ORİJİNAL ARAŞTIRMALAR
Erkek İnfertilitesinde Sperm Parametreleri ile Serum ve Seminal Plazma Çinko Düzeyleri İlişkisi
Relation of Sperm Parameters to Serum and Seminal Plasma Zinc Levels in Male Infertility
Received Date : 15 Aug 2024
Accepted Date : 06 Nov 2024
Available Online : 20 Nov 2024
Ayşen YÜCETÜRKa, Hale BAYRAMb, Özge KARAOSMANOĞLUa, Mehmet CINCIKb,
Özdemir HİMMETOĞLUc
aAcıbadem Maslak Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, İstanbul, Türkiye
bMaltepe Üniversitesi, Tıp Fakültesi, Histoloji ve Embriyoloji AD, İstanbul, Türkiye
cGazi Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum AD (Emekli Öğretim Üyesi), Ankara, Türkiye
Doi: 10.24074/tjrms.2024-105139 - Makale Dili: TR
Türk Üreme Tıbbı ve Cerrahisi Dergisi. 2024;8(3):83-90.
ÖZET
Amaç: Çinko gibi eser elementlerin eksikliği sık karşılaşılan erkek infertilitesi nedenleri arasında gösterilir. Bu çalışmada amaç, serum ve seminal sıvı çinko konsantrasyonları
ile erkek infertilitesi ve sperm parametreleri arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntemler: Çalışma, erkek infertilitesi tanısı almış 100 katılımcı ile gerçekleştirildi.
Katılımcılar semen parametrelerine göre dört gruba (normozoospermi, hafif oligozoospermi, şiddetli oligozoospermi, azoospermi); yaş gruplarına göre üç gruba ayrıldı. Semen
parametreleri ve seminal plazma çinko seviyeleri, kan serumunda FSH, LH, LTH, serbest testosteron, toplam testosteron ve çinko düzeyleri karşılaştırıldı. Serum ve seminal plazmadaki
çinko düzeyleri, normal ve anormal semen parametreleri ile motilite ve yaş grupları arasında karşılaştırıldı. Serum ve seminal plazma içerisindeki çinko miktarı atomik
absorbsiyon spektrofotometresi ile ölçüldü. Bulgular: Katılımcıların semen volümü 2,75±1,29 ml, sperm konsantrasyonu 21,15±24,75 x106/ml, toplam motil sperm yüzdesi
43,69±29,13, seminal plazma ve serum çinko düzeyleri sırasıyla 3952,91±1694,77 μg/dl ve 121,75±119,94 μg/dl ölçüldü. Gruplar arası karşılaştırmada normozoospermiklere göre
azoospermi grubunun yaş ortalaması, FSH ve LH düzeyleri ile semendeki lökosit sayısı yüksek (p=0,30; p=0,000; p=0,000; p=0,000), serbest testosteron ve toplam testosteron
düzeyleri ise düşük bulundu (p=0,039; p=0,003). Ortalama serum prolaktin seviyesi, semen volümü, seminal plazma ve serum çinko değerleri açısından bir fark saptanmadı
(p=0,136; p=0,65; p=0,65; p=0,38). Semen analizi normal ve anormal olan gruplarda, progresif motilite ≥%30 ve progresif motilite <%30 gruplarda ve yaş gruplarında seminal
plazma ve serum çinko düzeyleri arasında anlamlı bir fark bulunmadı. Sonuç: Çalışmamızda azoospermik erkeklerde FSH, LH seviyeleri yüksek, serbest testosteron, total testosteron
seviyeleri düşük bulunurken, seminal plazma ve serum Zn değerlerinde fark bulunmadı. Bu durum çalışmaya dahil edilen erkeklerin infertilite tanısı almış olmasıyla açıklanabilir.
