Oligoasthenoteratozoospermia refers to a pathological change in male sperm that often leads to infertility. The sperm changes are also known as OAT syndrome.
What is oligoasthenoteratozoospermia?
Oligoasthenoteratozoospermia is the term used when abnormal changes occur in a man’s sperm. In medicine, the phenomenon is also known as oligoasthenoteratozoospermia syndrome or OAT syndrome. The term oligoasthenoteratozoospermia is composed of the words “oligo”, “astheno” and “terato”. Oligo translates to “too little.” It means that there are no more than 20 million sperm in a milliliter of a man’s ejaculate. The term astheno stands for “immobility,” meaning that rapid movement is possible with less than 25 percent of sperm. Only 50 percent of sperm make purposeful movements. Terato is the term for “malformation”. In this case, a maximum of three percent of the sperm have a normal shape. However, oligoasthenoteratozoospermia is present only when the three symptoms mentioned above appear at the same time. More detailed investigations are required for the causes of the symptoms. Thus, there is a possibility that the infertility lasts only for a temporary period.
Causes
A variety of causes can be considered for the presence of oligoasthenoteratozoospermia. For example, either the formation of the sperm is impaired or difficulties occur in their transport. Among the most common causes of OAT syndrome are testicular malpositions. Normally, they form approximately on the position of the lower pole of the kidney. Between birth and the completion of the first year of life, they move further into the scrotum. However, if there are disturbances during the descent of the testicles, it is possible that they settle in the abdominal cavity or other parts of the body. Doctors then speak of a positional anomaly of the testicle. This may involve gliding testicles or inguinal testicles. Disorders of the testicles are sometimes already congenital. These include testicular dystopias such as testicular retention and testicular ectopy, chromosomal defects such as Klinefelter syndrome, testicular hypoplasia and hereditary diseases such as cystic fibrosis. Similarly, hormonal disorders are possible causes of oligoasthenoteratozoospermia such as FSH deficiency, LH deficiency, hyperthyroidism, hypothyroidism, or testosterone deficiency. Other conceivable causes include varicose veins on the testicles, prostate inflammation, inflamed testicles or epididymis after a mumps disease, febrile infections or disorders of the sex chromosomes. Other possible indications are the consumption of drugs or alcohol, the intake of certain medications. But also venereal diseases such as gonorrhea or syphilis, radiation therapy for cancer, stress, a poor diet, and being overweight or underweight can promote oligoasthenoteratozoospermia. In some cases, however, no specific cause for the OAT syndrome can be found at all. In such cases, we speak of idiopathic oligoasthenoteratozoospermia.
Symptoms, complaints, and signs
Oligoasthenoteratozoospermia can result in infertility in men. OAT syndrome can be recognized by the fact that the sperm count is too low. Their motility also suffers. It is not uncommon for extensive sperm malformations to occur. Oligoasthenoteratozoospermia is divided into three different degrees of severity from OAT I to OAT III, with the classification of severity depending on the concentration of sperm:
- In the case of OAT I, there is only a minor impairment of the ability to conceive.
- In the case of OAT II, on the other hand, there is already a significant restriction of the ability to procreate.
- From OAT III, physicians speak at a severely limited ability to procreate.
Diagnosis and course of the disease
To find out the cause of oligoasthenoteratozoospermia, the examining physician takes care of the medical history of his patient. Of particular interest are possible diseases in the past that could be considered for impaired fertility. These can be venereal diseases, urinary tract diseases or childhood diseases such as mumps. Following the anamnesis, the physician performs a thorough physical examination.Sonography (ultrasound examination) also takes place. The next step is the creation of a spermiogram to examine the sperm. Other diagnostic options include a sugar test, a penetration test and a membrane stability test. It is also useful to check the hormone level in the blood. If no specific causes can be found, it is not uncommon for some tissue to be taken from the testicle for examination in a laboratory. Oligoasthenoteratozoospermia is not always positive despite medical treatment. The affected individuals then remain infertile. In such cases, artificial insemination may be useful.
Complications
Due to oligoasthenoteratozoospermia, affected individuals suffer from infertility in most cases. This need not occur to a complete extent, so the affected person is only limited in fathering children. In the worst case, however, complete infertility occurs, so that the patient is unable to father children. Not infrequently, oligoasthenoteratozoospermia thus has a very negative effect on the patient’s quality of life. Furthermore, it can also lead to tension with the patient’s own partner if there is a desire to have children. However, the rest of the patient’s health is not negatively affected or otherwise worsened by this disease. Life expectancy is also not limited or reduced by oligoasthenoteratozoospermia. Affected individuals also have various other options to still pursue the desire to have children. Possible depression or other psychological complaints can be treated with the help of a psychologist or a therapist. There are usually no particular complications. Oligoasthenoteratozoospermia can only be treated if the condition is caused by another underlying disease. In this case, possible inflammations can usually be treated well with the help of antibiotics.
When should you go to the doctor?
