Медико-социальные факторы риска бесплодия у мужчин

Abstract

Subjects and methods. A total of 917 men from infertile couples with abnormal ejaculate indicators were examined. Their age was 34.1 ± 6.3 years; the infertility period was 4.6 ± 3.9 years. A retrospective analysis of their case histories, clinical examination, questioning to identify risk factors for infertility, and anthropometric measurements of weight and height were made. Weight was rated normal at a body mass index (BMI) of ≤ 24.9 kg/m2 ; overweight at 25.0–29.9 kg/m2 , and obesity at ≥ 30 kg/m2 . When identifying infertility risk factors, the investigators kept in mind 24 risk factors at the moment of examination or in the patient histories, which were grouped into 3 clusters: 1 – environmental factors and occupational hazards; 2 – evidence of congenital and acquired abnormalities; 3 – social and quality-of-life factors; this cluster also includes history and examination evidence of tuberculosis, sexually transmitted diseases, and other social diseases, such as hepatitis B and C, or human immunodeficiency infection. Then the men who did not show an exacerbation of somatic diseases, genetic anomalies associated with reproductive disorders, or an exacerbation of social diseases at the moment of examination were selected from the total sample. These were divided into 2 groups: normal weight and obese patients. The frequency of the above mentioned infertility risk factors and additionally the proportion of persons engaged in intellectual or manual labor were calculated in each group. Results and discussion. In the total sample, the frequency of infertility risk factors including occupational hazards and environmental factors was 40 %. Conclusion. The sociomedical risk factors of infertility make the most significant contribution to the development of male infecundity. Moreover, among the contemporary men there is a social group of persons at high risk of infertility; these are 30–40-year-old men who have constitutional prerequisites to the development of obesity accompanied by the high rate of chronic hepatitis, who are engaged in intellectual labor and experience frequent emotional stresses, for relief of which they regularly consume alcohol.