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Study of Variables Involved in Male Infertility Identified in the Spermograms Assessed in Assisted Human Reproduction

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Study of Variables Involved in Male Infertility Identified in the Spermograms Assessed in Assisted Human Reproduction Bárbara Stefany da Silva Souza et al., IJOAR, 2020 3:62 Research Article IJOAR (2020) 3:62 International Journal of Aging Research (ISSN:2637-3742) Study of Variables Involved in Male Infertility Identified in the Spermograms Assessed in Assisted Human Reproduction Bárbara Stefany da Silva Souza1*, Evandro Valentim da Silva2, Sérgio Antônio Santos da Costa e Silva1, Ana Maria Medeiros de Ataídes3, Fálba Bernadete Ramos dos Anjos1, Adriana Fracasso4 1UNIVERSIDADE FEDERAL DE PERNAMBUCO; 2HOSPITAL DAS CLÍNICAS/UFPE; 3UNIVERSIDADE DE PERNAMBUCO; 4CLÍNICA NASCER/PE. ABSTRACT Introduction: According to the World Health Organization, about *Correspondence to Author: 8 to 10% of couples worldwide have infertility problems and male Bárbara Stefany da Silva Souza internal aspects are the main reasons for half of occurrences of UNIVERSIDADE FEDERAL DE human sterility. Through the spermogram, it is possible to qual- PERNAMBUCO itatively and quantitatively analyze semen, contributing to the diagnosis of male fertile state. Objective: To study the relation- ship among sperm viscosity, concentration, motility and volume How to cite this article: parameters and male infertility factors and to show the influence Bárbara Stefany da Silva Souza, of the subject age on these seminal parameters. Methodol- Evandro Valentim da Silva, Sérgio ogy: A survey was conducted in the male infertility database Antônio Santos da Costa e Silva, of the Nascer Clinic (Recife / Pernambuco) of men aged 27 to Ana Maria Medeiros de Ataídes, 61 years, with a history of marital infertility, from 2018 to 2019. Fálba Bernadete Ramos dos An- The subjects studied were grouped into categories according to jos, Adriana Fracasso.Study of the classification of the seminal parameters analyzed (volume, Variables Involved in Male Infertil- concentration, motility and viscosity) in their sperm. Student’s t-test was used for normal distribution and Mann-Whitney test ity Identified in the Spermograms for non-normal using the GraphPad Prism 8 program. Results: Assessed in Assisted Human Re- Among the studied individuals, there was a significant difference production. International Journal of (p <0.05) between the populations with obstructive azoospermia Aging Research, 2020, 3:62 and nonobstructive azoospermia and among the percentages of oligozoospermic individuals with obstructive azoospermia. The azoospermia group had a significantly higher average age than the normozoospermia group. Conclusions: This suggests that eSciPub LLC, Houston, TX USA. azoospermia is present in older men, compromising male fertili- ty. Sperm testing should be performed by all men of childbearing Website: https://escipub.com/ age to investigate possible changes in the genesis of gametic cells. Keywords: age groups, azoospermia, semen. IJOAR: https://escipub.com/international-journal-of-aging-research/ 1 Bárbara Stefany da Silva Souza et al., IJOAR, 2020 3:62 INTRODUCTION concentration, motility and volume parameters and male infertility factors, as well as to show the Assisted Human Reproduction (RHA) consists influence of age on these seminal parameters. of appropriate technologies for the study of human infertility through the manipulation of MATERIALS AND METHODS female and male gametes in laboratory and the Study population: We evaluated men from 27 subsequent introduction of these cells into the to 61 years old who seek the clinic to undergo female reproductive system artificially1. the RHA process, with a history of marital According to the World Health Organization infertility (whether or not male), from 2018 to (WHO), about 8 to 10% of couples worldwide, ie 2019. In this study it was not possible to analyze 50 to 80 million people, are experiencing some seminal parameters such as volume, motility and kind of infertility problem, with male internal viscosity of the azoospermia group, since aspects being the main reason for half of the individuals with this condition present total occurrences of human sterility. The sperm count absence of sperm in the ejaculate. Therefore, should be the most important element in the only the sperm concentration of this group was investigation of male infertility. To perform this considered and counted as 0 and for the other exam, it is necessary to obtain a seminal sample variables (motility, volume and viscosity) that comes from a practical and noninvasive azoospermic individuals were not included. Data procedure: masturbation. Through it, it is collection: For this study, a survey was carried possible to qualitatively and quantitatively out on the infertility database of the Nascer Clinic analyze semen (liquefaction