Abstract

In order to increase the success of treating by family doctor male with infertility, developing the right tactics and optimal treatment regimens, verification of various factors of male infertility is required. From the accuracy of determining the causes of male infertility depends the further study of the pathogenesis of reproduction impairment, which will contribute to the development of effective therapies. More and more facts are being accumulated that point to the important role of immune processes in the pathogenesis of infertility, which provides the basis for studying the levels of cytokines in patients with chronic urogenital inflammatory processes. The objective : study the production of IL-12 and IL-18 cytokines in seminal plasma in males with low asymptomatic forms of chronic urogenital infection depending on fertility. Materials and methods . The patients (n=72) were examined for small asymptomatic forms of chronic inflammation of the urogenital tract, aged from 22 to 40 years. All surveyed are divided into two groups: the first (35 people) – infertile men and the second (37 people) – fertile men. Duration of infertility in patients of the І th group was 3 6 years. Polymerase chain reaction (PCR) method was used to detect Chlamidia trachomatis, M. hominis, U. urealyticum, V. herpes in seminal plasma. At the beginning of the survey, it took more than a year after the completion of the previous treatment. Sperm studies were performed and sperm morphology was determined using staining for Papanicolaou. Levels of IL-12 and IL-18 cytokines were studied in serum and in the semen. Control parameters of cytokine concentrations were obtained during the study of 24 fertile men without clinical signs of a disease of a similar age composition. Results . Investigation of cytokine levels in patients, depending on fertility, found that in the I group (male infertility), the level of IL-12 in the semen tended to decrease, with its concentration in blood in patients in this group did not differ from the norm. As for the group of fertile men (group II), an immunological study indicates diverse shifts in concentrations of IL-12 and IL-18 in both serum and seminal plasma. An increase in the content of the studied cytokines is much more pronounced in the semen than in the serum. The spermometry of both groups of patients showed that hyperfertility and microsomal type of sperma was observed in infertility men, and in fertile men, although there was a normospermia, however, in that part of the patients of the II group, which showed a decrease in the concentrations of IL-12 and IL-18 in the semen we stated an increase in the pathological forms of sperm. The data obtained indicate, in our opinion, the participation of IL-12 and IL-18 in the course of inflammation (mainly increased concentrations) and participation in the process of maturation of sperm. Conclusion . Microenvironment is important during maturation of the germ cells. An important role in this is played by cytokines, in particular IL-12 and IL-18. The study of the concentration of IL-12 and IL-18 in semen is more appropriate than in serum when the inflammatory process is established in the urogenital tract. Reduced concentrations of IL-12 and IL-18 in semen indicate the development of infertility, as evidenced by the presence of pathospermia. Immunocorrection therapy in men with oligosymptomatic forms of chronic inflammation of the urogenital tract complicated by infertility should take into account the shift of the cytokine profile both in serum and in the semen.

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