Influence of bacterial extract on morphogenesis of spermatozoa of infertile men with chronic inflammation of urogenital tract
Authors: С. Ю. Ціпоренко  , Л. Ф. Матюха  
Published: December 2018

The prerogative of primary medicine is the care of reproductive health, which includes along with other issues the treatment for male infertility. Along with the causes that violate reproductive capacity – providing adequate for the conception of frequency, rhythm and technique of sexual intercourse, some details in sexual life (premature ejaculation, interrupted sexual intercourse) – which are a component of excretory infertility, there are causes of secretory infertility, including inflammatory diseases of reproductive systems that are caused by sexually transmitted infections (STIs) and range from 10% to 40%. Comprehensive medication anti-inflammatory therapy in urogenital inflammatory processes does not always provide a lasting therapeutic effect, since its results depend on the biological properties of pathogens, the state of the immune system and the patient’s natural resistance. Extracting from this, in modern conditions, considerable attention is paid to the study of the effectiveness of immunoactive drugs in the treatment and medical rehabilitation of patients with chronic urogenital pathology.The objective: is to study of variants of sperm morphotype in seminal plasma of infertile men who have transmitted STIs and the presence of connection between disproportion of subpopulative composition of leukocytes of sperm and changes in morphotype and pathogenetic substantiation of immunorehabilitation of patients with chronic uroglinginal infection, using bacterial extract of Escherichia coli.Materials and methods. 88 men with chronic inflammation of the urogenital tract were examined from the age of 22 to 40 years. All surveyed are divided into two groups: the first (44 persons) – infertile men and the second (44 persons) – fertile men. Duration of infertility in patients of the І-th group was 3–6 years. 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. Considered the concentration of sperm, pH of semen, the content of leukocytes and their subpopulations (granulocytes, macrophages, lymphocytes). Infertility men were examined further after a course of immunorehabilitation. Statistical analysis was performed on a personal computer using the MedStat program package.Result. Patients of the infertility group (Group I) were characterized by a significant decrease in the number of monocytes/macrophages, both in comparison with the control group, and with normative indicators. Fluctuations in the number of monocytes/macrophages in fertile patients in the second group were within the normative limits. At the same time, the number of lymphocytes had a reversible tendency to a significant increase in Group I patients compared with Group II and with normative indicators. Such an imbalance of monocytes/macrophages and lymphocytes in the infertile men in seminal plasma in the absence of leukocytospermia suggests the presence of intimate mechanisms of disorder of spermatogenesis and the participation of the immune system in this process. During micrometry, differences in the variants of sperm morphotypes in patients of both groups were established. However, infertility patients, in spite of the normal amount and sperm motility, have more pronounced morphofunctional changes that are characterized by the predominance of macrosomatic and hypercitated spermatozoa. The results of the comprehensive therapy of infertile men with chronic inflammation of the urogenital tract showed that the inclusion of bacterial extract of Escherichia coli in the immunorehabilitation of patients leads to an improvement in the subpopulation composition of leukocytes in the sperm, and, consequently, to an increase in fertilizing potential.Conclusion. Diagnostically important is the determination of morphological changes in spermatozoa and the determination of disproportion of leukocyte subpopulations in semen in the establishment of male infertility. This makes it possible to apply a differentiated approach both to the treatment of commonly used therapeutic agents and to differentiated immunotherapy.