressive motility and 5% with normal morphology.
The causes of oligoastenoteratozoospermia are very varied and are not easy to specify, only a clear diagnosis is reached in 20% of cases. In the rest of patients oligoastenatozoospermia will be of unknown or idiopathic cause.
Among the known causes are:
- Hyperprolactinemia
- there is an increase of prolactin in blood. It can be treated pharmacologically when it is mild and by surgery if it is severe.
- Prostatitis and urinary tract infections
- is the presence of a bacterial infection in the prostate or urinary tract. It is easily treated with antibiotics.
- Hypo or hyperthyroidism
- lowering or elevation of thyroid hormones. Adequate treatment by the endocrinologist can improve the seminal quality of these patients.
- Genetics
- such as the microdeletions of the Y chromosome, there is no treatment.
- Hypogonadotropic hypogonadism
- when there is a problem in the production of FSH and LH hormones. It can be treated by administering these hormones.
- Varicocele
- consists of the presence of varicose veins in the spermatic cord. Only very severe cases are treated with surgery.
- Consumption of toxic substances
- it has been demonstrated that the consumption of tobacco, alcohol or drugs, including marijuana, produce a decrease in the quality of semen, therefore, the drastic reduction of its consumption will improve.
In cases where the cause is not known, an empirical treatment with antioxidants or antiestrogens can be used. These treatments must last at least three months and their effectiveness has not been proven.
In conclusion, there are only a few patients with oligoastenothermia who can benefit from a specific treatment, the rest of patients could use empirical treatments and try to lead a healthy lifestyle. In most cases, assisted reproduction is the only treatment for them.
