Absolute asthenozoospermia and ICSI: what are the options?
Open Access
- 3 August 2011
- journal article
- review article
- Published by Oxford University Press (OUP) in Human Reproduction Update
- Vol. 17 (5), 684-692
- https://doi.org/10.1093/humupd/dmr018
Abstract
Complete asthenozoospermia, i.e. 100% immotile spermatozoa in the ejaculate, is reported at a frequency of 1 of 5000 men. Its diagnosis implies a poor fertility prognosis even with ICSI. It is extremely important to distinguish between two different groups of patients with complete asthenozoospermia, i.e. virtual or absolute asthenozoospermia. With the former group having some motile spermatozoa after extensive processing of the semen, absolute asthenozoospermia can be associated with metabolic deficiencies, ultrastructural abnormalities of the sperm flagellum, necrozoospermia otherwise it can be idiopathic. In the management of persistent absolute asthenozoospermia, it is very important to elucidate its nature and whenever possible to correct the potential causes. We reported data published in the literature on the aetiology of absolute asthenozoospermia and the different techniques to improve ICSI outcome. We propose an algorithm for diagnosis and treatment of this condition. Different results regarding fertilization, cleavage and pregnancy rate have been published in patients with absolute asthenozoospermia undergoing ICSI. However, the results vary widely depending on the sperm origin and the technique applied for immotile sperm selection. The percentage of viable spermatozoa varies between 0 and 100%. Absolute immotile spermatozoa is one of the most important causes of reduced fertilization and pregnancy rates after ICSI and different techniques are used to improve ICSI outcomes. However, it still remains unclear which is the best technique to improve the pregnancy outcomes in these couples.Keywords
This publication has 66 references indexed in Scilit:
- Notulae seminologicae. 1. New combinations of Kartagener's syndromeAndrologia, 2009
- Use of a laser to detect viable but immotile spermatozoaAndrologia, 2004
- Role of oxidants in male infertility: rationale, significance, and treatmentUrologic Clinics of North America, 2002
- The relative viability of human spermatozoa from the vas deferens, epididymis and testis before and after cryopreservationHuman Reproduction, 1999
- Developmental capacity of damaged spermatozoaHuman Reproduction, 1999
- Efficient modification of intracytoplasmic sperm injection technique for cases with total lack of sperm movement.Human Reproduction, 1997
- The hypo-osmotic swelling test for selection of viable sperm for intracytoplasmic sperm injection in men with complete asthenozoospermiaFertility and Sterility, 1996
- Flagellar structure in normal human spermatozoa and in spermatozoa that lack dynein armsTissue and Cell, 1995
- Human Sperm Velocity and Postinsemination Cervical Mucus Test in the Evaluation of the Infertile CoupleArchives of Andrology, 1984
- A Human Syndrome Caused by Immotile CiliaScience, 1976