Comparació de les principals tècniques de millora de la motilitat espermàtica pel tractament de la infertilitat masculina

Abstract

The human spermatozoon is a highly differentiated cell type whose function is to transport the genetic material into the oocyte, without being altered in the process. Spermatozoa are produced in the testes and then have to undergo some modifications in order to become functional and be able to fertilize the oocyte. Among these modifications, the acquisition of motility is an essential process since it is indispensable that spermatozoa have good motility in order to perform their function. The motor that enables this motility is the axoneme, an internal microtubular structure that begins at the connecting piece and reaches the terminal piece of the sperm tail. Therefore, among the parameters involved in male fertility, sperm motility has a very important role. In recent years, the increasing rate of infertility has become a clinical problem and, the number of couples that must attend to assisted reproductive techniques (ART), in order to achieve pregnancy, is growing up. One of the most common causes of male infertility is due to problems related to sperm motility, mainly caused by an overproduction of reactive oxygen species. On the other side, sperm motility is also an important parameter in ART, because it influences the choice of the treatment. Therefore, it is necessary to find therapeutic agents that increase sperm motility in vitro and/or in vivo, but without affecting the fertilization capacity of the spermatozoa or further embryo development, in other words that is, without side effects derived from the process of sperm stimulation. For this reason, a literature search was carried out with the aim of learning and comparing different approaches and therapeutic agents that improve sperm motility to treat male infertility due to a low quality of this sperm parameter. Usually, the increase in sperm motility in vivo is due to a decrease of the oxidative stress at a testicular level through the use of antioxidants, meanwhile, in in vitro procedures, it is due to the use of phosphodiesterase inhibitors. The results obtained in in vitro treatments are more promising compared to those obtained in vivo ones, but further research is required to ensure clinical effectiveness and safety of the discussed compounds