What is OATS?

What is OATS?

Oligoasthenoteratozoospermia (OATS) is a condition of low Sperm Count and Motility and is one of the most common factors of male subfertility. It can be broken down into 3 parts:

  • Oligozoospermia – low number of sperm
  • Asthenozoospermia – poor sperm movement
  • Teratozoospermia – abnormal sperm shape.

OATS is a condition when all the above three are present. The term Idiopathic Oligoasthenoteratozoospermia is used when the cause of the condition is not known. About 30% of male infertility cases come under this bracket of Idiopathic OATS.

The causes of OATS are broadly due to the following factors – genetic, lifestyle, testicular as well as dysfunction.

Genetic factors can cause DNA damage in sperm cells, defects of the Y chromosome (males have one Y chromosome and one X chromosome and the Y chromosome triggers embryonic development as a male) and genetic disorders.

Lifestyle factors are habits that can directly affect the male sperm. Many of these conditions can be corrected which can significantly improve the chances of fertility. Some examples are smoking, alcohol consumption, obesity, strenuous exercise (like horse riding, cycling or overexertion at the gym) or even overheating the testes by very hot shower baths, saunas or by wearing too tight briefs. Sometimes, certain medications can also affect the quality and motility of the sperm.

Testicular factors include possible defects in the genital tract as also problems with ejaculation, which interferes with the testicle’s ability to produce sufficient and good quality sperm. Some of these factors cannot be treated, like older age, testicular trauma (when the testicle is hurt by force), past infections like syphilis, mumps, malaria, testicular cancer and others.

OATS can be diagnosed by a variety of means, such as a physical exam, blood tests, genetic tests, semen analysis, DNA test and sperm analysis, spermatic venography (to check the position of the veins in the scrotum) and a scrotal ultrasound to check for lumps or varicoceles (enlargement of the veins in the skin that holds the scrotum).

In a semen analysis, which is the most common test to evaluate the sperm, the parameters covered are sperm count, motility, morphology, volume, fructose level and pH (acidity or alkalinity of a solution). According to the WHO standard in 2010, a sperm count over 15 million sperm per milliter is considered normal. The morphology norm is 4%, while motility should be 50 – 60%, to be measured within 60 minutes of collection.

OATS is a condition that can be treated and the type of treatment will be dependent on the cause.

  • An infection can be treated with medication.
  • Hormonal imbalance can be supplemented with hormones.
  • If there is an immune system problem, steroids are suggested.
  • Antioxidants can be given to decrease ROS (reactive oxygen species) damage to the sperm.
  • If it is a varicocele, it can be treated by percutaneous embolization of the affected vein, by an outpatient procedure involving minimal invasion, which has proven to have rates of high technical success and low recurrence.  Else, surgery may be required to remove a varicocele.
  • Sperm extraction may be required when sperm needs to be removed from the testicles or epididymis.  Such sperm can be saved and used to fertilize the egg of a female.

Because of the reduced motility of the sperm in patients with OATS, the ART (assisted reproductive technology) techniques of IUI (intrauterine insemination) or IVF (in vitro fertilization) are usually not very successful.  The ICSI  (intracytoplasmic sperm injection) and, preferably, the IMSI (intracytoplasmic morphologically selected sperm injection) have shown to have higher results of fertilization.

It is always better to have the condition diagnosed at the earliest, so that treatment can be started immediately.  Hence, it is advisable that, if you have not been able to conceive within a year of unprotected intercourse, or if you have a swelling or lump in your scrotum or pain in the groin area which remains, you contact your GP.

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