Андрология и генитальная хирургия. 2015; 16: 51-54
Прогностическая ценность различных показателей спермы относительно мужской фертильности
https://doi.org/10.17650/2070-9781-2015-16-4-51-54Аннотация
Введение. Одной из возможных причин снижения фертильного потенциала мужчин является фрагментация ДНК сперматозоидов. Однако не выявлено значимой корреляции между традиционными параметрами спермы и фрагментацией ДНК сперматозоидов. С учетом этого актуальность представляет изучение влияния различных показателей спермы на фертильность мужчин.
Материалы и методы. Исследование включало 60 мужчин в возрасте 26–36 лет (медиана – 30 лет) с идиопатическим бесплодием и уровнем фрагментации ДНК сперматозоидов более 15 %. У них проведен курс лечения с помощью гипербарической оксигенации, после этого через 3 мес выполняли процедуру экстракорпорального оплодотворения. Фрагментацию ДНК сперматозоидов определяли с помощью метода TUNEL (верхняя граница нормы – 15 %). Уровень активных форм кислорода (АФК) в эякуляте определяли методом хемилюминесценции (верхняя граница нормы – 0,64 мВ/с).
Результаты. Частота беременности у партнерш при экстракорпоральном оплодотворении составила: 62,8 и 64,7 % (p > 0,05) при количестве сперматозоидов < 38 × 106 и ≥ 38 × 106 соответственно; 63,3 и 63,6 % (p > 0,05) при подвижности (a + b) спер- матозоидов < 40 и ≥ 40 % соответственно; 58,3 и 64,6 % (p > 0,05) при количестве нормальных форм сперматозоидов < 4 и ≥ 4 % соответственно; 67,3 и 20,0 % (p < 0,05) при уровне фрагментации ДНК сперматозоидов ≤ 15 и > 15 % соответственно; 64,9 и 33,3 % (p < 0,05) при уровне АФК в сперме ≤ 0,64 и > 0,64 мВ/с соответственно.
Заключение. Вероятность наступления беременности после экстракорпорального оплодотворения достоверно зависит от уровней фрагментации ДНК сперматозоидов и АФК в сперме.
Список литературы
1. Рутинский А.И. Особенности диагностики идиопатического мужского бесплодия (обзор литературы). Медико-социальные проблемы семьи 2013;18(1):116–21. [Rutinskiy А.I. Peculiarities of the diagnosis of the idiopathic men,s infertility (literature review). Medikosotsial,nye problemy sem,i = Меdical and Social Problems of the Family 2013;18(1):116–21. (In Russ.)].
2. Sabanegh E.J., Agarwal A. Male infertility. In: Campbell-Walsh urology. 10th ed. Eds.: M.F. Campbell, P.C. Walsh, A.J. Wein. Philadelphia: Saunders Elsevier, 2012. Pp. 616–47.
3. Jung J.H., Seo J.T. Empirical medical therapy in idiopathic male infertility: Promise or panacea? Clin Exp Reprod Med 2014;41(3):108–14.
4. Imamovic Kumalic S., Pinter B. Review of clinical trials on effects of oral antioxidants on basic semen and other parameters in idiopathic oligoasthenoteratozoospermia. Biomed Res Int 2014;2014:426951.
5. Lewis S.E., John Aitken R., Conner S.J. et al. The impact of sperm DNA damage in assisted conception and beyond: recent advances in diagnosis and treatment. Reprod Biomed Online 2013;27(4):325–37.
6. Walczak-Jedrzejowska R., Wolski J.K., Slowikowska-Hilczer J. The role of oxidative stress and antioxidants in male fertility. Cent European J Urol 2013;66(1):60–7.
7. Aitken R.J., Jones K.T., Robertson S.A. Reactive oxygen species and sperm function – in sickness and in health. J Androl 2012;33(6):1096–106.
8. Ko E.Y., Sabanegh E.S. Jr, Agarwal A. Male infertility testing: reactive oxygen species and antioxidant capacity. Fertil Steril 2014;102(6):1518–27.
9. Patrizio P., Sanguineti F., Sakkas D. Modern andrology: from semen analysis to postgenomic studies of the male gametes. Ann NY Acad Sci 2008;1127:59–63.
10. Fraser L. Structural damage to nuclear DNA in mammalian spermatozoa: its evaluation techniques and relationship with male infertility. Pol J Vet Sci 2004;7(4):311–21.
11. Das M., Al-Hathal N., San-Gabriel M. et al. High prevalence of isolated sperm DNA damage in infertile men with advanced paternal age. J Assist Reprod Genet 2013;30(6):843–8.
12. Bungum M., Bungum L., Giwercman A. Sperm chromatin structure assay (SCSA): a tool in diagnosis and treatment of infertility. Asian J Androl 2011;13(1):69–75.
13. Avendaño C., Oehninger S. DNA fragmentation in morphologically normal spermatozoa: how much should we be concerned in the ICSI era? J Androl 2011;32(4):356–63.
14. Giwercman A., Lindstedt L., Larsson M. et al. Sperm chromatin structure assay as an independent predictor of fertility in vivo: a case-control study. Int J Androl 2010;33(1):e221–7.
15. Wyrobek A.J., Eskenazi B., Young S. et al. Advancing age has differential effects on DNA damage, chromatin integrity, gene mutations, and aneuploidies in sperm. Proc Natl Acad Sci USA 2006;103(25):9601–6.
