Asthenospermia - causes, diagnosis and treatment
Medically Reviewed by Dr Sravya, MBBS, MS
Introduction
Asthenospermia, also known as asthenozoospermia, is an infertility condition in which a person has reduced sperm motility (the ability of sperm to move). Reduced sperm motility makes it less likely that sperm will fertilize an egg in the female reproductive tract.
One in 5000 men experience complete asthenozoospermia, or 100% immotile sperm in the ejaculate. The capacity to move sperm is known as sperm motility. Sperm comes in two varieties: those that can swim and those that cannot. Keep in mind that only sperm with rapid forward motion can swim to the egg and fertilize it; all other sperm are ineffective.
According to the criteria of the World Health Organization (WHO) manual, mobility is graded from A to D as follows. Grade a (fast progressive) sperm are those that swim forward quickly in a straight line – like cruise missiles. Sperms in grade B (slowly progressive) move forward, but they do so either slowly (slow linear or non-linear motility) or in a curved or crooked line. Sperm of grade C (non-progressive) have local motility only; they move their tails but do not advance. Staggered (immotile) sperm do not move at all. Grade c and d sperm are considered bad.
It decreases sperm quality and is therefore one of the major causes of infertility or reduced fertility in men. Intracytoplasmic sperm injection, or ICSI, is a technique to increase the likelihood of conception. Between 0 and 100% of the sperm in a full asthenospermia are viable.
A man with weak sperm motility may have male factor infertility. Because improperly coordinated sperm will not be able to fertilize the egg in time. For pregnancy with low sperm motility, at least 50% of the sperm should be motile and contain more progressive motility. The causes of complete asthenozoospermia include metabolic deficits and ultrastructural abnormalities of the sperm flagellum.
Symptoms of Asthenospermia
Physical Symptoms: -
Unlike some medical conditions that present with noticeable physical symptoms, asthenospermia itself does not cause any specific physical symptoms. It is usually identified through laboratory tests performed during fertility investigations.
Also known as “weak sperm” asthenospermia is a condition that affects sperm motility. Although it may not manifest itself in visible physical symptoms, it can have significant consequences for couples trying to conceive.
When sperm do not have the ability to swim properly, their chances of reaching and fertilizing an egg are greatly reduced. This reduced mobility can be the result of a variety of factors, including genetic abnormalities, hormonal imbalances, or structural problems in the reproductive system.
Asthenospermia doesn’t immediately create physical symptoms, but it can have an impact on a couple’s physical health in other ways. The stress that can result from trying to conceive but failing can have a negative impact on one’s health in general.
Emotional and Psychological Impacts
Although asthenospermia may not directly cause physical symptoms, it can nonetheless have an emotional and psychological impact on people and couples who are having trouble getting pregnant. Stress, frustration, worry, and even melancholy can result from being unable to conceive a child. It is crucial that folks who are going through these feelings get support from medical professionals or fertility counsellors.
The emotional toll that infertility has on people and couples should not be understated because it can be a difficult journey. A deeply embedded human inclination, the desire to have children can give rise to a wide range of complicated emotions when such desires are thwarted.
The news can be especially upsetting for males who have been diagnosed with asthenospermia. The substantial importance society frequently places on virility and the capacity to father children can exacerbate feelings of inadequacy or self-doubt. Men must always keep in mind that infertility is a medical condition and that asking for help is a show of strength rather than weakness.
When asthenospermia is diagnosed, women may also feel a great feeling of loss and disappointment. It can be quite stressful to feel pressured by society to have kids and to worry that you won’t be able to. Finding good coping techniques and seeking emotional support are crucial stages in overcoming the emotional difficulties associated with infertility.
It’s crucial for couples to express their emotions through open communication and to get expert assistance when necessary. The emotional rollercoaster that frequently accompanies infertility can be managed by individuals and couples with the help of fertility counsellors who can offer direction, support, and coping techniques.
A person or a relationship is not defined by infertility, keep in mind. With the correct assistance, individuals and couples can discover hope and resiliency on their route to starting a family. There are many medical therapies and alternative parenting paths accessible.
Asthenospermia causes
There are many causes of asthenospermia, including the following:
- Inflammation: Inflammatory diseases of the spermiogram or any other reproductive organ can reduce sperm motility. Sperm can be negatively impacted by these diseases' microbes, which slow down their movement and reduce their capacity to penetrate cervical mucus.
