Abstract

Abstract Study question This study aimed to investigate the influence of lifestyle factors on sperm quality according to Motile Sperm Organelle Morphology Examination (MSOME) criteria. Summary answer The introduction of MSOME permits the examination of subcellular defect like nuclear vacuoles at hight magnification (6000x) in real time on vital sperm. What is known already It is increased accepted that lifestyle factors have an impact on sperm quality. Recent evidence shows that the selection of spermatozoa based on the analysis of morphology under high magnification may have a positive impact on embryo development in cases with severe male factor infertility and/or previous implantation failures. Therefore, MSOME has been considered as representing an improvement in the evaluation of semen quality. Although numerous studies have shown the influences of nutrition, lifestyle, age on semen quality, only very few study, have considered the influence of these factors on the vacuolization rate in semen analysis (MSOME criteria) Study design, size, duration The objective of this prospective study was to compare the semen parameters of 87 male patients undergoing evaluation or treatment of infertility at Unit of Pathophysiology of Reproduction ad PMA-Santa Maria Goretti Hospital -Latina according to MSOME and WHO (World Health Organization) criteria between January and September 2019.Written informed consent was obtained from all partecipant of this study. Participants/materials, setting, methods The subjects were divided into three groups according to age: Group 1 ≤ 35 yearş group II ,36–40 years; and Group III ≥ to 41 years .All patients filled a questionnaire answering questions regarding age, BMI, caffeine and alcohol consumptions, smoking and nutrition behavior. Were excluded from the study patients with chromosomal alteration. For multifactorial lifestyle influence patients were evaluated with a point base system with a cut-off >2 and cut off<3 for unhealthy style. Main results and the role of chance There was no difference between the groups with regard all semen parameters such as volume, concentration, number of leukocytes, morphology and vitality (%).The percentage of spermatozoa with LNV (Large Nuclear vacuoles) was significantly higher in the older group than in the younger (I and II) (39,14±13,74 vs 31,8±12 and 31,7 ±13,4 rispectively (p < 0,05)which does not correspond to a worsening of semen morphology. Regression analysis demonstrated a correlation between the percentage of spermatozoa with LNV and male age (r = –0,1) (p < 0,001). There was no correlation between lifestyle parameters ad enviroments factors . Comparing the semen parameters of healthy and unhealthy population we found no difference except a significantly higher number of spermatozoa with vacuoles in the unhealthy population (p < 0.001) Limitations, reasons for caution Although the sample examined in this study is limited in size and other studies are needed to confirm this evidence, the data available to us support the routine use of MSOME for ICSI and as a criterion for semen analysis with potential clinical repercussions. Wider implications of the findings: To date, there are few works in the literature that analyze the relationship between the morphology assessed with the MSOME and the age of the patients and the results are conflicting. To our knowledge many works agree with our results. Trial registration number Not applicable

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