P-019 Semen analysis results are negatively affected in patients with vitiligo:a cross-sectional study
Authors: Dokuzeylül Güngör N , Gungor K , Yurci A , Cil K 
Published: June 2022

Abstract

Study question
Does vitiligo affect the results of semen analysis?

Summary answer
Semen analysis results are negatively affected in patients with vitiligo.

What is known already
Vitiligo is a multifactorial disorder characterized by the loss of functional melanocytes, and both genetic and non-genetic factors play a pathogenic role.Male infertility is also a common problem, contributing to almost 50% of all infertility problems.It was reported that skin-derived cytokines triggered in diseases with inflammation in the skin negatively affect spermatogenesis and sperm viability.Although vitiligo is a common skin disorder, the pathogenesis remains unknown. It was shown that inflammation and oxidative stress was accepted as a trigger factor in melanocyte degeneration.It was emphasized that the increase in inflammation in the body might be indirectly related to male infertility.

Study design, size, duration
This cross-sectional study was conducted between January 2015 and January 2021 by retrospectively evaluating patients who underwent sperm analysis at an university hospital. All patients aged between 25-45 years who underwent semen analysis at the relevant dates were evaluated in terms of the study (N = 5167).76 patients with vitiligo and 71 healthy controls were included in our study. The diagnosis of vitiligo was made clinically and using Wood's lamp.

Participants/materials, setting, methods
The control group was selected from among age and BMI-matched patients who underwent semen analysis (n = 71).The parameters examined in the study were as follows: Characteristics of cases (age, BMI, family history), Disease features (duration of disease, clinical type, Koebner phenomenon, halo naevi)The level of hormones [follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroxine (FT4), thyroid-stimulating hormone (TSH), testosterone, prolactin], and blood glucose, Semen analysis (volume, sperm concentration, total motility, A + B motility, morphology).

Main results and the role of chance
Seventy-six patients with vitiligo and 71 healthy controls were included in our study. The mean age was 30.29 ± 4.18 (range, 25-45) years. The mean age at onset was 23.66 ± 3.96 (range, 15-35) years, and the mean duration of disease was 6.36 ± 2.80 (range, 2-20) years in the vitiligo group. Sixty-seven (88.16%) patients had non-segmental vitiligo and nine (11.84%) had segmental vitiligo. Seven (9.21%) patients had a family history, three (3.95%) had Koebner phenomenon, and one (1.32%) patient had halo naevi.Free T4 levels were significantly lower in the vitiligo group than in the control group (P &lt; 0.001) There were no significant differences between the groups regarding age, BMI, FSH, LH, TSH, testosterone, prolactin, and blood glucose levels. When we evaluated the semen analysis results, we found that sperm concentrations A+B motility and morphology were significantly higher in the controls than in the patients with vitiligo (P &lt; 0.001,p&lt;0.01,and P &lt; 0.001) )There were no significant differences between the groups concerning volume and total motility. We divided patients with vitiligo into three groups according to their sperm concentrations.There were no significant differences between groups regarding age and BMI Free T4 levels were significantly higher in the control group than in the other groups. (p &lt; 0.001).

Limitations, reasons for caution
The retrospective design of the study is an important limitation. Although the relationship between vitiligo and sperm parameters has been examined, the direction and cause of this relationship could not be determined due to the study design.

Wider implications of the findings
Inflammation and oxidative stress may affect sperm quality.One of the reasons for the more negative results in sperm analysis parameters in patients with vitiligo in our study might be due to increased inflammation level.Oxidative stress may be the trigger factor in the destruction of melanocytes as well as semen parameters.

Trial registration number
not applicable