If sexually mature couples have an unfulfilled desire to have children, a doctor should be consulted. A check-up visit is advisable as soon as the planning of offspring remains unsuccessful over a longer period of time despite all efforts. If all known guidelines for conceiving a child are followed and yet pregnancy does not occur, a visit to the doctor to clarify the physical possibilities is advisable. Only men can suffer from oligoasthenoteratozoospermia, but it is advisable for both partners to be examined by a doctor regarding their fertility requirements. In addition, a comprehensive clarification of the individual state of health should take place so that possible optimizations can be made. This can help to alleviate the mental strain and inner stress. If psychological problems arise due to the infertility of the man, a doctor is needed. If there are behavioral problems, depressive moods or a persistent sadness, a doctor or a therapist should be consulted. If there are disturbances in libido, restrictions in sexual functioning, a reduced sense of well-being or a lowered zest for life, a doctor should be consulted. In the case of partnership problems or difficulties in coping with everyday life, the affected person needs support. In many cases, therapeutic treatment can help so that the mental strength of the affected person can be strengthened and a reorientation of possible life goals can take place.
Treatment and therapy
Depending on the cause from which oligoasthenoteratozoospermia is triggered, the therapy of the syndrome is directed. Because several complaints can often occur simultaneously in this disorder, there is no standard treatment. For example, if inflammation is present, it is treated first. If the therapy is completed, a further control takes place. If a varicose vein is responsible for the OAT syndrome, a surgical procedure is performed in which the testicular vein is cut off or sclerosed. In the case of hormone deficiency, appropriate hormones can be administered to correct the infertility. If certain medications or stimulants are the cause of oligoasthenoteratozoospermia, the patient must abstain from their consumption. If the vas deferens is blocked, the vas deferens is opened surgically.Another treatment option is testicular sperm extraction (TESE), in which the patient’s sperm cells are surgically removed and used for artificial insemination.
Prospect and prognosis
Oligoasthenoteratozoospermia – also called OAT syndrome – refers to an abnormal reduction in sperm count. Genetic causes are often found to cause this disorder. These cannot be influenced. By means of a spermiogram, the treating physicians determine the extent and cause of the disorder. In most cases, oligoasthenoteratozoospermia involves an unfulfilled desire to have children. For about half of the men affected by oligoasthenoteratozoospermia, the desire to have a child can still become a reality. For the other half, however, the prognosis is rather poor. One of the problems is that the genetically caused malformations on certain chromosomes can be transferred to a male offspring. The latter would therefore suffer from the same disorder. So it depends on whether oligoasthenoteratozoospermia is caused by too few sperm, or defined by too few motile sperm or too many pathologically altered sperm. Chromosomal or genetic fertility disorders are found in about 20 percent of men with oligoasthenoteratozoospermia. Chromosomal Klinefelter syndrome is frequently present. Since genetic preconditions and genetic diseases can also lead to oligoasthenoteratozoospermia, the prognosis for fertility is usually no better than 50:50. There are currently no treatment options for oligoasthenoteratozoospermia. Only in vitro fertilization can be attempted.
Prevention
Preventing oligoasthenoteratozoospermia is difficult because its causes are not always known. Sometimes it may be useful to change previous lifestyle habits and avoid alcohol and anabolic steroids.
Aftercare
In most cases, the person affected by oligoasthenoteratozoospermia has only a few and often limited measures of aftercare available to him, so that in the first place a doctor should be consulted very early in this disease to prevent the occurrence of further complications. A self-healing of oligoasthenoteratozoospermia can usually not occur, so that the patient is always dependent on medical treatment. Most affected patients are dependent on a quick surgical intervention. There are no particular complications, but the patient should rest and take care of his body after the operation. In this context, the patient should refrain from exertion or stressful activities in order not to put unnecessary strain on the body. However, the disease cannot generally be completely cured, so the affected person may become infertile even after surgery. The further course of recovery depends very much on the time of diagnosis, so that a general prediction is usually not possible. The life expectancy of the affected person is not reduced by this disease. In some cases, contact with other sufferers of the disease can also be useful, as this leads to an exchange of information.
What you can do yourself
Oligoasthenoteratozoospermia can be treated by affected individuals themselves, depending on the cause and severity. If the fertility disorder is based on causes such as obesity, malnutrition, stress or the consumption of stimulants such as alcohol and nicotine, a change in lifestyle habits is necessary. If hormonal disorders or diseases such as tumors, diabetes mellitus or a varicose vein hernia are the underlying causes, these must first be treated. In the case of psychological causes such as stress, physical exercise is essential. Often, the men affected also need therapeutic support. Couples therapy can also reduce possible conflicts in the relationship and thus possibly also contribute to an improvement in sperm quality. At the same time, the men affected must go for regular medical check-ups. The doctor will check the quality of the sperm at regular intervals and diagnose infertility if necessary. In many cases, however, the problems can be improved by consistently combating the causes. The urologist can answer in detail which measures are sensible and necessary.If treatment of the possible triggers brings improvement in sperm quality, alternatives such as artificial insemination or adoption should be considered.
