Classification of pathozoospermia in infertile men

Abstract

Background. Since its growing social significance, the male infertility arouses much interest in medical and scientific communities. Nevertheless, it’s hardly possible to evaluate the contribution of male factor in all infertility cases. Basic infertility test in men is routine semen analysis. But its parameters often fluctuate vastly even among healthy fertile men. Also, there is lack of strong evidence concerning influence of different pathological conditions on conventional sperm parameters.Aim. To analyze causes (diseases and/or pathological conditions) that lead or might lead to decline of conventional sperm parameters, i. e. to pathozoospermia, and to evaluate varicocele impact at this parameters.Materials and methods. The study group consisted of 383 men (mean age 35,5 years) with pathozoospermia whose partners were unable to conceive more than 12 months (mean duration of infertility 4 years). Also, we have tested control group of 31 men with normozoospermia and varicocele of different grades. All men were undergoing standard physical examination, scrotal and prostate ultrasound and semen analysis according to WHO manual. Hormonal and genetic examination was performed if needed. The classification based of summary of conventional sperm parameters scores was proposed for evaluation of severity of pathozoospermia.Results. All patients were divided in 5 groups of pathozoospermia according to the classification: mild (n = 106; 27,7 %), intermediate (n = 46; 12 %), moderately severe (n = 19; 4,5 %), severe (n =147; 38,4 %) and azoospermia (n = 65; 17 %). Such differentiation allows to reveal pathological factors proven to lead to pathozoospermia. Among factors that might lead to pathozoospermia varicocele was a point of special interest. It was shown that grade of varicocele corresponds to the severity of pathozoospermia. Mild and intermediate pathozoospermia prevailed in grade I varicocele (n = 20; 65 %), in grade II mild + intermediate pathozoospemia was almost equivalent to moderately severe + severe (n = 84; 50 and 45,24 % respectively), in grade III moderately severe + severe prevailed over mild + intermediate pathozoospemia (n = 22, 54,55 % vs 36,37 % respectively). In control group, varicocele I and II grades prevailed over III grade (I grade – 48,4 %, II grade – 41,9 %, III grade – 9,7 %).Conclusion. Suggested classification of pathozoospermia has shown its efficacy and can be used by urologists, andrologists for assessment of men’s fertility and revealing indications for varicocele repair.