CORRECTION OF DISORDERS OF SPERMATOGENESIS IN MALE INFERTILITY IN UNDER THE CONDITIONS OF HAZARDOUS PROFESSIONAL FACTORS

Lomeiko E. А.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Actuality. Unfavourable effects of professional factors induce different types of endocrine disorders and male infertility. Because of variability professional factors, treatment and recommendations of these disorders can not be unified. In conditions of harmful occupational factors, of the most common pathological pathways in male infertility is hyperproduction of active forms of oxygen. So, antioxidant therapy could be effective for complex treatment and could be used for correction of some parameters in spermograms. The aim of research is analisys endocrine disoders and parameters in spermograms, its dynamic after complex treatment with including of L-carnitine in men which work in unfavourable occupational conditions. Methods. The research includes 187 cases of male infertility. All patients have worked in unfavourable occupational conditions for a long time: 58 - in conditions of stress, 48 – in contact with pesticides, in 43 patients professional activity was in conditions of low temperature, 38 – in high temperatures conditions. Clinical, biochemical examination and analisys of spermogram was used in all clinical cases. Basic therapy included antibiotics, anti-inflammatory treatment, physiotherapy. On the background of basic therapy was prescribed the complex treatment with L-carnitine. Results. It was found that usage of L-carnitine complex in men working in low temperatures contributes to the growth of free testosterone (p<0,05), decreased estradiol content (p<0,05), and an increase in T/E ratio (p<0,05); in the conditions of high temperatures probable changes in testosterone-estrogen ratio (p<0,05) was detected as a result of reliable decrease of estrogen (p<0,05). It was found that in the stress conditions, complex treatment with antioxidant therapy leads to increase in the level of bound testosterone (p<0,05) and free testosterone (p<0,05), estradiol (p<0,05) and T/E (p<0,05). It is proved that in contact with agricultural poisons in men with infertility there is a probable increase in bound (p<0,05) and free testosterone (p<0,05) and T/E ratio (p<0,05) due to the decrease in the content of estrogen (30,0%, p<0,05). It was verified that effectiveness of complex therapy by parameters of spermogram were set to the total number of spermatozoa per 1 ml (72,2%), the number of living spermatozoa (73,9%), the number of active spermatozoa (75,9%), the spermatozoa with translational movement (81,8%). It is presented, that response to complex treatment with the inclusion of antioxidants in various occupational factors is heterogeneous: in patients, who working in low temperatures, it is set the increase in the number of spermatozoa per 1 ml (p<0,05), the number of spermatozoa with translational motion (p<0,05); in high temperatures it is set the increase in the total sperm number (p<0,05), the number of spermatozoa per 1 ml (p<0,05); in stress conditions, the antioxidant therapy induced the increase of spermatozoa with translational movement (p<0,05); at patients which contact with agriculture fertilizers determined the growth of total sperm number (p<0,05), the sperm number of per 1 ml (p<0,05), the number of active cells (p<0,05), including spermatozoa with translational motion (p<0,05). It has been determined that efficacy of L-carnitine for sperm quality according to the Kruger criterion is 84,5%, the efficacy for pathosospermia is 81,2%, for DNA fragmentation is 78,0%, the pathology of the heads is 68,9%, the acrosomal pathology - 71,1%, pathology of flagella – 74,3%. Conclusion: complex treatment of male infertility with including of L-carnitine is effective for correction of testosterone level and morphological parameters of spermogram.

male infertility, occupational factors, hormonal status, spermogram, L-carnitine

1. Singh K, Jaiswal D. Human Male infertility: A Complex Multifactorial Phenotype. Reproductive Sciences. 2011;18:418-25.
2. Feldman HA. Age trends in the levels of serum testosterone and other hormones in the middle-aged men: longitudinal results from the Massachusetts Male Aging Study. J. Clin. Endocrinol. Metab. 2002;87:589-98.
3. Semina SB, Hayes FJ, Crowley WF. Gonadotropin-releasing hormone deficiency in the human (idiopathic hypogonadotropic hypogonadism and Kallmann’s syndrome): pathophysiological and genetic considerations. Endocr. Rev. 1998;19:521-39.
4. Coradi PF, Coradi RB, Greene LW. Physiology of the hypothalamic pituitaey gonadal axis in the male. Urol Clin North Am. 2016;43(2):151-62.
5. Fernández-Miró M, Chilleón JJ, Pedro-Botet J. Testosterone deficiency, metabolic syndrome and diabetes mellitus. Med Clin. 2016;146(2):69-73.
6. Aitken RJ, De Iuliis GN, Gibb Z, Baker MA. The Simmet lecture: new horizons on an old landscape--oxidative stress, DNA damage and apoptosis in the male germ line. Reprod. Domest. Anim. 2012;47(Suppl. 4):7-14.
7. Du Plessis SS, Agarwal A, Halabi J, Tvrda E. Contemporary evidence on the physiological role of reactive oxygen species in human sperm function. J. Assist. Reprod. Genet. J Assist Reprod Genet. 2015;32(4):509-20.
8. Arcaniolo D, Favilla V, Tiscione D, Pisano F, Bozzini G, Creta M, et al. Is there a place for nutritional supplements in the treatment of idiopathic male infertility? Arch Ital Urol Androl. 2014;86(3):164-70.
9. Hamada AJ, Montgomery B, Agarwal A. Male infertility: a critical review of pharmacologic management. Expert Opin Pharmacother. 2012;13(17):2511-31.
10. Chen SJ, Allam JP, Duan YG, Haidl G. Influence of reactive oxygen species on human sperm functions and fertilizing capacity including therapeutical approaches. Arch. Gynecol. Obstet. 2013;288(1):191-9.
11. Chehab M, Madala A, Trussell JC. On-label and off-label drugs used in the treatment of male infertility. Fertil Steril. 2015;103(3):595-604.
12. Showell MG, Brown J, Yazdani A, Stankiewicz MT, Hart RJ. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2011;(1):CD007411. DOI: 10.1002/14651858.CD007411

«Bulletin of problems biology and medicine» Issue 4 Part 2 (147), 2018 year, 156-161 pages, index UDK 621.43:612.616.2:613.646

10.29254/2077-4214-2018-4-2-147-156-161