Андрология и генитальная хирургия (Sep 2021)
Comprehensive analysis of male ejaculate from infertile couples in the age aspect
Abstract
Introduction. According to Russian Association of Urology a number of infertile couples ranges from 8 to 17.2 % in various regions of Russia. One of the causes of which is the male factor. Raising the age of the father reduces the chance of conception, increases the risk of early termination of pregnancy and the risk of certain diseases of the child. In this regard the existing knowledge of age-related changes in ejaculate parameters needs to be de veloped. This is particularly true for men of infertile couples.The study objective – to investigate the age patterns of change in the spermological status of infertile men and identify the most age-related variations.Materials and methods. Research design – observation, retrospective, crossection. Analysis of the medical records of 517 Novosibirsk male residents from couples with infertility in marriage was made. The sampling is divided into 5 age groups: 1st group (n = 108) – men of ≤29.9 years old; 2nd group (n = 171) – 30.0–34.9 years old; 3rd group (n = 130) – 35.0–39.9 years old; 4th group (n = 68) – 40.0–44.9 years old; 5th group (n = 40) – ≥45.0 years old.Results. Median of male age in total sample – 34 years, frequency of persons over 40 years – 21 %. Overall sample shows a decline in reference values of proportion of morphologically normal forms – 3.0 (1.5–5.0) % and increase in sperm DNA fragmentation index (SDFI) – 16.0 (11.0–22.2) %. In groups from 1st to 5th there is an age-specific decrease in ejaculate volume (3.5 (2.5–4.8) ml; 3.3 (2.4–4.2) ml; 3.2 (2.4–4.5) ml; 3.0 (1.7–4.9) ml; 2.7 (1.9–3.5) ml, р1–5 <0.005) and sperm count (127.1 (58.8–264.0) million; 122.5 (62.4–214.0) million; 118.5 (52.8–217.5) million; 98.0 (58.5–199.5) million; 81.0 (36.5–137.9) million, р1–5, 2–5 <0.005). SDFI has an age-associated increase in the value of the indicator (14.4 (10.8–19.5) %; 15.0 (10.0–21.0) %; 17.2 (11.0–22.0) %; 18.5 (14.0–24.2) %; 19.2 (13.2–29.6) %, р1–4 <0.005).Conclusion. It was first time shown for the male population of Novosibirsk of Siberian Federal District that a reduction in the proportion of morphologically normal sperm below the reference values observed in the total sample and it did not depend on the age of the men examined. Only three of the examined indicators of sperm status studied infertile males had a significant age dependency: ejaculate volume decrease, reduction of total sperm, increased DNA fragmentation of sperm. The lack of a reliable influence of age on HBA-test indicators was first shown. However the trends identified require further study. The results show that age-associated increase in DNA fragmentation of sperm starts with young men under 30, and underscores the need to define SDFI in actual clinical practice. And negative processes of age influence on the quantitative, morphological and ultrastructural characteristics of sperm occur most frequently in men after 40 years.
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