İnci KAHYAOGLU, Nafiye YİLMAZ, M. Nedim ÇİÇEK, Osman BALCI, Magdi ADEM, Fatma BEYAZIT

Açıklanamayan İnfertil Hastalarda Lökosperminin Sperm Parametreleri Üzerine Etkisi

Amaç: Seminal sıvıdaki lökositler ile semen kalitesi arasındaki ilişki literatürde hala bir tartışma konusudur. Bu çalışmada amaç, açıklanamayan infertil hasta grubunda lökosperminin semen parametreleri üzerine etkilerini araştırmaktır. Materyal Metod: Haziran 2011 ile Aralık 2011 tarihleri arasında Ankara’da üçüncü basamak bir eğitim araştırma hastanesinin tüp bebek kliniğinde yapılan semen analizleri retrospektif olarak incelendi. Açıklanamayan infertilite nedeni ile başvuran çiftlerden erkeğe ait sonuçlar bu veriler arasından seçildi. Toplamda intrauterine inseminasyon ve in-vitro fertilizasyon siklusları için hazırlanmış olan 1637 semen analizi çalışmaya dahil edildi. Azospermik ve oligospermik erkekler çalışma dışı bırakıldı. Lökospermi saptanan 348 semen analizi ile Grup I saptanmayan 1289 semen analizi sonucu Grup II karşılaştırıldı. Sonuç: Lökospermi >106 /mL 348 hastada tespit edildi. Prevelansı toplamda %21.2 olarak değerlendirildi. İki grup arasında yaş, semen motilite ve morfolojisi açısından herhangi bir fark saptanmadı. p>0.05 Semen hacmi, pH, konsantrasyon ve total sperm sayısı açısından ise iki grup arasındaki farkı istatistiksel olarak anlamlı olduğu izlendi. p

Anahtar Kelimeler:

Lökospermi, açıklanamayan infertilite, in-vitro fertilizasyon, intrauterin inseminasyon

The Effect of Leukospermia on Sperm Parameters in Couples With Unexplained Infertility

Objective: The association between seminal leukocytes and semen quality is still a matter of debate in the literature. The purpose of this study was to evaluate the effect of leukospermia on semen parameters in unexplained infertile men. Materials and Methods: Semen analysis performed between June 2011 and December 2011 at infertility and in-vitro fertilization IVF clinic of a tertiary research and education hospital in Ankara were studied retrospectively. Results of the male partners of the couples with unexplained infertility were selected. A total of 1637 semen analysis of intrauterine insemination and in-vitro fertilization cycles were included in the study. Results of oligospermic and azospermic males were excluded. Semen parameters of 348 men with leukospermia Group I and 1289 without leukospermia Group II were compared. Results: Leukospermia >106 /mL was found in 348 patients. The prevelance was found to be 21.2% in total. There were no differences between two groups according the age, semen motility and morphology p>0.05 . With regard to semen volume, pH, concentration and total sperm count the difference between two groups were found to be statistically significant p

Keywords:

Leukospermia, unexplained infertility, in-vitro fertilization, intrauterine insemination,

