FEATURES OF SPERMOGRAM INDICATORS IN IDIOPATHIC INFERTILITY IN MEN

Melnyk O. V., Vorobets M. Z., Fafula R. V., Onufrovych O. K., Vorobets Z. D.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

According to the European Society of Reproductive and Embryological Society, about 1 million couples in Ukraine suffer from infertility, i.e. 15-17%. However, in reality, this indicator is higher because, according to the results of sociological surveys, the number of cases of infertility significantly exceeds the number of requests for medical help in this regard. According to statistical data, infertility affects 15% of married couples in the world, and the share of the male factor in the structure of total infertility is about 50% and has a growing tendency. In infertile couples resorting to assisted reproductive technologies, idiopathic infertility represents about 30% of all causes of male infertility. According to the data of the European Association of Urology (2022), idiopathic infertility is the inability of a couple to conceive a child, in which the reasons for impaired fertility remain unclear. The aim of the work was to compare reproductive function in men with idiopathic infertility and a control group with normozoospermia based on spermogram indicators. Diagnosis of idiopathic infertility in men (n=73) aged 22-45 was carried out at the outpatient stage according to WHO standards (group I). The control group consisted of persons of the same age who lived in the Lviv region (group II, n=56). The study consisted in studying spermogram indicators in patients of both groups according to WHO recommendations and comparing them with each other and with reference values. Comparison of physicochemical parameters of ejaculate revealed that the volume of ejaculate in men with idiopathic infertility and in the control group did not differ significantly from each other, as did the pH indicator. The indicators of the time of dilution of ejaculate in persons with idiopathic infertility significantly increased (by 1.4 times) in comparison with men of the control group. Reliable violations of the quality indicators of ejaculate, characterized by a decrease in sperm motility by 1.6 times, were revealed. The number of immobile spermatozoa was 1.7 times higher in idiopathic infertility compared to control values. A 1.8-fold decrease in the concentration of fructose in the ejaculate correlated with pronounced processes of sperm motility and viability impairment. The indicator of the concentration of citric acid, which reflects the functional state of the prostate gland and the endocrine function of the testicles, was 1.7 times higher in patients with idiopathic infertility compared to the control group. It acts as a factor in the dilution of ejaculate, activation of hyaluronidase and other factors that contribute to the process of penetration of the spermatozoon to the egg cell. The content of zinc in seminal fluid differs most between infertile men and men of the control group, it was 3.4 times lower in men with idiopathic infertility. It should be noted that zinc is a cofactor for more than 300 enzymes involved in DNA transcription and protein synthesis. The presence of this trace element is necessary for cell division in general and spermatogenesis in particular. Thus, the obtained data on the indicators of spermograms indicate that reproductive problems in men with idiopathic infertility consist in a reliable violation of the quality indicators of ejaculate, namely, mobility is lower, which correlates with changes in the index of dilution time, which increases and biochemical indicators (decrease in the concentration of fructose, citrate and zinc) compared to ejaculate indicators in men with normozoospermia.

idiopathic male infertility,ejaculate,seminal plasma,spermogram.

1. Tahmasbpour E, Balasubramanian D, Agarwal A. A multi-faceted approach to understanding male infertility: gene mutations,molecular defects and assisted reproductive techniques (ART). J. Assist. Reprod. Genet. 2014;31:1115-1137. DOI: 10.1007/s10815-014-0280-6.
2. Horpynchenko II, Hurzhenko YUM, Spyrydonenko VV, Lytvynetsʹ YEA. Porivnyalʹna kharakterystyka pokaznykiv spermohramy pry idiopatychnykh formakh bezpliddya u cholovikiv z radiatsiyno zabrudnenykh ta umovno chystykh rehioniv Ukrayiny. Problemy radiatsiynoyi medytsyny ta radiobiolohiyi. 2019;24:367-379. [in Ukrainian].
3. Salonia A, Bettocchi C, Carvalho J, Corona G, Jones TH, Kadioglu A, et al. EAU Guidelines on sexual and reproductive health. European Association of Urology; 2022. 251 p.
4. Gorpinchenko II, Stus’ VP, Malyshkin DI, Polion NYU. Muzhskoye besplodiye: Etiologiya, patogenez, klassifikatsiya, diagnostika i metody lecheniya. Dnepr: OOO «Aktsent PP»; 2016. 344 s.
5. Agarwal A, Parekh N, Kumar M, Selvam P, Henkel R, Shan R, et al. Male oxidative stress infertility (MOSI): proposed terminology and clinical practice guidelines for management of idiopathic male infertility. World J. Mens. Health. 2019;37:296-312. DOI: 10.5534/wjmh.190055.
6. Tan J, Taskin O, Albert A, Bedaiwy MA. Association between sperm DNA fragmentation and idiopathic recurrent pregnancy loss: a systematic review and meta-analysis. Reprod. Biomed. Online. 2019;3896):951-960. DOI: 10.1016/j.rbmo.2018.12.029. 
7. Vaughan DA, Tirado E, Garcia D, Datta V, Sakkas D. DNA fragmentation of sperm: a radical examination of the contribution of oxidative stress and age in 16945 semen samples. Human Reprod. 2020;35(10):2188-2196. DOI: https://doi.org/10.1093/humrep/deaa159.
8. Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HW, Behre HM, et al. World Health Organization reference values for human semen characteristics. Hum. Reprod. Update. 2010;16(3):231-245. DOI: 10.1093/ humupd/dmp048.
9. Campbell MJ, Lotti F, Baldi E, Stefan Schlatt S, Festin MPR, Bjorndahl L, et al. Distribution of semen examination results 2020 – A follow up of data collated for the WHO semen analysis manual 2010. Andrology. 2021;9:817-822. DOI: https://doi.org/10.1111/andr.12983.
10. WHO. WHO laboratory manual for the examination and processing of human semen. 6th ed. Geneva: WHO; 2021. 276 p. 
11. Colagar AH, Marzony ET, Chaichi MJ. Zinc levels in seminal plasma are associated with sperm quality in fertile and infertile men. Nutrition Research. 2009;29(2):82-88. DOI: https://doi.org/10.1016/j.nutres.2008.11.007.

«Bulletin of problems biology and medicine» Issue 4 (167), 2022 year, 187-192 pages, index UDK 612.616:612.015.11:612.014.484

10.29254/2077-4214-2022-4-167-187-192