Oligoasthenoteratozoospermia (OATS)

Oligoasthenoteratozoospermia is a male pathology that combines three disorders: oligozoospermia (low sperm count), asthenozoospermia (low sperm motility) and teratozoospermia (abnormalities in the structure of sperm). The main manifestation of this pathology is male infertility, as conception does not occur due to the poor quality of sperm.

Causes and Types of OATS

The deterioration of sperm quality can be caused by various factors, including endocrine pathologies such as:

• diabetes mellitus
• hyperprolactinemia
• hypothyroidism.

Additionally, OATS is often found in the following contexts:

• Varicocele;
• Retrograde ejaculation;
• Hypogonadism (decreased levels of male hormones), which can be associated with the man's age or diseases of the sexual system.

Infectious and inflammatory diseases also have a negative impact on spermatogenesis. These diseases include, for example, chlamydia, gonorrhea, prostatitis, and epididymitis.

The other risk factors are as follows

• Exposure to toxins (working in harmful conditions, unfavorable environmental conditions);
• smoking
• Excessive alcohol consumption;
• stress and chronic overwork.

Nature of Changes in Sperm Quality

Changes in sperm quality in men can manifest in the following ways:

• Oligozoospermia: low concentration of viable sperm;
• Asthenozoospermia: low motility of sperm.
• Teratozoospermia: morphological abnormality of sperm.

Treatment of OATS

OATS is diagnosed using methods such as sperm analysis, Kruger’s extended sperm analysis, and other studies on the ejaculate. The sperm analysis assesses the general parameters of sperm, such as volume, concentration, and motility of sperm. A Kruger extended sperm analysis analyzes the morphology of sperm in more detail, which is important for detecting structural anomalies. A man may be referred to a reproductive gynecologist, urologist, or andrologist for examination. Treatment is developed individually, depending on the cause, nature of the pathology, as well as the age of the man and his partner.

Main Treatment Approaches

1. Treatment of the underlying disease. If OATS is caused by a specific disease, therapy will aim to eliminate it. For example:
   • In the case of varicocele, surgical intervention may be recommended.
   • In infectious-inflammatory diseases, antibiotic treatment is prescribed.
   • In the case of hypogonadism, hormone replacement therapy is implemented.
2. Stimulation of spermatogenesis. This approach includes medications aimed at improving sperm parameters. After treatment, the concentration, motility, and morphological structure of sperm can be improved, which, in some cases, allows the couple to conceive naturally.
3. Sperm vitrification. If necessary, sperm can be frozen for later use in in vitro fertilization (IVF) programs. This method is preferred in cases where sperm quality is unstable and before starting treatment that may negatively affect spermatogenesis, such as chemotherapy or surgery.

Possibility of Natural Pregnancy and Assisted Technology

The question of whether OATS is compatible with natural pregnancy can only be determined by a doctor after a complete examination of both partners. This examination may include a sperm analysis, hormonal tests, pelvic ultrasound, and infection tests to obtain a comprehensive assessment of the couple's reproductive health. In some cases, after appropriate treatment, a couple may conceive without resorting to assisted reproductive techniques.

If natural conception is not possible, in vitro fertilization (IVF) may be offered to the couple. IVF allows the use of a man's sperm after it has been previously improved or vitrified.

IVF with Sperm Donation

In extreme cases, if the quality of sperm is severely compromised and cannot be corrected, the use of donor sperm in an IVF program may be considered. This allows a couple to have a child using high-quality donor sperm and the woman's egg.

A man can consult a urologist or andrologist to assess his reproductive health. Timely referral to a specialist, conducting necessary examinations, and appropriate treatment are the main steps in eliminating OATS and increasing the chances of conception.