Azospermik ve oligospermik hastaların spermiyogram parametrelerine göre sınıflandırılması

Yıl 2018, Cilt: 1 Sayı: 4, 85 - 93, 30.12.2018

Kasım Ertaş Özgür Eroğlu Serdar Yüksel

https://doi.org/10.32322/jhsm.471058

Cited By: 1

Öz

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. 

Anahtar Kelimeler

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

Classification of azospermic and oligospermic patients by spermiogram parameters

Öz

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.

Anahtar Kelimeler

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

Kaynakça

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