16. Benchaib M., Lornage J., Mazoyer C. et al. Sperm deoxyribonucleic acid fragmentation as a prognostic indicator of assisted reproductive technology outcome. Fertil Steril 2007;87(1):93–100.
Andrology and Genital Surgery. 2015; 16: 51-54
The predictive value of various indicators of sperm for male fertility
https://doi.org/10.17650/2070-9781-2015-16-4-51-54Abstract
Introduction. DNA fragmentation of sperm is one of the possible causes of reduced fertility potential of men. However, a significant correlation between conventional semen parameters and sperm DNA fragmentation was not found. This fact determines the relevance of the study of the influence of various parameters of sperm on male fertility.
Materials and methods. The study included 60 men, aged 26–36 years (median – 30 years) with idiopathic infertility and the level of DNA fragmentation of sperm is higher than 15 %. These men were treated with hyperbaric oxygen therapy, after 3 months in vitro fertilization performed partners of these men. DNA fragmentation of sperm cells was determined by TUNEL (upper limit of normal – 15 %). The level of reactive oxygen species (ROS) of the ejaculate were determined by chemiluminescence (upper limit of normal – 0.64 mV/s).
Results. The frequency of pregnancy in vitro fertilization was following: 62.8 and 64.7 % (p > 0.05) for the total number sperm of spermatozoa < 38 × 106 /ejaculate and ≥ 39 × 106 /ejaculate, respectively; 63.3 and 63.6 % (p > 0.05) for mobility (a + b) of spermatozoa < 40 and ≥ 40 %, respectively; 58.3 and 64.6 % (p > 0.05) for normal forms of spermatozoa < 4 and ≥ 4 %, respectively; 67.3 and 20.0 % (p < 0.05) for the level of DNA fragmentation of sperm ≤ 15 and > 15 %, respectively; 64.9 and 33.3 % (p < 0.05) for the level of ROS in semen ≤ 0.64 and > 0.64 mV/s, respectively.
Conclusion. The probability of pregnancy after in vitro fertilization significantly depends on the levels of sperm DNA fragmentation in the sperm and level of ROS in semen.
References
1. Rutinskii A.I. Osobennosti diagnostiki idiopaticheskogo muzhskogo besplodiya (obzor literatury). Mediko-sotsial'nye problemy sem'i 2013;18(1):116–21. [Rutinskiy A.I. Peculiarities of the diagnosis of the idiopathic men,s infertility (literature review). Medikosotsial,nye problemy sem,i = Medical and Social Problems of the Family 2013;18(1):116–21. (In Russ.)].
2. Sabanegh E.J., Agarwal A. Male infertility. In: Campbell-Walsh urology. 10th ed. Eds.: M.F. Campbell, P.C. Walsh, A.J. Wein. Philadelphia: Saunders Elsevier, 2012. Pp. 616–47.
3. Jung J.H., Seo J.T. Empirical medical therapy in idiopathic male infertility: Promise or panacea? Clin Exp Reprod Med 2014;41(3):108–14.
4. Imamovic Kumalic S., Pinter B. Review of clinical trials on effects of oral antioxidants on basic semen and other parameters in idiopathic oligoasthenoteratozoospermia. Biomed Res Int 2014;2014:426951.
5. Lewis S.E., John Aitken R., Conner S.J. et al. The impact of sperm DNA damage in assisted conception and beyond: recent advances in diagnosis and treatment. Reprod Biomed Online 2013;27(4):325–37.
6. Walczak-Jedrzejowska R., Wolski J.K., Slowikowska-Hilczer J. The role of oxidative stress and antioxidants in male fertility. Cent European J Urol 2013;66(1):60–7.
7. Aitken R.J., Jones K.T., Robertson S.A. Reactive oxygen species and sperm function – in sickness and in health. J Androl 2012;33(6):1096–106.
8. Ko E.Y., Sabanegh E.S. Jr, Agarwal A. Male infertility testing: reactive oxygen species and antioxidant capacity. Fertil Steril 2014;102(6):1518–27.
9. Patrizio P., Sanguineti F., Sakkas D. Modern andrology: from semen analysis to postgenomic studies of the male gametes. Ann NY Acad Sci 2008;1127:59–63.
10. Fraser L. Structural damage to nuclear DNA in mammalian spermatozoa: its evaluation techniques and relationship with male infertility. Pol J Vet Sci 2004;7(4):311–21.
11. Das M., Al-Hathal N., San-Gabriel M. et al. High prevalence of isolated sperm DNA damage in infertile men with advanced paternal age. J Assist Reprod Genet 2013;30(6):843–8.
12. Bungum M., Bungum L., Giwercman A. Sperm chromatin structure assay (SCSA): a tool in diagnosis and treatment of infertility. Asian J Androl 2011;13(1):69–75.
13. Avendaño C., Oehninger S. DNA fragmentation in morphologically normal spermatozoa: how much should we be concerned in the ICSI era? J Androl 2011;32(4):356–63.
14. Giwercman A., Lindstedt L., Larsson M. et al. Sperm chromatin structure assay as an independent predictor of fertility in vivo: a case-control study. Int J Androl 2010;33(1):e221–7.
15. Wyrobek A.J., Eskenazi B., Young S. et al. Advancing age has differential effects on DNA damage, chromatin integrity, gene mutations, and aneuploidies in sperm. Proc Natl Acad Sci USA 2006;103(25):9601–6.
16. Benchaib M., Lornage J., Mazoyer C. et al. Sperm deoxyribonucleic acid fragmentation as a prognostic indicator of assisted reproductive technology outcome. Fertil Steril 2007;87(1):93–100.
