Андрология и генитальная хирургия. 2024; 25: 54-60
Динамика показателей эякулята за период с 2017 по 2023 год: ретроспективный одноцентровой анализ
https://doi.org/10.62968/2070-9781-2024-25-2-54-60Аннотация
Введение: одним из важнейших исследований, выполняемых при оценке мужской фертильности, является спермограмма. Оценка параметров эякулята позволяет предположить возможные причины нарушения мужской фертильности, помогает в определении тактики лечения. В то же время, по данным мировой литературы, отмечается небольшое, но постоянное ухудшение параметров эякулята.
Цель исследования: оценить показатели спермограммы у пациентов, проходивших обследование по различным причинам в одном медицинском центре.
Материалы и методы: проведена ретроспективная оценка показателей эякулята с помощью анализа спермограмм, выполненных в одной лаборатории с 1 января 2017 года по 31 октября 2023 года, всего включено 47902 пациента. Оценивали объем эякулята, концентрацию и количество сперматозоидов, долю сперматозоидов разных категорий подвижности, определяли долю морфологически нормальных сперматозоидов. Статистическую обработку данных выполняли с помощью пакета программного обеспечения MS Office и SPSS v26.
Результаты: средний объем в период с 2017 по 2023 год составил 3,5 ± 1,5 мл, концентрация 51,9 ± 39,3 млн/мл, доля прогрессивно-подвижных сперматозоидов – 48,2 ± 16,5%, число прогрессивно-подвижных сперматозоидов в образце – 93,7 ± 94,3 млн, доля подвижных сперматозоидов – 55,6 ± 17.4%, общее число подвижных сперматозоидов – 107,5 ± 105,6 млн, в 2017 году количество морфологически нормальных форм в среднем составляло 2,8 ±1,4%, в 2023 году – 2,2 ± 0,9%, в среднем за период наблюдения – 3.5 ± 1.5%. Показатель pH эякулята в среднем составил 7,6 ± 0.3, отмечали тенденцию к его повышению в динамике (7,38 ± 0,33 в 2017 году, 7,6 ± 0,38 в 2023 году). Частота азооспермии выросла с 2,8% в 2017 году до 4,5% в 2023 году. Количество пациентов с криптозооспермией составило в среднем 1,5%.
Заключение: отмечается тенденция к снижению доли морфологически нормальных сперматозоидов, повышению pH эякулята и увеличению частоты азооспермии за период с 2017 по 2023 год.
Список литературы
1. Carlsen E, Giwercman A, Keiding N, Skakkebaek NE. Evidence for decreasing quality of semen during past 50 years. BMJ 1992;305:609–13. https://doi.org/10.1136/bmj.305.6854.609.
2. Levine H, Jørgensen N, Martino-Andrade A, Mendiola J, Weksler-Derri D, Jolles M, et al. Temporal trends in sperm count: a systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries. Hum Reprod Update 2023;29:157–76. https://doi.org/10.1093/humupd/dmac035.
3. Cipriani S, Ricci E, Chiaffarino F, Esposito G, Dalmartello M, La Vecchia C, et al. Trend of change of sperm count and concentration over the last two decades: A systematic review and meta‐regression analysis. Andrology 2023;11:997–1008. https://doi.org/10.1111/andr.13396.
4. Korneyev IA. Annual trends in semen parameters among men attending a fertility center between 2016 and 2022. Urology Reports (St - Petersburg) 2023;13:23–9. https://doi.org/10.17816/uroved296569.
5. Agarwal A, Mulgund A, Hamada A, Chyatte MR. A unique view on male infertility around the globe. Reproductive Biology and Endocrinology 2015;13:37. https://doi.org/10.1186/s12958-015-0032-1.
6. Xie Y, Mirzaei M, Kahrizi MS, Shabestari AM, Riahi SM, Farsimadan M, et al. SARS-CoV-2 effects on sperm parameters: a meta-analysis study. J Assist Reprod Genet 2022;39:1555–63. https://doi.org/10.1007/s10815-022-02540-x.
7. Драпкина Ю.С., Долгушина Н.В., Шатылко Т.В., Николаева М.А., Менжинская И.В., Иванец Т.Ю., et al. Вакцина Гам-КОВИД-Вак (Спутник V) не оказывает негативного влияния на сперматогенез у мужчин. Акушерство и Гинекология 2021:88–94. https://doi.org/https://doi.org/10.18565/aig.202L7.88-94.
8. Punjani N, Alawamlh OA, Kim SJ, Salter CA, Wald G, Feliciano M, Williams N, Dudley V, Goldstein M. Changes in Semen Analysis over Time: A Temporal Trend Analysis of 20 Years of Subfertile Non-Azoospermic Men. World J Mens Health. 2023 Apr;41(2):382-389. doi: 10.5534/wjmh.210201. Epub 2022 Jun 13.
