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Necrozoospermia: The tree that hides the forest
Angèle Boursier1, Agathe Dumont2, Florence Boitrelle3
1Institut de Biologie de La Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, CHU Lille, Lille, France.
Andrology
|March 5, 2022
Summary
Necrozoospermia, a male infertility cause, stems from testicular or post-testicular damage often involving oxidative stress and sperm DNA fragmentation. Investigating its causes can lead to treatments, potentially avoiding or improving outcomes with intracytoplasmic sperm injection (ICSI).
Area of Science:
- Reproductive Medicine
- Andrology
- Infertility Research
Background:
- Necrozoospermia affects 0.2%-0.4% of male infertility cases.
- Potential causes include testicular/post-testicular damage, reactive oxygen species (ROS) production, and sperm DNA fragmentation (SDF).
- These factors can negatively impact natural conception and assisted reproductive technology (ART) success rates.
Purpose of the Study:
- To explore the etiologies, diagnostic approaches, and therapeutic strategies for necrozoospermia.
- To emphasize management options prior to intracytoplasmic sperm injection (ICSI).
Main Methods:
- A comprehensive literature search was conducted across major databases (PubMed/Medline, Web of Science, Cochrane Library) and institutional websites.
- Keywords included "necrozoospermia", "sperm vitality", "sperm viability", "SDF", and "ICSI".
Main Results:
- Twelve primary etiologies contributing to decreased sperm vitality and varying degrees of necrozoospermia were identified.
- Recommended management includes thorough check-ups, etiological treatments when possible, and interventions like repeated ejaculations or drug therapies.
- For non-treatable cases, ICSI with ejaculated or surgically retrieved sperm is an option.
Conclusions:
- Investigating necrozoospermia's causes is crucial as many are correctable, potentially obviating the need for ICSI.
- Effective therapeutic management of necrozoospermia can enhance ICSI success rates by mitigating oxidative stress and SDF.
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