Azospermik ve oligospermik hastaların spermiyogram parametrelerine göre sınıflandırılması

Abstract

Amaç: İnfertilite evli çiftlerin bir yıllık korunmasız ilişkiye rağmen gebeliğin oluşmaması olarak tanımlanabilir. Çiftlerde infertilite %10’u kadınlardaki, %15’i erkeklerdeki genetik problemlerden kaynaklanır. Erkek infertilitesine ayrıca enfeksiyonlar, toksik maddeler, tıkanıklar ve varikosel sebep olmaktadır. Erkek infertilitesinin tespitinde ilk uygulanacak en önemli test spermiyogram analizidir. Spermiyogram sonucuna göre semen sıvısı içinde hiç sperm bulunmamasına azospermi, az sayıda bulunmasına oligospermi denir. Çalışmamızda spermiyogram ve gonadotropin test parametrelerinin azospermi, oligospermi ve normal hasta gruplarında nasıl değiştiğini tespit etmeyi amaçladık. Diğer bir amacımız ise bu hastaların azospermi nedenlerine göre dağılım yüzdelerinin hesaplanmasıydı.   

Gereç ve Yöntem: Çalışmada rutin spermiyogram ve gonadotropin hormon testlerinin sonuçları değerlendirilmiştir. Test parametrelerinden viskozite, likefaksiyon, pH, hacim, hareketlilik değerleri, Kruger sonuçları ve gonadotropin seviyeleri kullanılmıştır. Hasta gruplarının ayrımında hangi test parametrelerinin etkin olduğunu belirlemek için Anova, Mann Whitney U ve diskriminant analizleri yapılmıştır.

Bulgular: Azospermi hastalarının %7’sinin enfeksiyon, % 9’unun genetik problemler, %5’inin inmemiş testis, %22’sinin testis fonksiyon bozukluğu ve %22’sinin varikosel teşhisi ile değerlendirildiği,  Hastaların %35’inin ise sadece infertilite şikayeti ile kliniğimize başvurduğu belirlendi.  Normal popülasyon ile azospermi ve oligospermi hastaları Anova, Mann Whitney U testleri ile karşılaştırıldığında,  gonadotropin seviyelerinin azospermi ve oligospermi hastalarında kontrol grubundan farklı olduğu,  spermiyogram parametrelerinden pH, viskozite ve likefaksiyonun değişiklik göstermediği, morfoloji, hareket, hacim ve sperm sayısının farklılık gösterdiği bulundu.

Sonuç:  İncelediğimiz Azospermi ve oligospermi hastalarında, literatür ile uyumlu olarak FSH, LH seviyeleri artmıştır, testosteron seviyesi ise bu hastalarda kısmi olarak azalmıştır. İstisna olarak, azospermi görülen ilerlememiş varikosel vakalarında, hormon seviyeleri normal seviyededir.   Prolaktin ve östradiol azospermi ve oligospermi hastalarında normal seviyededir. Spermiyogram parametrelerinden sadece sperm hacim, morfoloji, hareket ve sayısının hastaların ayrımında önemli olduğu belirlenmiştir.   Sonuç olarak; bu hastaların ayrımında, FSH, LH ve testosteron seviyesinin, sperm hacim, morfoloji, hareket ve sayısının belirlenmesi yeterlidir. 

Keywords

• Azospermi,oligospermi,spermiyogram,likefaksiyon,viskozite,sperm hareketi,gonadotropin

Classification of azospermic and oligospermic patients by spermiogram parameters

Abstract

Aim: Infertility can be defined as the fact that married couples do not have a pregnancy despite one year of unprotected intercourse. In couples, infertility is caused by genetic problems in 10% of females and 15% in males. Male infertility is also caused by infections, toxic substances, blockages and varicocele. The most important test to be applied in the determination of male infertility is spermiogram analysis. According to the results of the spermiogram, there is no sperm in the semen fluid and azospermia, and the small number of them are called oligospermia. In our study, we aimed to determine how spermiogram and gonadotropine test parameters change in azospermia, oligospermia and normal patient groups. Another aim was to calculate the distribution percentages of these patients according to the azospermia reasons.

Material and Method: The method used in the study is routine spermiogram analysis. Viscosity, liquefaction, pH, volume, motility, Kruger and gonadotropine level were used as test parameters. Anova, Mann Whitney U and discriminant analyzes were performed to determine which test parameters were effective in the differentiation of patient groups.

Results: According to the results obtained, 7% of azospermia patients had infection, 9% had genetic problems, 5% had undescended testis, 22% had testicular dysfunction and 22% varicocele. 35% of patients admitted to our clinic with complaints of infertility. When the normal population and azospermia patients were compared, it was determined that the rate of abnormality of liquefaction and viscose was high in azospermia patients, pH and volume did not differ, and gonadotropine levels were high in azospermia patients according to the literature. In addition, FSH, LH and testosterone levels were found to differ between patient groups. Spermiogram parameters showed that only sperm volume was different between azospermia and normal patient groups.

Conclusion: In patients with azospermia and oligospermia, FSH, LH levels were increased and testosterone levels were partially decreased in these patients. As an exception, in advanced varicocele cases with azospermia, hormone levels are normal. Prolactin and estradiol are normal in azospermia and oligospermia patients. It was determined that sperm volume, morphology, motility and number of sperm were important in the differentiation of patients. As a result; In the differentiation of these patients, the level of FSH, LH and testosterone, sperm volume, morphology, motility and total sperm is sufficient to determine.

Keywords

• Azospermia,spermyogram,liquefaction,viscosity,sperm motility,gonadotropine

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