1
|
Dumont A, Barbotin AL, Lefebvre-Khalil V, Mitchell V, Rigot JM, Boitrelle F, Robin G. [Necrozoospermia: From etiologic diagnosis to therapeutic management]. ACTA ACUST UNITED AC 2017; 45:238-248. [PMID: 28697346 DOI: 10.1016/j.gofs.2017.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 01/19/2017] [Indexed: 12/11/2022]
Abstract
This review describes necrospermia, its diagnosis, causes and management. Sperm vitality is commonly assessed in the laboratory of reproductive biology, with the eosin test or with the hypo-osmotic swelling test. Necrospermia is defined by a percentage of living spermatozoa inferior to 58%, and can be related to male infertility. Several pathological mechanisms may be involved and can be classified either in testicular causes (hyperthyroidism, local hyperthermia, varicocele), or post-testicular causes (epididymal necrospermia, dysregulation of seminal plasma, adult polycystic kidney disease, vasectomy reversal, anti-sperm antibodies) or both (infection, toxic, age, spinal cord injury). The first treatment is to correct the underlying cause, if possible. Repetitive ejaculation has demonstrated to be effective as well. Many drugs would also improve the sperm vitality (antioxidants, non-and-steroidal anti-inflammatory drugs) but there is currently no guideline to recommend their use. With necrospermia, fertilization rates are lower but in vitro fertilization (IVF) with Intracytoplasmic sperm injection (ICSI) improves the chances of conception.
Collapse
Affiliation(s)
- A Dumont
- Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire, 2, avenue Oscar-Lambret, 59000 Lille, France.
| | - A-L Barbotin
- Service de biologie de la reproduction-spermiologie-CECOS, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire, 59000 Lille, France; EA 4308 gamétogenèse et qualité du gamète, institut de biologie de la reproduction-spermiologie-CECOS, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France
| | - V Lefebvre-Khalil
- Service de biologie de la reproduction-spermiologie-CECOS, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire, 59000 Lille, France
| | - V Mitchell
- Service de biologie de la reproduction-spermiologie-CECOS, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire, 59000 Lille, France; EA 4308 gamétogenèse et qualité du gamète, institut de biologie de la reproduction-spermiologie-CECOS, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France
| | - J-M Rigot
- EA 4308 gamétogenèse et qualité du gamète, institut de biologie de la reproduction-spermiologie-CECOS, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France; Service d'andrologie, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France
| | - F Boitrelle
- Service de biologie de la reproduction et de cytogénétique, centre hospitalier Poissy-Saint-Germain-en-Laye, 78303 Poissy, France
| | - G Robin
- Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire, 2, avenue Oscar-Lambret, 59000 Lille, France; EA 4308 gamétogenèse et qualité du gamète, institut de biologie de la reproduction-spermiologie-CECOS, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France; Service d'andrologie, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France
| |
Collapse
|