The Effect of War Conditions and Social Stress on Semen Parameters in Syrian Refugees

Yıl 2024, Cilt: 6 Sayı: 1, 6 - 10, 01.03.2024

Deniz Aka Satar Rıdvan Bağcı Umut Demirdelen

https://doi.org/10.38175/phnx.1393369

Öz

Objective: This study aims to evaluate the effects of stress due to war in Syrians exposed to after migration to Turkey on sperm parameters.
Material and Method: Syrian migrant patients who underwent spermiogram due to infertility were included in the study. The patients were divided into two groups according to the period when the migration started and the stress was felt intensely, and the period when the immigrants had settled down and had less stress. Sexual abstinence duration, age, ejaculate volume, sperm concentration, total motility, progressive motility, morphology according to Kruger Strict criteria, were evaluated.
Results: There were 300 patients in group 1 and 902 patients in group 2. There was a statistically significant relationship between the marital status of the refugee patients and the years. There was no statistically significant difference between the groups in terms of ejaculate volume, concentration, morphology and sexual abstinence parameters. The total motility values of the patients in group 2 were statistically significantly higher than the patients in group 1. The progressive motility values of the patients in group 2 were statistically significantly higher than the patients in group 1.
Conclusion: The heavy psychosocial stress created by the war and post-war migration affects both sperm motility and progressive motility.

Anahtar Kelimeler

Stress, infertility, sperm concentration, sperm motility, sperm morphology

Suriyeli Mültecilerde Savaş Koşulları ve Sosyal Stresin Semen Parametreleri Üzerindeki Etkisi

Öz

Amaç: Bu çalışma, Türkiye’ye göç sonrası maruz kalan Suriyelilerde savaş kaynaklı stresin sperm parametreleri üzerine etkilerini değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem: İnfertilite nedeniyle spermiogram yapılan Suriyeli göçmen hastalar çalışmaya dahil edildi. Hastalar göçün başladığı ve stresin yoğun olarak hissedildiği dönem ile göçmenlerin yerleşip daha az stres yaşadıkları dönemlere göre iki gruba ayrıldı. Kruger Strict kriterlerine göre cinsel perhiz süresi, yaş, ejakülat hacmi, sperm konsantrasyonu, toplam hareketlilik, ilerleyici hareketlilik ve morfoloji değerlendirildi.
Sonuçlar: Grup 1’de 300, Grup 2’de ise 902 hasta vardı. Mülteci hastaların medeni durumu ile yıllar arasında istatistiksel olarak anlamlı bir ilişki vardı. Ejakülat hacmi, konsantrasyonu, morfolojisi ve cinsel perhiz parametreleri açısından gruplar arasında istatistiksel olarak anlamlı fark yoktu. Grup 2’deki hastaların total motilite değerleri grup 1’deki hastalara göre istatistiksel olarak anlamlı derecede yüksekti. Grup 2’deki hastaların ilerleyici motilite değerleri grup 1’deki hastalara göre istatistiksel olarak anlamlı derecede yüksekti.
Sonuç: Savaşın ve savaş sonrası göçün yarattığı ağır psikososyal stres, hem sperm hareketliliğini hem de ilerleyen hareketliliğini etkiliyor.

