International Journal of Infertility & Fetal Medicine

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VOLUME 14 , ISSUE 2 ( May-August, 2023 ) > List of Articles


Altered Sperm Analysis, Where Are We Now? The Reality of the Reproductive Medicine Unit of a Tertiary University Center

Beatriz Ferro, Filipa Sousa, Alexandra Carvalho, Ana F Ferreira, Luís Sousa, Ana P Sousa, Belmiro Parada, Paulo Cortesão, Teresa A Santos

Keywords : Azoospermia, Infertility, Intracytoplasmic, Male, Oligospermia, Sperm injections, Sperm retrieval, Varicocele

Citation Information : Ferro B, Sousa F, Carvalho A, Ferreira AF, Sousa L, Sousa AP, Parada B, Cortesão P, Santos TA. Altered Sperm Analysis, Where Are We Now? The Reality of the Reproductive Medicine Unit of a Tertiary University Center. Int J Infertil Fetal Med 2023; 14 (2):85-93.

DOI: 10.5005/jp-journals-10016-1315

License: CC BY-NC 4.0

Published Online: 12-05-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Background: In the last decades, a substantial decline in sperm counts has been described. We aim to evaluate clinical outcomes of treatment strategies in patients referred to andrology due to abnormal sperm parameters. Materials and methods: Observational descriptive study performed at one country's largest public reproductive unit during 5 years (2015–2019). Patients were selected according to the World Health Organization (WHO) criteria for sperm analysis. Results: A total of 670 patients were included, with a median age of 35 (18–54) years old. During the infertility investigation, 15 patients were diagnosed with Klinefelter syndrome and two with a disorder of sexual development (46, XX). Three malignant testicular tumors were identified. Among treatments applied—varicocele correction was the most frequent (31.49%, n = 210), followed by antioxidant therapy (11.04%, n = 74). Posttreatment sperm analysis was obtained in 255 cases, demonstrating an improvement in 58.04% (n = 148), including normalization in 6.67% (n = 17) of men. An assisted reproductive technique (ART) was performed in 45.97% (n = 308), with a clinical pregnancy rate per initiated cycle of 26.92% (n = 91). Among azoospermic patients (19.55%, n = 131), there was a higher exposure to heat (p = 0.02) and a higher prevalence of previous testicular surgery (p = 0.002), and orchitis (p = 0.022). Varicocele was more frequent in non-azoospermic patients (p = 0.007), while Y chromosome microdeletions and chromosomal alterations were mostly found in azoospermic patients (p = 0.004 and p < 0.001, respectively). Conclusion: Even in patients with a poor prognosis a priori, improvements in sperm parameters or sperm retrieval might be achieved after treatment, namely low-grade varicocele correction. Clinical significance: An adequate investigation of male infertility can improve reproductive outcomes and contribute to an early diagnosis/secondary prevention of tumors.

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