SOME ASPECTS REGARDING MALE FACTORS IN INFERTILE COUPLES. NOTE II. SPERM COUNTS IN PATIENTS FROM

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1 SOME ASPECTS REGARDING MALE FACTORS IN INFERTILE COUPLES. NOTE II. SPERM COUNTS IN PATIENTS FROM 2013 Delia Hutanu 1, F. Dorneanu 2, Cezara Muresan 3 1 WEST UNIVERSITY OF TIMISOARA, CHEMISTRY-BIOLOGY-GEOGRAPHY FACULTY, BIOLOGY-CHEMISTRY DEPARTMENT 2 GYNATAL HUMAN ASSISTED REPRODUCTION CENTER TIMISOARA 3 UNIVERSITY OF MEDICINE AND PHARMACY VICTOR BABES TIMISOARA Summary The desire to conceive a child is very important in our society. The male factor involved in infertility is consider today to have a high impact, almost 50 of couples having difficulties to conceive. The present paper presents the results of m counts (different parameters were taking in account) performed during 2013 at Gynatal Human Assisted Reproduction Center in Timisoara.The results obtained during this intervals were compared with previous data from 2009 intervals already published. The parameters analyzed included the number, motility and morphology of human ms also the age of patients. The aim of this study is to present the current situation regarding the male factor in order to approach the infertility issue with better understanding and to enhance the chances to solve this problem. Key words: m counts, m number, m motility, m morphology. Introducere Previous investigations analyzed some aspects regarding the role of male factor in infertile couples during 10 at Bega Universitary Clinic of Obstetrics and Gynecology, Timisoara. In the previous study were analyzed some parameters from m count, such as volume of ejaculate, number and motility of ms and the presence of abnormal ms. The results obtained allowed us to affirm that the male factor is highly involved as an infertility cause. In this paper, as a continuation of these preoccupations, we analyzed the same parameters, obtained after m counts performed during 2013 at Gynatal Human Reproduction Center, Timisoara. We compared the results obtained with previous cited study (Hutanu, 2010), as an 70 attempt to bring new data regarding the role of male factor in infertile couples. Material and methods The data presented in this paper are the results of m counts performed in two time periods: 1 st of January 30 of August 2013 and 1 st of January 20 December Obtaining,determining the number of ms and microscopically examination of the samples and the results obtained in 2009 period were presented by Hutanu,(2010). There are different approaches in the investigated periods, taking in consideration the modification imposed by W.H.O guide (5 th Edition) published in 2010.

2 The analyzed values take in consideration were the volume of ejaculate, the age of men who address us for m count and diagnostic (number, motility, and morphological status of ms). The data we had obtained were statistically assessed using the comparison of two fervencies test (Steinbach 1961).The total number of m counts analyzed was 3193, 1662 were performed in 2009 interval and the rest of 1531 in 2013 interval. Results and discussions The first parameter assessed was the volume of ejaculate, the normal value according to W.H.O. guide is 2-5 ml. In table 1 are presented the data of volume ejaculate in the two periods assessed. Table 1 Distribution of semen volume. interval/to < 2ml ml >5 ml tal no of 2009/ Analyzing the data presented in Table 1, we can say that in both periods investigated, the higher percentages (61.37 and 58.91) are in ml interval, followed by <2 ml interval (23.46 and 26.71).The differences are not statistically significant. The next parameter analyzed was the age of men who address us for m count and the results obtained are shown in Table 2 Table 2 Data regarding the m count number and the age of men during the time interval investigated. interva ls/total no of 2209/ /1 531 <20 48 * * *1, p< > From Table 2 we can say that the higher number of men who addressed us for m count have the age between (without significant differences between the two periods investigated). In 2013 interval we can say that the number of younger men (21-30 ) investigated is significantly lower (p<0.001) compared with 2009 interval. We can also say that the number of very young men (<20 ) is significantly lower in 2013 interval compared with 2009 interval. Our investigations showed that the main age of investigated men is in interval, according with the data published by Hammond et al The distribution of diagnostics (azoo, oligo and normo) in the two investigated periods is presented in table 3. 71