Anahtar Kelimeler: Erkek infertilitesi; semen analizi; sperm hareketliliği; çinko; in vitro fertilizasyon
ABSTRACT
Objective: Deficiency of trace elements such as zinc is one of the common causes of male infertility. The aim of this study was to evaluate the relationship between serum and
seminal fluid zinc concentrations and male infertility and sperm parameters. Material and Methods: The study was conducted with 100 participants diagnosed with male infertility
or unexplained infertility Participants were divided into four groups according to semen parameters (normozoospermia, mild oligozoospermia, severe oligozoospermia,
azoospermia) and three groups according to age groups.The study was conducted with 100 participants diagnosed with male infertility. Participants were divided into four groups
according to semen parameters (normozoospermia, mild oligozoospermia, severe oligozoospermia, azoospermia) and three groups according to age groups. Semen parameters and
seminal plasma zinc levels, blood serum FSH, LH, LTH, free testosterone, total testosterone and zinc levels were compared. Zinc levels in serum and seminal plasma were compared
between normal and abnormal semen parameters, motility and age groups. Zinc levels in serum and seminal plasma were measured by atomic absorption spectrophotometry.
Results: Semen volume was 2.75±1.29 ml, sperm concentration 21.15±24.75 x106/ml, total motile sperm percentage 43.69±29.13, seminal plasma and serum zinc levels
3952.91±1694.77 μg/dl and 121.75±119.94 μg/dl, respectively. The mean age, FSH and LH levels and leukocyte count in semen were higher (p=0.30; p=0.000; p=0.000; p=0.000;
p=0.000) and free testosterone and total testosterone levels were lower (p=0.039; p=0.003) in azoospermia group compared to normozoospermia group. There was no difference
in mean serum prolactin level, semen volume, seminal plasma and serum zinc levels (p=0.136; p=0.65; p=0.65; p=0.38). No significant difference was found between seminal
plasma and serum zinc levels in semen analysis normal and abnormal groups, progressive motility ≥30% and progressive motility <30% groups and age groups. Conclusion: In
our study, FSH, LH levels were found to be high, free testosterone and total testosterone levels were found to be low, while no difference was found in seminal plasma and serum
Zn levels in azoospermic men. This may be explained by the fact that the men included in the study were diagnosed with infertility.
Keywords: Male infertility; semen analysis; sperm motility; zinc; in vitro fertilisation
REFERANSLAR
- Dadgar Z, Shariatzadeh SMA, Mehranjani MS, Kheirolahi A. The therapeutic effect of co-administration of pentoxifylline and zinc in men with idiopathic infertility. Ir J Med Sci. 2023;192(1):431-9. [Crossref] [PubMed]
- Zhao J, Dong X, Hu X, et al. Zinc levels in seminal plasma and their correlation with male infertility: A systematic review and meta-analysis. Sci Rep. 2016;6:22386. [Crossref] [PubMed] [PMC]
- Bhattacharya I, Sharma SS, Majumdar SS. Etiology of Male Infertility: an Update. Reprod. Sci. 2024;31(4), 942-65. [Crossref] [PubMed]
- Kaltsas A. Oxidative Stress and Male Infertility: The Protective Role of Antioxidants. Medicina. 2023;59(10):1769. [Crossref] [PubMed] [PMC]
- Takalani NB, Monageng EM, Mohlala K, et al. Role of oxidative stress in male infertility. Reproduction and Fertility. 2023;4(3):e230024. [Crossref] [PubMed] [PMC]
- Kumar N, Singh AK. Role of Zinc in Male Infertility: Review of Literature. Ind Jour of Obstet and Gyn Res. 2016;3(2):167-71. [Crossref]
- Marreiro D, Cruz K, Morais J,et al. Zinc and Oxidative Stress: Current Mechanisms. Antioxidants. 2017;6(2):24. [Crossref] [PubMed] [PMC]
- Bjorndahl L, Kvist U. Human sperm chromatin stabilization: a proposed model including zinc bridges. Molecular Human Reproduction. 2010;16(1):23-9. [Crossref] [PubMed]
- Wong WY, Merkus HMWM, Thomas CMG, et al. Effects of folic acid and zinc sulfate on male factor subfertility: a double-blind, randomized, placebo-controlled trial. Fertility and Sterility. 2002;77(3):491-8. [Crossref] [PubMed]
- Nadjarzadeh A, Mehrsai A, Mostafavi E, Gohari MR, Shidfar F. The association between dietary antioxidant intake and semen quality in infertile men. Med J Islam Repub Iran. 2013;27(4):204-9.
