Abstract
AimTo assess the prevalence of isolated teratozoospermia (iTZS) in a cohort of infertile and fertile men; explore the relationship between iTZS, inflammatory parameters and sperm DNA fragmentation index (SDF) in the same cohort.Materials and methods1824 infertile men and 103 fertile controls. Semen analysis, the neutrophil-to-lymphocyte ratio (NLR) and serum hormones were investigated. DFI was tested in infertile men only. According to 2010 WHO semen analysis, patients were categorized in 3 sub-groups of isolated sperm defects: isolated oligozoospermia (iOZS), isolated asthenozoospermia (iAZS) and iTZS. Descriptive statistics and linear regression models tested the association between clinical variables and inflammatory markers.ResultsAmong infertile men, iAZS, iTZS, and iOZS were found in 13.9%, 11.9% and 4.1% participants, respectively. iTZS was found in 37 (35.9%) fertile men. Infertile men with iTZS had higher NLR values than those with iOZS, iAZS and men with normal semen parameters (all p<0.001). FSH and LH were higher and inhibin B lower in iOZS infertile men compared to all other groups (p≤0.001). Hormonal characteristics were similar between iTZS infertile and fertile men. Similarly, iTZS infertile men had higher SDF than all other groups (all p<0.001). Infertile men with iTZS had higher NLR values than fertile men with iTZS (p<0.01). Linear regression analysis showed that, in infertile men, iTZS was associated with SDF and NLR (all p≤0.01).ConclusionsiTZS was found in 11.9% of infertile men but it was even more prevalent in fertile controls. Infertile men with iTZS had higher NLR than fertile controls and increased SDF values than infertile participant with iAZS, iOZS, or normal semen parameters. No differences in hormonal characteristics were found between infertile and fertile men with iTZS.
Highlights
Couple’s infertility is a rising issue worldwide with a male factor infertility (MFI) contributing to approximately half of the cases [1]
IAZS, isolated TZS (iTZS), and isolated oligozoospermia (iOZS) were found in 13.9%, 11.9% and 4.1% participants, respectively. iTZS was found in 37 (35.9%) fertile men
follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were higher and inhibin B lower in iOZS infertile men compared to all other groups (p 0.001)
Summary
Couple’s infertility is a rising issue worldwide with a male factor infertility (MFI) contributing to approximately half of the cases [1]. Epidemiological studies have shown a tremendous decrease in sperm quality over the last decades in the general male population (50– 60% decline of sperm count) [2,3,4]. In this context, men with MFI should always undergo a detailed evaluation, including medical and reproductive history, an accurate physical examination and a semen analysis [1, 5]. Teratozoospermia is the result of a defective cell differentiation during spermatogenesis and it has been associated with several genetic and environmental factors as well as advanced paternal age and psychological distress [6,7,8,9]. Even isolated TZS (iTZS), depicted as the only impaired parameter at semen analysis, is a relatively common finding in infertile men [10, 11]
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