PDF

___

1. World Health Organization. WHO Semen Manual for the Examination of Human Semen and Cervical Mucus. Cambridge: Cambridge University Press, 1992; p8–11.
2. Pentyala S, Lee J, Annam S, Alvarez J, Veerraju A, Yadlapalli N, Khan SA. Current perspectives on pyospermia: a review. Asian J Androl. 2007;9(5):593-600.
3. Menkveld R. Leukocytospermia. In: Daya S, Harrison R, Kempers R editor. Advances in fertility and reproductive medicine International Congress Series No 1266. Amsterdam: Elsevier; 2004;p. 218–224.
4. Close CE, Roberts PL, Berger RE. Cigarettes, alcohol and marijuana are related to pyospermia in infertile men. J Urol. 1990;144:900–903.
5. Barratt CL, Bolton AE, Cooke ID. Functional significance of white blood cells in the male and female reproductive tract. Hum Reprod. 1990;5:639–648. 6. Kiessling AA, Lamparelli N, Yin HZ, Seibel MM, Eyre RC. Semen leukocytes: friends or foes? Fertil Steril. 1995;64:196–198.
7. Fedder J. Nonsperm cells in human semen: with special reference to seminal leukocytes and their possible influence on fertility. Fertil Steril 1996;36:41–65.
8. Arata de Bellabarba G, Tortolero I, Villarroel V, Molina CZ, Bellabarba C, Velazquez E. Nonsperm cells in human semen and their relationship with semen parameters. Fertil Steril. 2000;45:131– 136.
9. Henkel R, Ichikawa T, Sanchez R, Miska W, Ohmori H, Schill WB. Differentiation of ejaculates showing reactive oxygen species production by spermatozoa or leukocytes. Andrologia. 1997;29:295– 301.
10. Saleh RA, Agarwal A, Kandirali E, Sharma RK, Thomas AJ, Nada EA, Evenson DP, Alvarez JG. Leukocytospermia is associated with increased reactive oxygen species production by human spermatozoa. Fertil Steril. 2002;78:1215–1224.
11. Lemkecher T, Dartigues S, Vaysse J, Kulski O, Barraud-Lange V, Gattegno L, Wolf JP. Leucocytospermia, oxidative stress and male fertility: facts and hypotheses. Gynecol Obstet Fertil. 2005;33:2–10.
12. Sharma RK, Agarwal A. Role of reactive oxygen species in male infertility. Urology. 1996;48:835–850.
13. Domes T, Lo KC, Grober ED, Mullen JB, Mazzulli T, Jarvi K. The incidence and effect of bacteriospermia and elevated seminal leukocytes on semen parameters. Fertil Steril. 2012;97:1050–1055.
14. Moustafa MH, Sharma RK, Thornton J, Mascha E, AbdelHafez MA, Thomas AJ, et al. Relationship between ROS production, apoptosis and DNA denaturation in spermatozoa from patients examined for infertility. Hum Reprod. 2004;19:129–138.
15. Berger RE, Karp LE, Williamson RA, Koechler J, Moore DE, Holmes KK. The relationship of pyospermia and seminal fluid bacteriology to sperm function as reflected in the sperm penetration assay. Fertil Steril. 1982; 37: 557–64.
16. World Health Organization. WHO Laboratory Manual for the Examination and Processing of Human Semen. 5th ed. Geneva: World Health Organization; 2010.
17. Branigan EF, Muller CH. Efficacy of treatment and recurrence rate of leukocytospermia in infertile men with prostatitis. Fertil Steril. 1994;62:580–4.
18. Cavagna M, Oliveira JB, Petersen CG, Mauri AL, Silva LF, Massaro FC, Baruffi RL, Franco JG Jr. The influence of leukocytospermia on the outcomes of assisted reproductive technology. Reprod Biol Endocrinol. 2012;10:44.
19. Athayde KS, Cocuzza M, Agarwal A, Krajcir N, Lucon AM, Srougi M, Hallak J. Development of normal reference values for seminal reactive oxygen species and their correlation with leukocytes and semen parameters in a fertile population. J Androl. 2007;28:613-20.
20. De Lamirande E, Gagnon C. Reactive oxygen species and human spermatozoa. I. Effects on the motility of intact sper- matozoa and on sperm axonemes; and II. Depletion of adenos- ine triphosphate plays an important role in the inhibition of sperm motility. J Androl. 1992;13:368–86.
21. Aziz N1, Agarwal A, Lewis-Jones I, Sharma RK, Thomas AJ Jr. . Novel associations between specific sperm morphological defects and leukocytospermia. Fertil Steril. 2004;82:621-7.
22. Ziyyat A, Barraud-Lange V, Sifer C, Ducot B, Wolf JP, Soufir JC. Paradoxical increase of sperm motility and seminal carnitine associated with moderate leukocytospermia in infertile patients. Fertil Steril. 2008;90:2257-2263.
23. Lackner JE1, Agarwal A, Mahfouz R, du Plessis SS, SchatzlG. The association between leukocytes and sperm quality is concentration dependent. Reprod Biol Endocrinol.2010 ;8:12.
24. Eggert-Kruse W, Bellmann A, Rohr G, Tilgen W, Runnebaum B. Differentiation of round cells in semen by means of monoclonal antibodies and relationship with male fertility. Fertil Steril. 1992;58:1046-55.
25. Gonzales GF, Kortebani G, Mazzolli AB. Leukocytospermia and function of the seminal vesicles on seminal quality.FertilSteril. 1992;57:1058-65.
26. Yanushpolsky EH1, Politch JA, Hill JA, Anderson DJ. Is leukocytospermia clinically relevant? Fertil Steril. 1996;66:822-5.
27. Fedder J1, Askjaer SA, Hjort T. Nonspermatozoal cells in semen: relationship to other semen parameters and fertility status of the couple. Arch Androl. 1993;31:95-103.
28. Van der Ven HH, Jeyendran RS, Perez-Pelaez M, Al-Hasani S, Diedrich K, Krebs D.Leucospermia and the fertilizing capacity of spermatozoa.Eur J Obstet Gynecol Reprod Biol. 1987 Jan;24:49- 52.
29. Tomlinson MJ, White A, Barratt CL, Bolton AE, Cooke ID. The removal of morphologically abnormal sperm forms by phagocytes: a positive role for seminal leukocytes? Hum Reprod. 1992;7:517– 522.
30. Barraud-Lange V, Pont JC, Ziyyat A, Pocate K, Sifer C, CedrinDurnerin I, Fechtali B, Ducot B, Wolf JP. Seminal leukocytes are Good Samaritans for spermatozoa. Fertil Steril. 2011; 96:1315-9.
31. Moskovtsev SI, Willis J, White J, Mullen JB. Leukocytospermia: relationship to sperm deoxyribonucleic acid integrity in patients evaluated for male factor infertility. Fertil Steril. 2007; 88:737–740.