Anahtar Kelimeler

Stres, İnfertilite, Sperm konsantrasyonu, Sperm hareketliliği, Sperm morfolojisi

Kaynakça

• Baskaran S, Finelli R, Agarwal A, Henkel R. Diagnostic value of routine semen analysis in clinical andrology. Andrologia. 2021; 53(2): 1-12.
• Satar Aka D, Gencdal S. Sperm Analysis. Arsiv Kaynak Tarama Dergisi. 2013;22 (4): 532-542.
• Zou P, Sun L, Chen Q, Zhang G, Yang W, Zeng Y, et al. Social support modifies an association between work stress and semen quality: Results from 384 Chinese male workers. Journal of psychosomatic research. 2019; 117: 65–70.
• Satar Aka D, Narin R, Globozoospermia. Cukurova Medikal Journal. 2014; 392(1): 1-6.
• Agarwal A, Parekh N, Panner Selvam MK, Henkel R, Shah R, Homa ST, et al. Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility. World JMen Health. 2019;37(3): 296–312.
• Fainberg J, Kashanian JA. Recent advances in understanding and managing male infertility. F1000Research. 2019; 8(670): 1- 8.
• Abu-Musa AA, Nassar AH, Hannoun AB, Usta IM. Effect of the Lebanese civil war on sperm parameters. Fertil Steril. 2007;88(6): 1579–1582.
• Abu-Musa AA, Kobeissi L, Hannoun AB, Inhorn MC. Effect of war on fertility: a review of the literature. Reprod Biomed Online. 2008;17(1): 43–53.
• Bolouki A, Zal F. Impact of War on Fertility and Infertility. Arch. Iran Med. 2020;23(4): 16-22.
• Sharara SL, Kanj SS. War and infectious diseases: challenges of the Syrian civil war. PLoS Pathog. 2014;10 (11): 1-4.
• Pierini M. In Search Of An Eu Role In the Syrian War Carnegie Endowment for International Peace. 2016; 1-33.
• Ozden S. Syrian refugees in Turkey. Migration Policy Centre (MPC), Research Report. 2013;5: 1-12.
• Toksoz S, Kızılkan Y. Azospermia rates and affecting factors in local population and refugee patient groups. Androloji Bulteni. 2019;(21): 45-49.
• Smeekes A, Verkuyten M, Celebi E, Acarturk C, Onkun S. Social identity continuity and mental health among Syrian refugees in Turkey. Soc Psychiatry Psychiatr Epidemiol. 2017;52: 1317-1324.
• Sijbrandij M, Acarturk C, Bird M, Bryant RA, Burchert S, Carswell K, et al. Strengthening mental health care systems for Syrian refugees in Europe and the Middle East: integrating scalable psychological interventions in eight countries. Eur J Psychotraumatol. 2017;8: 1-11.
• World Health Organization: WHO Laboratory Manual for the Examination and Processing of Human Semen. 5th Edition. Geneva 2010.
• Porter M, Haslam N. Predisplacement and postdisplacement factors assosiated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA.2005;294 (5): 602-612.
• Kobeissi L, Inhorn MC, Hannoun AB, Hammoud N, Awwad J, Abu-Musa AA. Civil war and male infertility in Lebanon. Fertil Steril. 2008;90(2): 340–345.
• Javenic T, Kahn LG, Landsbergis P, Crillo PM, Chon BA, Liu X, Factor- Litvak P. Effects of work and life stress on semen quality. Fertil Steril. 2014; 102(2):530-538.
• Gollenberg AL, Liu F, Brazil C, Drobnis EZ, Guzick D, Overstreet JW, et al. Semen quality in fertile men in relation to psychosocial stress. Fertil Steril. 2010;93(4), 1104–1111.
• Pallav S, Arafa M, Haitham Elbardisi H. Hormonal regulation of spermatogenesis. Molecular signaling in spermatogenesis and male infertility. CRC Press, 2019. 41-49.
• Kao S, Chao H, Chen H, Hwang T, Liao T, Wei Y. Increase of oxidative stress in human sperm with lower motility. Fertil Steril. 2008;89: 1183-90.
• King JA, Rosal M.C, Ma Y, Reed GW. Association of stress hostility and plasma testosterone levels. Neuro Endocrinol Lett. 2005;26: 355-360.
• Kreuz LE, Rose RM, Jennnigs JR. Supression of plasma testosterone levels and psychological stress. A longutidinal study of young men in Officer Candidate School. Arch Gen Psychiatry. 1972;26: 479-482.
• Bhongade MB, Prasad S, Jiloha RC, Ray PC, Mohapatra S, Koner BC. Effect of psychological stress on fertility hormones and seminal quality in male partners of infertile couples. Andrologia. 2015;47(3):336-342.
• Eskiocak S, Gozen AS, Taskiran A, Kilic AS, Eskiocak M, Gulen S. Effects of psychological stress on the L-arginine- nitric-oxide pathway and semen quality. Braz J Med Biol Res. 2006;39: 581-588.
• Zorn B, Sucur V, Stare J, Maden-Vrtovec H. Decline in sex ratio at birth after 10 day war in Slovenia. Hum Reprod. 2002; 17: 3173- 3177.
• Zorn B, Auger J, Velikonja V, Kolbezen M, Meden-Vrtovec H. Psychological factors in male partners of infertile couples: relationship with semen quality and early miscarriage. International Journal of Andrology. 2008; 0105-6263.
• Fukuda M, Fukuda K, Shimizu T, Moler H. Decline in sex ratio at birth after Kobe eartquake. Hum Reprod. 1998; 13: 2321-2322.
• Baran C, Hellstrom WJ, Sikka SC. A comparative evaluation of semen parameters in pre- and post- Hurricane Katrina human population. Asian Journal of Andrology. 2015;17: 676-680.