- Hadwan MH, Almashhedy LA, Alsalman ARS. Oral zinc supplementation restore high molecular weight seminal zinc binding protein to normal value in Iraqi infertile men. BMC Urol. 2012;12(1):32. [Crossref] [PubMed] [PMC]
- Jawad HM. Zinc sulfate treatment of secondary male infertility associated with positive serum and seminal plasma anti-sperm antibody test. Middle East Fertility Society Journal. 2013;18(1):24-30. [Crossref]
- Eggert-Kruse W, Zwick EM, Batschulat K, et al. Are zinc levels in seminal plasma associated with seminal leukocytes and other determinants of semen quality? Fertil Steril. 2002;77(2):260-9. [Crossref] [PubMed]
- Lin YC, Chang TC, Tseng YJ, et al. Seminal plasma zinc levels and sperm motion characteristics in infertile samples. Chang Gung Med J. 2000;23(5):260-6.
- Henkel R, Maass G, Schuppe HC, et al. Molecular aspects of declining sperm motility in older men. Fertil Steril. 2005;84(5):1430-7. [Crossref] [PubMed]
- Eskenazi B, Kidd SA, Marks AR, et al. Antioxidant intake is associated with semen quality in healthy men. Human Reproduction. 2005;20(4):1006-12. [Crossref] [PubMed]
- Camejo MI, Abdala L, Vivas-Acevedo G, et al. Selenium, Copper and Zinc in Seminal Plasma of Men with Varicocele, Relationship with Seminal Parameters. Biol Trace Elem Res. 2011;143(3):1247-54. [Crossref] [PubMed]
- Colagar AH, Marzony ET, Chaichi MJ. Zinc levels in seminal plasma are associated with sperm quality in fertile and infertile men. Nutrition Research. 2009;29(2):82-8. [Crossref] [PubMed]
- Fuse H, Kazama T, Ohta S, Fujiuchi Y. Relationship between Zinc Concentrations in Seminal Plasma and Various Sperm Parameters. Int Urol Nephrol. 1999;31(3):401-8. [Crossref] [PubMed]
- Şeflek HN, Erbayram FZ, Menevşe E. Erkek İnfertilitesinde Güncel Semen Biyobelirteçleri. Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2022;48(1):121-30. [Crossref]
- Karabulut S, Korkmaz S, Güneş E, et al. Seminal trace elements and their relationship with sperm parameters. Andrologia. 2022;54(11):e14610. [Crossref] [PubMed]
- Meeker JD, Rossano MG, Protas B, et al. Cadmium, Lead, and Other Metals in Relation to Semen Quality: Human Evidence for Molybdenum as a Male Reproductive Toxicant. Environ Health Perspect. 2008;116(11):1473-9. [Crossref] [PubMed] [PMC]
- Rodríguez-Díaz R, Alcaide-Ruggiero L, Rodríguez-Fiestas S, et al. Associations of Semen Quality with Seminal Non-essential Heavy Metals in Males from the Canary Islands. Biol Trace Elem Res. 2021;199(12):4525-34. [Crossref] [PubMed]
- Beigi Harchegani A, Dahan H, Tahmasbpour E, Bakhtiari Kaboutaraki H, Shahriary A. Effects of zinc deficiency on impaired spermatogenesis and male infertility: the role of oxidative stress, inflammation and apoptosis. Human Fertility. 2020;23(1):5-16. [Crossref] [PubMed]
- Björndahl L, Apolikhin O, Baldi E, et al., editors. WHO laboratory manual for the examination and processing of human semen. 6th ed. Geneva: World Health Organization; 2021 Erişim adresi: https://iris.who.int/bitstream/handle/10665/343208/9789240030787-eng.pdf?sequence=1
- Li WN, Jia MM, Peng YQ, et al. Semen quality pattern and age threshold: a retrospective cross-sectional study of 71,623 infertile men in China, between 2011 and 2017. Reprod Biol Endocrinol. 2019;17(1):107. [Crossref] [PubMed] [PMC]