9. Nordkap L, Joensen UN, Blomberg Jensen M, Jørgensen N. Regional differences and temporal trends in male reproductive health disorders: Semen quality may be a sensitive marker of environmental exposures. Mol Cell Endocrinol 2012;355:221–30. https://doi.org/10.1016/j.mce.2011.05.048.
10. Jensen TK, Heitmann BL, Jensen MB, Halldorsson TI, Andersson A-M, Skakkebæk NE, et al. High dietary intake of saturated fat is associated with reduced semen quality among 701 young Danish men from the general population. Am J Clin Nutr 2013;97:411–8. https://doi.org/10.3945/ajcn.112.042432.
11. Afeiche MC, Williams PL, Gaskins AJ, Mendiola J, Jørgensen N, Swan SH, et al. Meat Intake and Reproductive Parameters Among Young Men. Epidemiology 2014;25:323–30. https://doi.org/10.1097/EDE.0000000000000092.
12. LaPointe S, Mehta A, Gaskins AJ. Diet and recreational drug use in relation to male reproductive health. Fertil Steril 2023. https://doi.org/10.1016/j.fertnstert.2023.10.013.
13. Gollenberg AL, Liu F, Brazil C, Drobnis EZ, Guzick D, Overstreet JW, et al. Semen quality in fertile men in relation to psychosocial stress. Fertil Steril 2010;93:1104–11. https://doi.org/10.1016/j.fertnstert.2008.12.018.
14. Sharma R, Harlev A, Agarwal A, Esteves SC. Cigarette Smoking and Semen Quality: A New Meta-analysis Examining the Effect of the 2010 World Health Organization Laboratory Methods for the Examination of Human Semen. Eur Urol 2016;70:635–45. https://doi.org/10.1016/j.eururo.2016.04.010.
15. Kleshchev M, Osadchuk L, Osadchuk A. Age-Related Changes in Sperm Morphology and Analysis of Multiple Sperm Defects. Frontiers in Bioscience-Scholar 2023;15:12. https://doi.org/10.31083/j.fbs1503012.
16. Griffin DK. Is the Y chromosome disappearing?—Both sides of the argument. Chromosome Research 2012;20:35–45. https://doi.org/10.1007/s10577-011-9252-1.
17. Esteves SC, Roque M, Bedoschi G, Haahr T, Humaidan P. Intracytoplasmic sperm injection for male infertility and consequences for offspring. Nat Rev Urol 2018;15:535–62. https://doi.org/10.1038/s41585-018-0051-8.
Andrology and Genital Surgery. 2024; 25: 54-60
Dynamics of ejaculate parameters from 2017 to 2023: a retrospective single-center analysis
https://doi.org/10.62968/2070-9781-2024-25-2-54-60Abstract
Introduction: One of the most important tests to evaluate male fertility is a semen analysis. Assessment of ejaculate parameters allows to assume possible causes of male infertility and helps to determine further treatment. According to modern literature there is a slight but constant deterioration of ejaculate parameters with time.
Purpose of the study: to evaluate semen analysis parameters in patients examined in one medical center.
Materials and Methods: retrospective evaluation of semen analyses performed in the same laboratory from January 1, 2017 to October 31, 2023 was performed with a total of 47902 patients included. The ejaculate volume, concentration and number of spermatozoa, the proportion of spermatozoa of different categories of motility, sand the proportion of morphologically normal spermatozoa were evaluated. Statistical processing of data was performed using MS Office and SPSS v26 software packages.
Results: the mean semen volume from 2017 to 2023 was 3.5 ± 1.5 mL, sperm concentration was 51.9 ± 39.3 million/mL, progressively motile spermatozoa was 48.2 ± 16.5%, number of progressively motile spermatozoa in the sample was 93.7 ± 94.3 million, motile spermatozoa 55.6 ± 17.4%, total motile spermatozoa was 107.5 ± 105.6 million, mean number of morphologically normal forms was 2.8 ± 1.4% in 2017, 2.2 ± 0.9% in 2023, and 3.5 ± 1.5% during the observation period. Mean pH of ejaculate was 7.6 ± 0.3 with noted tendency to increase (7.38 ± 0.33 in 2017, 7.6 ± 0.38 in 2023). The proportion of samples with azoospermia increased from 2.8% in 2017 to 4.5% in 2023. Mean number of patients with cryptozoospermia was 1.5%.
Conclusion: there is a trend of decreasing proportion of morphologically normal spermatozoa, increasing ejaculate pH and increasing frequency of azoospermia from 2017 to 2023.
References
1. Carlsen E, Giwercman A, Keiding N, Skakkebaek NE. Evidence for decreasing quality of semen during past 50 years. BMJ 1992;305:609–13. https://doi.org/10.1136/bmj.305.6854.609.
