Abstract
Popularization of the real-time polymerase chain reaction method (RT-PCR), which is a trend of the recent years, allowed to significantly expand of the range of microorganisms that can be detected in the genitourinary tract of men. Moreover, the available picture of the microbiome's bacterial component structure became more detailed. Lactobacillus spp. remains one of the least studied groups of microorganisms. Treating patients with reproductive disorders, the authors have accumulated clinical experience demonstrating the possible relationship between presence of Lactobacillus spp. in the ejaculate and changes in the level of sex hormones and the key values registered with a spermogram. This study aimed to compare the levels of luteinizing hormone, follicle-stimulating hormone, testosterone, estradiol, prolactin, progesterone, and sex hormone binding globulin (SHBG) in blood serum and changes in spermogram values in 210 men with and without Lactobacillus spp. detected in their ejaculate. The treatment group included 105 men whose ejaculate had Lactobacillus spp. in the amount of (Lg) ≥ 103, as detected by RT-PCR. The control group included 105 men whose ejaculate did not have Lactobacillus spp. detected; the microbiome's bacterial component structure of their ejaculate was normal. Compared to the control group, treatment group had hormonal disorders registered more often: abnormal levels of three or more hormones (p = 0.04), hyperestradiolemia (p = 0.05), increased level of SHBG (p = 0.01). It was established that the presence of Lactobacillus spp. in the ejaculate of treatment group participants is associated with oligoastenoteratozoospermia (p < 0.01), decreased concentration of spermatozoa (p = 0.01), their decreased motility (p < 0.01) morphology abnormalities (p < 0.01). Thus, the presence of Lactobacillus spp. in the ejaculate can be interpreted as an additional marker of hormonal imbalance and fertility dysfunction in men.
Highlights
Author contribution: Pochernikov DG — research planning, literature analysis, data interpretation and analysis, manuscript drafting, preparation of the final version of the article; Postovoytenko NT — literature analysis, data collection, analysis and interpretation, manuscript drafting, preparation of the final version of the article; Getman VV — data collection, analysis and interpretation, manuscript drafting; Galkin IS — research planning, data interpretation, manuscript drafting, preparation of the final version of the article
The exclusion criteria were: hypogonadotropic and hypergonadotropic hypogonadism, diabetes mellitus, hypo- and hyperthyroidism; sexually transmitted infections and clinical manifestations of prostatitis, such as pain and dysuria; karyotype abnormalities, CFTR gene mutations, microdeletions in the AZF locus of Y chromosome. All men had their ejaculate examined with the help of the Androflor testing kit (RT-PCR); their serum was examined to determine the levels of luteinizing hormone (LH), folliclestimulating hormone (FSH), total testosterone, estradiol, prolactin, progesterone, and sex hormone binding globulins (SHBG), free androgen index (FAI), testosterone to estradiol ratio (TER), which are typically checked during examination of infertile men or men undergoing a preconception course [2, 3]
Nine (8.5%) patients of the treatment group had the levels of all studied hormones corresponding to the reference values
Summary
Author contribution: Pochernikov DG — research planning, literature analysis, data interpretation and analysis, manuscript drafting, preparation of the final version of the article; Postovoytenko NT — literature analysis, data collection, analysis and interpretation, manuscript drafting, preparation of the final version of the article; Getman VV — data collection, analysis and interpretation, manuscript drafting; Galkin IS — research planning, data interpretation, manuscript drafting, preparation of the final version of the article. При ведении пациентов с репродуктивными нарушениями авторами накоплен клинический опыт, демонстрирующий возможную взаимосвязь изменения уровня половых гормонов и основных показателей спермограммы с наличием Lactobacillus spp. Целью работы было сравнить уровни лютеинизирующего гормона, фолликулостимулирующего гормона, тестостерона, эстрадиола, пролактина, прогестерона, а также глобулина, связывающего половые гормоны (ГСПГ), в сыворотке крови и изменения показателей спермограммы у 210 мужчин при выявлении в эякуляте Lactobacillus spp. В основную группу были включены 105 мужчин, в эякуляте которых по данным ПЦР-РВ выявлены Lactobacillus spp. Контрольная группа включала 105 мужчин, у которых отсутствовали Lactobacillus spp. Г. Почерников — планирование исследования, анализ литературы, интерпретация и анализ данных, подготовка черновика рукописи, подготовка финального варианта статьи; Н. Т. Постовойтенко — анализ литературы, сбор, анализ и интерпретация данных, подготовка черновика рукописи, подготовка финального варианта статьи; В. С. Галкина — планирование исследования, интерпретация данных, подготовка черновика рукописи, подготовка финального варианта статьи. Все пациенты подписали добровольное информированное согласие на участие в исследовании
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