Biometric analysis spermograms of men of different age groups in normal and pathology in Lviv region, Ukraine

Abstract

Background. Analysis of the causes of infertility revealed an increase in the proportion of male factors over the past 20 years by an average of 10–12 %. World Health Organization data, which summarize the observations of many authors in recent years, show a decrease in male reproductive potential. The ejaculate parameters of the modern average man are steadily declining. For example, the concentration of germ cells in the seminal fluid has decreased three times, and this trend continues: the concentration of sperm decreases annually by about 2 %, and their motility – by 1.5 %. Not only is infertility a pressing problem in modern medicine, but also an important social issue, as it is associated with the mental state of men and the preservation of the family. Materials and Methods. Spermograms were obtained during the study of patients in the clinic of reproductive medicine “Alternative Clinic” (Lviv, Ukraine). A total of 50 men were surveyed, including 16 men aged 20 to 29 (junior age group), 17 men aged 30 to 39 (middle age group) and 17 men 40 to 49 years old (senior age group), respectively. We found that out of the 16 men in the junior group, 4 spermograms corresponded to asthenozoospermia, and 12 – normozoospermia, of the 17 middle-aged group, 7 spermograms corresponded to asthenozoospermia, and 10 – normozoospermia and 10 men of the senior group to 15 spermograms asthenozoospermia, 2 – normospermia. Spermograms were evaluated by the following indicators: ejaculate count, viscosity, sperm count per 1 mL of ejaculate, sperm motility in categories “A” and “B”, the number of morphologically normal and morphologically degenerative sperm, Farris index. For control we took spermograms of patients with normozoospermia. Results. Analyzing spermograms according to the studied indicators, we found a decrease in the amount of ejaculate in older men relative to the norm, which may indicate a lack of function of the seminal vesicles, prostate. According to the criteria for the number of sperm in 1 ml of ejaculate and the total number of sperm in the whole ejaculate, it was shown that in the spermograms of patients with asthenozoospermia of different age, these figures are much lower than normal. This indicates a decrease in male fertility in these diseases. Examining sperm motility according to the following criteria: “A” – fast translational movements and “B” – slow, sluggish translational movements, we found a decrease in these indicators compared with the norm in men of all ages with asthenozoospermia. This indicates a decrease in the quality of ejaculate in men, and, consequently, reduce the likelihood of fertilization. Examining sperm morphology, we assessed the number of normal and degenerative sperm. We have shown that in men of all ages with asthenozoospermia, the number of morphologically normal sperm is lower than in the control, and the number of morphologically degenerative sperm is increasing. Probably, such pathology can lead to a decrease in the possibility of fertilization and increases the likelihood of malformations in the fetus, if fertilization has occurred. Evaluating the spermograms of men in the study groups according to the Farris index, we found a significant reduction in this number in men with asthenozoospermia. This indicates a low probability of fertilization. Conclusions. Male infertility (in particular, asthenozoospermia) can be caused by many different diseases in which there are deviations from the norms of qualitative and quantitative indicators of ejaculate. According to the data obtained from the observation of men, there is a tendency for the reduction of ejaculate volume, concentration and motility of sperm, as well as their morphological status. Keywords: asthenozoospermia, normozoospermia, spermogram, male infertility