Asthenospermia: The Leading Cause of Male Infertility in Most Cases

Male infertility is a significant issue affecting many couples trying to conceive, and a considerable proportion of these cases are attributed to asthenospermia, a condition characterized by reduced sperm motility. When men visit outpatient clinics for semen quality testing, issues with sperm motility are frequently discovered. A semen analysis, which reflects sperm motility, is typically performed multiple times to ensure accuracy, as a single test can be influenced by various factors.

If, after 2 to 3 checks, the results consistently indicate that motility is below the reference values, the condition is diagnosed as asthenospermia.

Understanding Asthenospermia

Asthenospermia is a condition where the sperm’s motility function is impaired, affecting human reproduction. Only sperm that move forward normally can reach the ampulla of the fallopian tube to fertilize an egg. In normal conditions, ex vivo sperm exhibit limited mobility before semen liquefaction, and once liquefied, they display good motility. However, if motility is hindered by certain factors, sperm may not reach the egg in time, preventing fertilization.

Asthenospermia can be categorized into three levels: mild, moderate, and severe.

- Mild Asthenospermia: Grade A and B sperm are less than 50% but more than 30%, or Grade A sperm are less than 25% but more than 10%.

- Moderate Asthenospermia: Grade A and B sperm are less than 50% but more than 30%, with Grade A sperm less than 10%.

- Severe Asthenospermia: Grade B and C sperm are less than 30%, with Grade A sperm being zero.

Causes of Asthenospermia

Asthenospermia is not a disease in itself but rather a result of various factors:

1. Immune Factors: Anti-sperm antibodies can affect fertilization, reducing sperm vitality and motility, leading to infections.

2. Reproductive System Infections: Conditions like male varicocele, prostatitis, and testicular inflammation can directly damage male reproductive organs. Inflammation can alter the composition of seminal plasma, causing asthenospermia.

3. Abnormal Semen Liquefaction: Issues like non-liquefaction or high viscosity of semen are major causes of male infertility.

4. Endocrine Factors: The hypothalamus-pituitary-gonad axis is crucial for male endocrine function. Issues in any of these segments can directly cause asthenospermia.

5. Lifestyle Factors: Exposure to high temperatures, radiation, noise, smoking, alcohol, long-term abstinence, or excessive indulgence can all lead to asthenospermia and infertility.

In some cases, men may show no semen presence even after high-speed centrifugation, known as azoospermia. Severe infections due to insufficient motility can significantly affect pregnancy prospects.

Management and Treatment

Sperm generation takes time, and semen analysis provides a snapshot of spermatogenic conditions over several months. If a semen report indicates weak motility, it reflects poor spermatogenic conditions over the past 3-6 months. Changing lifestyle habits and taking medications can improve sperm vitality. Patients should not be overly worried as poor motility does not mean that fertilization is impossible.

For severe conditions, cooperation with a doctor for examinations and treatments is essential. Medications like Diuretic and Anti-inflammatory Pill can help eliminate symptoms, improve sperm quality, and address bad habits such as excessive drinking and smoking. Without treatment or lifestyle changes, the activity rate may continue to decrease, affecting conception and potentially the health of offspring.

Preventative Measures

1. Healthy Lifestyle: Avoid smoking and drinking, understand sexual health, and recognize male physiological characteristics. If there are changes in the testicles like swelling, hardening, unevenness, or pain, seek medical attention promptly.

2. Temperature Management: Testicles function best at temperatures slightly lower than body temperature. Avoid factors that increase testicular temperature, such as prolonged cycling, hot baths, and tight clothing.

3. Personal Hygiene: Maintain hygiene, especially of the reproductive organs, to prevent bacterial invasion and proliferation.

4. Diet: Avoid spicy, greasy, and stimulating foods. Reduce smoking and drinking to prevent negative impacts on sperm development.

5. Adequate Sleep and Exercise: Ensure enough sleep, avoid late nights, and engage in regular physical activity to improve disease resistance.

6. Avoid Chemicals: Men working in environments with radiation, high temperatures, or chemicals should take protective measures. Avoid these environments when planning for pregnancy, and let dry-cleaned clothes air out before wearing.