Androlog Mail
In response to Dr. Garcia-Ochoa's response to my inquiry (regarding 2%
asthenoteratozoospermia) Androlog 01/03/2001, I now have the following
comments:
I am very thankful to Dr Garcia-Ochoa's response and appreciate the
careful investigation performed. It is now much easier to have an
opinion.
In summary, you have a couple with an infertility problem and the only
abnormality noted after a thorough examination of both partners over a
period of more or less three months is an extremely low sperm motility
combined with a low percentage of live spermatozoa.
Since you have excluded toxic factors, incorrect sampling of the semen
and high temperature to the testis as possible causes it seems
reasonable to assume a defect in the ultra structure of the midpieces
and tails. If that can be documented by an EM investigation you will
have a diagnosis but still no treatment.
Has the patient any relatives with a similar situation or is there any
other data indicating a genetic defect? If there are no indications of a
genetic factor I would recommend ICSI. If there are indications of a
hereditary factor, ICSI is still an option but I would recommend a
proper genetic counselling before such a procedure.
I fully agree with you that the present trend to replace a proper
examination of the infertile couple with ICSI, if one semen sample is
abnormal, is deplorable. To me that praxis is no better than
old-fashioned quackery. It is unfair to the patients and incompatible
with good medical care.
Best regards
Rune Eliasson, MD, PhD
Andrology Lab, Sophiahemmet Hospital
Box 5605, SE 114 86 Stockholm, Sweden
Phone: +46-8-89 97 02 or 20 03 12
Fax: +46-8-739 30 84
E-mail: re@remcat.com
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