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Male idiopathic oligoasthenoteratozoospermia

Giorgio Cavallini1

  • 1Operative Unit of Andrology, Società Italiana di Medicina della Riproduzione, Via Mazzini 12, 40138 Bologna, Italy. giorgiocavallini@libero.it

Asian Journal of Andrology
|February 24, 2006
PubMed

Insights

Idiopathic oligoasthenoteratozoospermia (iOAT), affecting 30% of infertile men, has multiple potential causes including infections and environmental factors. Therapies like carnitines and cinnoxicam show promise for improving male fertility outcomes.

Area of Science:

  • Reproductive Medicine
  • Urology
  • Andrology

Background:

  • Idiopathic oligoasthenoteratozoospermia (iOAT) is a significant cause of male infertility, impacting approximately 30% of affected men.
  • Potential iOAT causes include age, post-testicular organ dysfunction, infections (Chlamydia trachomatis, herpes, adeno-associated viruses), gamete and mitochondrial DNA alterations, environmental pollutants, and subtle hormonal imbalances.
  • Increased reactive oxygen species and apoptosis are implicated in reduced sperm concentration, motility, and morphology.

Purpose of the Study:

  • To review recent data on the causes, diagnosis, and therapeutic options for idiopathic oligoasthenoteratozoospermia (iOAT).
  • To evaluate the efficacy of various treatments for iOAT, focusing on sperm parameters and pregnancy rates.

Main Methods:

  • This mini-review synthesized recent research findings on iOAT.
  • Diagnostic approaches discussed include exclusion criteria and spectral traces of the main testicular artery.
  • Therapeutic interventions analyzed include tamoxifen citrate, testosterone undecanoate, folic acid, zinc sulfate, L-carnitine, acetyl-L-carnitine, cinnoxicam, alpha-blocking drugs, and tranilast.

Main Results:

  • Several factors are considered potential causes of iOAT, with oxidative stress and apoptosis playing key roles.
  • Therapies evaluated showed varying effects: cinnoxicam (8.5% pregnancy rate per couple/month), L-carnitine (2.3%), and tamoxifen + testosterone undecanoate (3.8%).
  • Alpha-blocking drugs improved sperm concentration, while tranilast showed promise for sperm parameters and pregnancy rates in initial studies, though its efficacy requires further confirmation.

Conclusions:

  • iOAT is a complex condition with multifactorial origins, often diagnosed by exclusion.
  • Certain therapeutic agents, particularly cinnoxicam and combinations involving carnitines, demonstrate potential in improving fertility outcomes for men with iOAT.
  • Further research is needed to definitively establish the efficacy of treatments like tamoxifen, testosterone undecanoate, and recombinant FSH for iOAT.

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