time, viscosity, (Recife / Pernambuco) of couples seeking RHA. turbidity, color, pH, concentration, motility, The study of the quality and quantity of sperm morphology and vitality), contributing to the collected by masturbation for the RHA diagnosis of male fertile state2,3. In opposite to procedure followed the criteria for the evaluation what happens to women, the fertile potential of of normality of conventional seminal parameters men is maintained practically throughout their according to the guidelines of the World Health lives. In this context, there are few studies in the Organization (WHO) (2010). At this stage we Brazilian literature about the influence of male considered the patient's history, physical age on fertility. Some studies show that examination and seminal analysis obtained from increasing age influences spermatogenesis stimulation. Statistical analysis: All data were negatively, so that the number of sperm formed expressed around the mean. The significance of from spermatogonia decreases gradually with the results was through analysis of variance, male aging4,5,6,7. The data described above through the Prism Graphic Pad Statistical justifies this study, since it is important to Program (GRAPHPAD, 2005). Statistical produce new studies to investigate the influence differences considered significant were p <0.05. of male age on spermatogenic efficacy, Student's t-test was used for normal distribution enriching the Brazilian literature. Moreover, or equivalent for non-parametric (Mann-Whitney there is a close relationship between the intrinsic test), used for non-normal distributions. To processes of primordial germ cell formation and compare the average age of the normal group to characterization and the genetic and the groups with alterations, the t test was used environmental events that occur during through the GraphPad Prism 8 program. development, which possibly lead to infertility. RESULTS AND DISCUSSION Therefore, the spermogram is an essential tool Out of the 109 cases analyzed in the clinic from in the process of investigating sperm status and 2018 to 2019, 40.6 % showed male infertility possible changes in the genesis of gametic cells. factors. These factors were used: an The aim of this study was to analyze the oligozoospermia (39.66 %), followed by relationship between sperm viscosity, IJOAR: https://escipub.com/international-journal-of-aging-research/ 2 Bárbara Stefany da Silva Souza et al., IJOAR, 2020 3:62 asthenozoospermia (17.24 %) and obstructive Obstructive azoospermia, ANO: Nonobstructive azoospermia (18.96 %) (graphic 1). azoospermia, OS: Oligozoospermia, AS: Graph 1 - Causes of infertility identified in men Astenozoospermia, OAS: assisted at the Assisted Reproduction clinic. AO: Oligoastenozoospermia, HIV: Discordant serum, FG: Genetic factors. 39.66 STUDIED 17.24 18.96 15.52 1.72 1.72 5.17 PERCENTAGE OF INDIVIDUALS INDIVIDUALS OF PERCENTAGE AO ANO OS AS OAS HIV FG INFERTILITY FACTORS Source: Personal Collection. Out of the last ones, 17.24 % of patients (obstructive azoospermia (AO) or reduced underwent Percutaneous Sperm Aspiration production of these cells10. Cases of (PESA) and only 1.72 % underwent Testicular azoospermia are present in the order of 1-2 % of Sperm Aspiration (TESA). Moreover, the male population, being observed in 15-20 % oligoastenozoospermia represents 15.52 % of in infertile men11. In the study population, of the the cases, followed by 5.17 % of the cases that 40.6 % of infertile men, 18.96 % showed were classified as serodiscortant and 1.72 % obstructive azoospermia, while 1.72 % that presented genetic problems of the altered azoospermia is not obstructive, showing that karyotype. There were still 1.72 % of cases in they had some difference between those who which the cause of infertility was nonobstructive used p <0.05. Obstructive azoospermia can be azoospermia. It is noteworthy that 4.9 % of the identified in men with cystic fibrosis, for example, cases described infertility without apparent due to congenital deferred vessel agenesis as a cause. It is estimated that men are responsible consequence of the Cystic Fibrosis for 40 to 50 % of infertility cases, and woman 25 Transmembrane Conductance Regulator % and the remaining 20 % for idiopathic (CFTR) gene and some mutation12. Among infertility. A possibility of almost equal infertility these patients, some of them may be carriers of ratios is divided between undiscarded male and this disease and may identify this disease. female factors, once the percentage of Cases of azoospermia do not obstruct related to unexplained causes is excluded8,9. Some a sperm disability (graph 1). This condition is authors have commented that azoospermia is characterized by the absence of these cells in characterized by the complete absence of sperm the seminal ejaculate. In addition, the main in the ejaculate. An obstruction may occur in the morphological
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