Андрология и генитальная хирургия. 2015; 16: 37-43
Показатели спермограммы при полизооспермии
https://doi.org/10.17650/2070-9781-2015-16-2-37-43Аннотация
Полизооспермия – состояние, при котором наблюдается чрезвычайно высокая (≥ 250 млн/мл) концентрация сперматозоидов при нормальном объеме эякулята (≥ 1,5 мл). В целях изучения частоты распространения и особенностей сперматогенеза при полизооспермии мы провели анализ более 14 тыс. образцов эякулята мужчин, обратившихся в лабораторию генетики нарушений репродукции ФГБНУ «Медико-генетический научный центр» в 2007–2012 гг. в связи с бесплодием в браке и/или заболеваниями половой системы. В данное исследование включены только результаты семиологических исследований пациентов с полизооспермией. Полизооспермия (концентрация сперматозоидов ≥ 250 млн/мл при объеме эякулята ≥ 1,5 мл) была выявлена в 191 (1,3 %) образце эякулята. В 15 % образцов эякулята от пациентов с полизооспермией наблюдались нормальные показатели подвижности и морфологии сперматозоидов (нормозооспермия). В остальных 85 % образцов была выявлена патозооспермия: астенозооспермия (77 %) и астенотератозооспермия (8 %). Средняя доля живых сперматозоидов составила 90,09 ± 10,02 %, морфологически нормальных – 14,93 ± 8,51 %, а поступательно-подвижных сперматозоидов – 17,72 ± 11,81 %. Средняя концентрация сперматозоидов в эякуляте в обследованной группе пациентов с полизооспермией составила 313,29 ± 64,78 млн/мл. Концентрация сперматозоидов 250–300 млн/мл наблюдалась более чем в половине исследованных образцов, а концентрация ≥ 450 млн/мл – в 3 % случаев. Максимальное отмеченное нами общее количество сперматозоидов в эякуляте составляло более 2 млрд и выявлено в 2 из 191 образца эякулята с полизооспермией. При этом в одном из этих образцов наблюдалась максимальная концентрация сперматозоидов (615 млн/мл). При полизооспермии выявлена положительная корреляция (r = 0,89; p < 0,01) между объемом эякулята и общим количеством сперматозоидов. При количественном кариологическом анализе незрелых половых клеток из осадка эякулята с учетом их состава по стадиям сперматогенеза (от сперматоцитов I профазы I мейоза до поздних сперматид) у 5 из 7 обследованных пациентов выявлены признаки частичного блока сперматогенеза на допахитенных стадиях профазы I мейоза.
Список литературы
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Andrology and Genital Surgery. 2015; 16: 37-43
Semen parameters in polyzoospermic men
https://doi.org/10.17650/2070-9781-2015-16-2-37-43Abstract
Polyzoospermia is extremely high (above 250 mln/ml) sperm concentration with normal volume of ejaculate. In the laboratory of genetic disorders of reproduction of Research Centre for Medical Genetics in 2007–2012 years we analyzed more than 14 000 semen samples from infertile men and men with reproductive disorders in order to study the distribution and characteristics of spermatogenesis in polyzoospermic men. Only polyzoospermic men semen analysis results were interpretered in present article. Polyzoospermia (sperm count over 250 mln/ml in volume over 1,5 ml) was detected in 191 semen samples (1.3 %). At the same time 15 % of the samples with polyzoospermia were normozoospermic. Among 85 % of the sperm pathology samples asthenozoospermia occured most frequently (77 %), astenoteratozoospermia was detected in 8 % of cases with polyzoospermia. The average proportion of vitality was 90.09 ± 10.02 %, normal morphology – 14.93 ± 8.51 %, and progressive motility – 17.72 ± 11.81 %. The average concentration of spermatozoa in the ejaculate in the examined samples was 313.29 ± 64.78 mln/ml. More than half of the tested samples with polyzoospermia had a concentration 250–300 mln/ml. Concentration of 450 mln/ml and more detected in 3 % of samples. The maximum total number of spermatozoa in the ejaculate in our study was more than 2 billion sperm cells and was observed in two polyzoospermic men. One of these patients had the maximum concentration (615 mln/ml) also. We found a high correlation (r = 0.89; p < 0.01) between the volume of ejaculate and the total number of spermatozoa. Immature germ cells from ejaculate were estimated in 7 patients. There was a partial spermatogenesis arrest at meiosis I prophase in 5 out 7 of the examined semen samples.
References
1. Macomber D., Sanders M. The spermatozoa count: its value in the diagnosis, prognosis and concentration in fertile and infertile men. N Engl J Med 1929;200:981–4.
2. WHO laboratory manual for the examination and processing of human semen. 5th ed. WHO, 2010. 271 p.
3. Joël S.A. Fertility Disturbances in Men and Women: A Textbook with Special Reference to Etiology, Diagnosis and Treatment. Basel: Karger, 1971. 617 p.
4. Doepfmer R. Die Bedeutung einer absoluten Polyspermie für die Ätiologie einer sterilen Ehe und gehaufter Aborte. Munch Med Wochenschr 1962;104:794–7.
5. Niendorf F. Polyspermie und Spontanabort. Gynaecologia 1964; 158:35–41.
6. Rätz K.-H., Mattheus A. Beziehungen zwischen Polyspermie und Fehlgeburt. Andrologia 1970;2(3):137–45.
7. Amelar R.D., Dubin L., Quigley M.M., Schoenfeld C. Successful management of infertility due to polyzoospermia. Fertil Steril 1979;31(5):521–4.
8. Carlsen E., Giwercman A., Keiding N., Skakkebaek N.E. Evidence for decreasing quality of semen during past 50 years. BMJ 1992;305(6854):609–13.
