What is oligoasthenospermia?

Lower-than-standard sperm density and/or motility

The term "oligoasthenospermia" is a colloquial expression, medically referred to as "oligospermia," "asthenospermia," or "oligoasthenospermia."

This refers to a condition where semen analysis shows sperm concentration/density and the percentage of progressively motile sperm (sperm moving normally forward, not merely twitching or inactive) fall below the WHO semen analysis standards.

Currently, according to the WHO Laboratory Manual for the Examination and Processing of Human Semen, 5th Edition:

• Total sperm count less than 39 × 10⁶ per ejaculate or sperm concentration < 15 × 10⁶/mL is diagnosed as oligospermia (if the concentration is 0, it is azoospermia).
• Progressive motility rate < 32% is diagnosed as asthenospermia.

Oligoasthenospermia is a condition of abnormal sperm density and/or motility, which may reduce the chances of sperm-egg interaction and fertilization, leading to difficulty in conception.

What causes oligoasthenospermia?

Current research suggests that the causes of oligoasthenospermia are diverse and cannot be generalized. Sometimes, it is difficult to identify a definitive cause.

Common potential causes include:

1. Environmental factors

Prolonged exposure of the whole body or testicular region to high temperatures, such as working in hot environments, wearing tight and non-breathable underwear, or prolonged sitting. Additionally, exposure to toxic, radioactive, or high-radiation environments (e.g., chemical plants, military radar zones) can impair testicular spermatogenesis.

2. Genetic factors

Common genetic factors often involve the male Y chromosome, such as microdeletions in the AZF gene (which regulates spermatogenesis).

3. Endocrine factors

Similar to female ovulation, male testicular spermatogenesis is regulated by the neuroendocrine system (hypothalamus and pituitary). Hormonal imbalances can disrupt spermatogenesis.

4. Infections

Urogenital infections (e.g., chlamydia, gonorrhea, leprosy, tuberculosis, HIV) can damage sperm DNA, leading to abnormal sperm quality. Viral infections like mumps can also directly impair testicular spermatogenesis. However, non-bacterial chronic prostatitis does not affect sperm quality.

5. Varicocele (VC)

Varicocele refers to impaired venous return in the spermatic cord, leading to venous congestion, testicular hypoxia, and toxin accumulation, which can reduce sperm quality.

6. Immune factors

Some studies suggest that testicular trauma or infections can damage the blood-testis barrier, leading to the production of anti-sperm antibodies, which trigger immune reactions and impair sperm quality.

7. Micronutrient deficiencies

Zinc is a key component of semen. Deficiency may impair sperm production and motility.

8. Medications

Certain drugs, such as spironolactone, colchicine, reserpine, and alkylating chemotherapy agents, can cause gonadal dysfunction or damage.

9. Poor lifestyle habits

Studies show that smoking, excessive alcohol consumption, irregular sleep, high stress, insomnia, anxiety, and depression negatively impact spermatogenesis.

10. Systemic diseases

Chronic liver or kidney dysfunction may contribute to oligoasthenospermia.

How to conceive with oligoasthenospermia?

1. Reduce psychological stress

While oligoasthenospermia can affect fertility, not all cases lead to infertility. Many mild-to-moderate cases can conceive naturally or after lifestyle adjustments. Stress lowers libido, increases cortisol, and reduces testosterone, further impairing fertility.

2. Quit smoking and alcohol

Both are major risk factors for poor sperm quality and reduced fertility. Evidence confirms that quitting improves male fertility.

3. Maintain a healthy weight

Obesity adversely affects semen quality. Weight loss can enhance sperm parameters and conception success.

4. Exercise regularly

Moderate exercise aids weight control and boosts testosterone. Aim for ≥5 days/week, ≥30 minutes/day.

5. Adjust diet

Reduce refined carbs, increase fiber (leafy greens), and prioritize lean protein (fish, egg whites). Supplements like folic acid, vitamins E/C/D, zinc, selenium, and CoQ10 may improve sperm quality.

6. Avoid sleep deprivation

Irregular sleep disrupts circadian rhythms, impairing sexual function and semen quality. Prioritize sufficient rest.

7. Avoid toxins

Limit exposure to chemicals (e.g., heavy metals, industrial solvents), radiation, and high temperatures (saunas, prolonged sitting). Consult a doctor before taking medications that may harm sperm.

8. Optimal reproductive age

Female fertility peaks at 24–29, declining after 32. Male fertility starts declining after 40, with higher risks of sperm DNA defects. Conception between 20–39 maximizes success.

9. Optimal intercourse frequency

Abstinence >5 days reduces motility, but daily intercourse doesn’t affect concentration. Aim for every 2–4 days, increasing to every 1–2 days during the fertile window (3 days before to 1 day after ovulation).

10. Seek medical help

If lifestyle changes fail or other infertility factors exist, consult a fertility specialist promptly.