3 Table 3 Distribution of types of diagnosis in investigated time intervals. intervals/ total no of 2009/ /153 1 Azoo 163 * * *1,,*3 p<0.001 Oligospe r 1058 * Normosp er 441 * * The data showed in Table 3 allow us to say that 1. In both intervals we can see that the higher percentage is in oligo group with and 56.56, followed by normo group with and in the investigated intervals. 2. In 2013 intervals is an elevation of normo diagnosis compared with in 2009 interval. 3. In azoo and oligo groups are present a significantly decrease number of in the same interval (4.78 and 56.56) compared with 2009 interval (9.80 and ). Due to the fact that in oligospe group, in both intervals, are the most (see Table 3) we consider that a closer presentation of these is necessary. We also consider that, aside from the high percentage of included in these category, due to the fact that the best approach, in order to solve this problem (I.C.S.I., I.V.F., medical treatment in order to increase the ms number), is very hard to find, a closer look in necessary. In Table 4 are the data regarding oligo group in 2009 interval. Table 4 Repartition of oligo in 2009 interval. Total no <5 of We can see that in severe oligo group (<5 ) are 285 (26.93) and the rest, (73) are moderate and light oligo. Table 5 Repartition of oligo in 2013 interval. Total no of < In table 5 are presented the values of oligo in 2013 interval and we can see that severe oligo (<1 ) is present in from and the rest (73.87) are from moderate and light oligo groups. Comparing the values of oligo in the two intervals, we can see a decrease of oligo in 2013 intervals (without statistical significance). Another parameter investigated was the morphological aspect of ms. Table 6 presents the results linked to this aspect. In 2013 interval only in 7 (0.45) were detected ms with morphological alterations compared with 2009 interval where 129 (7.79) of ms were abnormal (statistically significant difference). 72

4 Table 6 The presence of normal and abnormal ms Normal intervals/t ms otal no of / / *1 p< 0,001 Abnormal ms 129 * * In table 7 are presented the data regarding m motility in the two intervals of time. normo. During 2013 intervals we can see that the most (46.16) are represented by ms with good motility from oligo group, followed by the same group from normo. Comparing the data from the two intervals of time, we can also see: -that in 2013 intervals the number of immotile ms is significantly lower than the number from 2009 intervals. -that in 2013 intervals the number of good motility ms in oligo group is significantly lower than the number from 2009 intervals. -that in 2013 intervals the number of hypokinetic ms in normo group is significantly higher than the number from 2009 intervals. Table 7 Data regarding m motility in normo and oligo groups interv al/tota l of no 2009/ / 1473 norm o norm o Oligo >50 <50 > * * *1,,*3 p<0.001 oligo <50 oligo * * In the first time interval we can see: that the higher percentage 55.5 is in the good motility group (oligo) followed by the same motility group from 73 Conclusions After analyzing 3193 m counts (1531 performed during 2013 interval and 1662 during 2009 intervals) the following aspects emerged: -in both time intervals analyzed, the volume of ejaculate is situated in normal range (2-5 ml), -in most, the main age of men who address to us for m count was between of age in both time intervals; during the 2013 interval, the young(21-30 ) and very young (under 20 ) number of was significantly lower comparing with 2009 interval. -the oligo diagnosis group has the higher number in both time intervals investigated. The normo group presented an increase during the 2013 intervals. One reason for this conclusion is that the W.H.O. changed the value of reference for normo from 20 to 15 in the number of azoomic patients is

5 significantly lower in 2013 intervals comparing with 2009 intervals. -the number of severe and moderate oligo is lower in 2013 intervals -the morphological alterations of ms in 2013 intervals are significantly lower comparing with 2009 intervals. -the immotile and well mobile ms (oligo group) showed a significantly decrease in 2013 interval and the hypokinetic ms (normo group) showed a significantly increase in 2013 interval comparing with 2009 interval. References Delia Hutanu,Some aspects regarding male factor in infertile couples, Annals of RSCB, vol XV, issue I, pg83-87, Delia Hutan, Obtaining and cultivation of human embryos in vitro. Structural and ultrastructure studies, PhD Thesis, Cluj Napoca, Hammond A.O., Van Derslice J., Temirni M.H.,Pederson C.M., Blauer K., Carrell D., Evidence of a recent decline in m count in a united stated population from , Fertility and Sterility, vol 100, issue 3, supplement, page S13, September 2013 Steinbach M., Prelucrarea statistica in medicina si biologie, Ed Academiei Republicii Populare Romine, 1961 W.H.O.laboratory manual for the examination and processing of human semen, 5-th editions,