9. Carlsen E., Giwercman A., Skakkebaek N.E., Keiding N. Decreasing quality of semen. BMJ 1993;306(6875):461–2.
10. Merzenich H., Zeeb H., Blettner M. Decreasing sperm quality: a global problem? BMC Public Health 2010;19:10–24.
11. Rukovodstvo VOZ po laboratornomu issledovaniyu eyakulyata cheloveka i vzaimodeĭstviya spermatozoidov s tservikal'noĭ sliz'yu. 4-e izd. Per. s angl. R.A. Nersesyana, nauch. red. L.F. Kurilo. M.: MedPress, 2001. 143 s. [WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction. 4th ed. Translation from English by R.A. Nersesyan, Science Editor L.F. Kurilo. M.: MedPress, 2001.143 p. (In Russ.)].
12. Glezerman M., Bernstein D., Zakut C. et al. Polyzoospermia: a definite pathologic entity. Fertil Steril 982;38(5): 605–8.
13. Damjanov I. Clinical evaluation of the infertile couple. In: Pathology of infertility. St. Louis, Missouri: Mosby-Year Book, Inc., 1993. Rp. 7–42.
14. Tournaye H., Staessen C., Camus M. et al. No evidence for a decreased fertilizing potential after in-vitro fertilization using spermatozoa from polyzoospermic men. Hum Reprod 1997;12(10):2183–5.
15. Chan S.Y., Tang L.C., Tang G.W. et al. Spermatozoal fertilizing capacity in polyzoospermia: a preliminary study. Andrologia 1986;18(2):208–13.
16. Haji-Maghsoudi F., Anvari M., Khalili M. Semen analysis and in vitro fertilization cycle outcome in polyzoospermia. J Reprod Infertil 2008; 9(3):238–45.
17. Cooper T.G., Noonan E., Eckardstein S. et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update 2010; 16(3):231–45.
18. Kurilo L.F., Grishina E.M., Sorokina T.M. i dr. Polizoospermiya kak odna iz prichin snizheniya muzhskoĭ fertil'nosti. Andrologiya i genital'naya khirurgiya 2004;3:32–5. [Kurilo L.F., Grishina E.M., Sorokina T.M. et al. Polyzoospermia as one of the causes of male fertility reduction. Andrologiya i genital,naya khirurgiya = Andrology and Genital Surgery 2004;3:32–5. (In Russ.)]
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20. Khan M.S., Ali I., Khattak A.M. et al. Frequency of polyzoospermia and teratozoospermia in infertile men. Gomal J Med Sci 2006;4(1):10–4.
21. Rabbani K.J. Infertility: the male factor. First national symposium on current trends in developmental and reproductive biology. Islamabad, Pakistan, 1997. Pp. 22–3.
22. Khayat S.Sh., Andreeva M.V., Shileĭko L.V. i dr. Analiz pokazateleĭ spermogrammy u muzhchin s narusheniyami reproduktivnoĭ funktsii i polizoospermieĭ. Andrologiya i genital'naya khirurgiya 2014;1:47–53. [Hayat S.S., Andreeva M.V., Shileyko L.V. et al. Analysis of semen analysis values in men with reproductive function disorders and polyzoospermia. Andrologiya i genital'naya khirurgiya = Andrology and Gential Surgery 2014;1:47–53. (In Russ.)].
23. Aziz N., Agarwal A., Lewis-Jones I. et al. Novel associations between specific sperm morphological defects and leukocytospermia. Fertil Steril 2004;82(3):621–7.
24. Villegas J., Schulz M., Soto L. et al. Influence of reactive oxygen species produced by activated leukocytes at the level of apoptosis in mature human spermatozoa. Fertil Steril 2005;83(3):808–10.
25. Barroso G., Taylor S., Morshedi M. et al. Mitochondrial membrane potential integrity and plasma membrane translocation of phosphatidylserine as early apoptotic markers: a comparison of two different sperm subpopulations. Fertil Steril 2006;5(1):149–54.
26. Henkel R., Kierspel E., Stalf T. et al. Effect of reactive oxygen species produced by spermatozoa and leukocytes on sperm functions in non-leukocytospermic patients. Fertil Steril 2005;83(3):635–42.
27. Tomlinson M.J., White A., Barratt C.L. et al. The removal of morphologically abnormal sperm forms by phagocytes: a positive role for seminal leukocytes? Hum Reprod 1992;7(4):517–22.
28. Kiessling A.A., Lamparelli N., Yin H.Z. et al. Semen leukocytes: friends or foes? Fertil Steril 1995; 64(1):196–8.
29. Henkel R., Müller C., Miska W. et al. Acrosin activity of human spermatozoa by means of a simple gelatinolytic technique: a method useful for IVF. J Androl 1995;16(3):272–7.
30. Khan M.S., Deepa F., Ahmed Z. et al. Assessment of male reproductive health by conventional method of semen analysis. J Ayub Med Coll Abbottabad 2011;23(1):84–8.
31. Bornman M.S., Schulenburg G.W., Boomker D. et al. Observations in infertile African males at an andrology clinic in South Africa. Arch Androl 1994; 33(2):101–4.
32. Merino G., Carranza-Lira S. Semen characteristics, endocrine profiles, and testicular biopsies of infertile men of different ages. Arch Androl 1995;35(3):219–24.
33. Vybornov S.V. Biokhimicheskie pokazateli reproduktivnogo zdorov'ya muzhchin, rabotayushchikh na Astrakhanskom gazopererabatyvayushchem zavode. Avtoref. dis. ... kand. med. nauk. M., 2006. 19 s. [Vybornov S.V. Biochemical values of reproductive health in men, working at Astrakhan Gas Processing Plant. Abstract of Thesis of Ph. D. in Medicine. M., 2006. 19 p. (In Russ.)].