- Varicocele: This condition causes the scrotal veins to expand. One of the typical causes of asthenospermia in males is this.
- Abnormal liquefaction of sperm: Abnormal liquefaction of sperm reduces the space for sperm activity and hinders sperm movement.
- Chromosome abnormalities: Sex chromosome abnormalities can affect not only sperm count but also sperm motility, increasing the chance of infertility.
- Immunological factors: Antibodies to sperm inhibit sperm activity in various ways. Studies suggest that the presence of anti-sperm antibodies around the sperm's tail reduces its ability to penetrate the cervical mucus.
- Lifestyle and environmental factors: Some unhealthy lifestyle habits significantly affect sperm motility. For example, smoking, excessive drinking and drug use can cause this condition. Men who have jobs such as driving or riding that cause repetitive trauma to the pelvic area are also at risk for asthenospermia.
- White blood cells (pus cells) in the Semen : - Low sperm motility or Infertility is frequently a result of white blood cells (WBCs), also known as pus cells, in the semen. Leucospermia, which is defined as a high concentration of white blood cells (pus cells) in semen, may be an indicator of an infection. A typical threshold is more than 1 million white blood cells per milliliter of semen, though cutoffs can vary.
- Aging: - Aging is the process of growing old, it is also a cause of asthenospermia or infertility In males.
Asthenospermia Diagnosis
The diagnosis of asthenospermia involves studying fresh sperm samples under a microscope to confirm sperm motility and identify causes. Sperm may also lose their motility due to exposure to spermicides, rubber (condoms), adverse temperatures, and delays between production and final examination. This is not counted as part of the immobility associated with the identification of asthenospermia. Blood tests to measure
hormone levels may also be part of the diagnosis.
When evaluating sperm for asthenospermia, other sperm parameters are also evaluated. the quality, colour, pH, and consistency of semen, the presence of immature sperm, and the presence of yeast or bacteria. In addition, sperm shape and count are also evaluated. Since the ejaculated sperm must penetrate the cervical mucus to reach the uterus and finally the fallopian tube where the egg awaits, sperm motility is very important to the fertilization process.
Asthenospermia Treatment
Treatment for asthenospermia depends on the cause. The presence of bacteria and pus cells can be treated with antibiotic treatment. Surgical correction of varicocele can improve sperm motility. Frequent ejaculation and avoiding long abstinence also help. Sometimes intercourse can cause the infection to spread from one partner to another. It is helpful to use appropriate systemic and topical antibiotics to treat a partner suffering from a vaginal infection.
Sperm processing using various techniques such as swimming, density gradient, and microfluidics at the time of intrauterine insemination can be useful. When motility is very low, intracytoplasmic sperm injection (ICSI) can be a good solution. ICSI is a procedure where a single sperm is inserted into the egg using a very fine micromanipulation device. This can overcome blockage of fertilization due to very low sperm count, motility, or morphology.
ICSI is an advanced form of IVF (in-vitro fertilization). An IVF treatment cycle includes ovarian stimulation and egg retrieval. To find out if ICSI is the right procedure for you, speak with a fertility doctor.
Know that there are substances that can aid with motility once a healthier stage in your life has been established. When used properly, vitamin E and selenium have been shown to greatly enhance sperm count and velocity. This may be the only additional regimen you need to address the issue. The use of prescription medications that balance hormone levels will help your condition when medical intervention is required.
Utilizing reproductive technologies and motility treatments, it is possible to conceive naturally. Your odds of success are considerably increased by in-vitro fertilization and in-utero fertilization, which avoid the requirement for sperm to swim and penetrate on their own. Idiopathic male infertility (IMI) is largely caused by oxidative stress, and several antioxidants have been used to treat IMI with varying degrees of success. Patients with idiopathic oligoasthenospermia (OA) may experience improved semen parameters and decreased oxidative stress thanks to the cofactor and antioxidant coenzyme Q10 (CoQ10).
Discuss your options for testing and treatments that will increase your chances of conception with a doctor if you and your spouse have been trying to conceive for twelve months or more. Couples that experience poor motility know they are not alone in their frustration. As you begin the exciting new path of parenthood, you will experience success with early intervention and everyday lifestyle modifications.