2. Levine H, Jørgensen N, Martino-Andrade A, Mendiola J, Weksler-Derri D, Jolles M, et al. Temporal trends in sperm count: a systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries. Hum Reprod Update 2023;29:157–76. https://doi.org/10.1093/humupd/dmac035.
3. Cipriani S, Ricci E, Chiaffarino F, Esposito G, Dalmartello M, La Vecchia C, et al. Trend of change of sperm count and concentration over the last two decades: A systematic review and meta‐regression analysis. Andrology 2023;11:997–1008. https://doi.org/10.1111/andr.13396.
4. Korneyev IA. Annual trends in semen parameters among men attending a fertility center between 2016 and 2022. Urology Reports (St - Petersburg) 2023;13:23–9. https://doi.org/10.17816/uroved296569.
5. Agarwal A, Mulgund A, Hamada A, Chyatte MR. A unique view on male infertility around the globe. Reproductive Biology and Endocrinology 2015;13:37. https://doi.org/10.1186/s12958-015-0032-1.
6. Xie Y, Mirzaei M, Kahrizi MS, Shabestari AM, Riahi SM, Farsimadan M, et al. SARS-CoV-2 effects on sperm parameters: a meta-analysis study. J Assist Reprod Genet 2022;39:1555–63. https://doi.org/10.1007/s10815-022-02540-x.
7. Drapkina Yu.S., Dolgushina N.V., Shatylko T.V., Nikolaeva M.A., Menzhinskaya I.V., Ivanets T.Yu., et al. Vaktsina Gam-KOVID-Vak (Sputnik V) ne okazyvaet negativnogo vliyaniya na spermatogenez u muzhchin. Akusherstvo i Ginekologiya 2021:88–94. https://doi.org/https://doi.org/10.18565/aig.202L7.88-94.
8. Punjani N, Alawamlh OA, Kim SJ, Salter CA, Wald G, Feliciano M, Williams N, Dudley V, Goldstein M. Changes in Semen Analysis over Time: A Temporal Trend Analysis of 20 Years of Subfertile Non-Azoospermic Men. World J Mens Health. 2023 Apr;41(2):382-389. doi: 10.5534/wjmh.210201. Epub 2022 Jun 13.
9. Nordkap L, Joensen UN, Blomberg Jensen M, Jørgensen N. Regional differences and temporal trends in male reproductive health disorders: Semen quality may be a sensitive marker of environmental exposures. Mol Cell Endocrinol 2012;355:221–30. https://doi.org/10.1016/j.mce.2011.05.048.
10. Jensen TK, Heitmann BL, Jensen MB, Halldorsson TI, Andersson A-M, Skakkebæk NE, et al. High dietary intake of saturated fat is associated with reduced semen quality among 701 young Danish men from the general population. Am J Clin Nutr 2013;97:411–8. https://doi.org/10.3945/ajcn.112.042432.
11. Afeiche MC, Williams PL, Gaskins AJ, Mendiola J, Jørgensen N, Swan SH, et al. Meat Intake and Reproductive Parameters Among Young Men. Epidemiology 2014;25:323–30. https://doi.org/10.1097/EDE.0000000000000092.
12. LaPointe S, Mehta A, Gaskins AJ. Diet and recreational drug use in relation to male reproductive health. Fertil Steril 2023. https://doi.org/10.1016/j.fertnstert.2023.10.013.
13. Gollenberg AL, Liu F, Brazil C, Drobnis EZ, Guzick D, Overstreet JW, et al. Semen quality in fertile men in relation to psychosocial stress. Fertil Steril 2010;93:1104–11. https://doi.org/10.1016/j.fertnstert.2008.12.018.
14. Sharma R, Harlev A, Agarwal A, Esteves SC. Cigarette Smoking and Semen Quality: A New Meta-analysis Examining the Effect of the 2010 World Health Organization Laboratory Methods for the Examination of Human Semen. Eur Urol 2016;70:635–45. https://doi.org/10.1016/j.eururo.2016.04.010.
15. Kleshchev M, Osadchuk L, Osadchuk A. Age-Related Changes in Sperm Morphology and Analysis of Multiple Sperm Defects. Frontiers in Bioscience-Scholar 2023;15:12. https://doi.org/10.31083/j.fbs1503012.
16. Griffin DK. Is the Y chromosome disappearing?—Both sides of the argument. Chromosome Research 2012;20:35–45. https://doi.org/10.1007/s10577-011-9252-1.
17. Esteves SC, Roque M, Bedoschi G, Haahr T, Humaidan P. Intracytoplasmic sperm injection for male infertility and consequences for offspring. Nat Rev Urol 2018;15:535–62. https://doi.org/10.1038/s41585-018-0051-8.