- Morris A, Mavrelos D, Odia R,et al. Paternal age over 50 years decreases assisted reproductive technology (ART) success: A single UK center retrospective analysis. Acta Obstet Gynecol Scand. 2021;100(10):1858-67. [Crossref] [PubMed]
- Salmon-Divon M, Shrem G, Balayla J, et al. An age-based sperm nomogram: the McGill reference guide. Human Reproduction. 2020;35(10):2213-25. [Crossref] [PubMed]
- Sharma R, Agarwal A, Rohra VK, et al. Effects of increased paternal age on sperm quality, reproductive outcome and associated epigenetic risks to offspring. Reprod Biol Endocrinol. 2015;13(1):35. [Crossref] [PubMed] [PMC]
- Stone BA, Alex A, Werlin LB, Marrs RP. Age thresholds for changes in semen parameters in men. Fertility and Sterility. 2013;100(4):952-8. [Crossref] [PubMed]
- Valizade K, Bayram H, Donmez Cakil Y, Selam B, Cincik M. Age related semen parameters and ICSI pregnancy outcomes of 8046 men in Turkey over a 9-year period. The Aging Male. 2024;27(1):2374724. [Crossref] [PubMed]
- Sermondade N. Obesity and Increased Risk for Oligozoospermia and Azoospermia. Arch Intern Med. 2012;172(5):440. [Crossref] [PubMed] [PMC]
- Dong Y, Mai X, Xu X, Li Y. Effects of the body mass index of males on hormone levels, sperm and embryo parameters, and clinical outcomes in non-obstructive azoospermia: a systematic review and meta-analysis. Transl Androl Urol. 2023;12(3):392-405. [Crossref] [PubMed] [PMC]
- Hammiche F, Laven JSE, Twigt JM, et al. Body mass index and central adiposity are associated with sperm quality in men of subfertile couples. Human Reproduction. 2012;27(8):2365-72. [Crossref] [PubMed]
- Harlev A, Agarwal A, Gunes SO, Shetty A, Du Plessis SS. Smoking and Male Infertility: An Evidence-Based Review. World J Mens Health. 2015;33(3):143. [Crossref] [PubMed] [PMC]
- Mostafa T. Cigarette smoking and male infertility. Journal of Advanced Research. 2010;1(3):179-86. [Crossref]
- Osadchuk L, Kleshchev M, Osadchuk A. Effects of cigarette smoking on semen quality, reproductive hormone levels, metabolic profile, zinc and sperm DNA fragmentation in men: Results from a population-based study. Frontiers in Endocrinology, 2023;14:1255304. [Crossref] [PubMed] [PMC]
- Gamidov S, Shatylko T, Popova A, Gasanov N, Sukhikh G. Azoospermic men with isolated elevation of follicle-stimulating hormone represent a specific subpopulation of patients with poor reproductive outcomes. Clin Exp Reprod Med. 2022;49(1):62-9. [Crossref] [PubMed] [PMC]
- Kavoussi PK, Hudson K, Machen GL, et al. FSH levels and testicular volumes are associated with the severity of testicular histopathology in men with non-obstructive azoospermia. J Assist Reprod Genet. 2021;38(11):3015-8. [Crossref] [PubMed] [PMC]
- Tek M, Akbay E. Management of the Infertile Male with Azoospermia. Düzce Tıp Fakültesi Dergisi. 2022;24(Special Issue):36-43. [Crossref]
- Basukarno A, Birowo P, Rasyid N. Cut-off Value of Testosterone and FSH Level In Patient With Azoospermia. KnE Medicine. 2016;145-52. [Crossref]
- Wong WY, Flik G, Groenen PM, et al. The impact of calcium, magnesium, zinc, and copper in blood and seminal plasma on semen parameters in men. Reprod Toxicol. 2001;15(2):131-6. [Crossref] [PubMed]
- Knudtson JF, Sun F, Coward RM, et al. The relationship of plasma antioxidant levels to semen parameters: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial. J Assist Reprod Genet. 2021;38(11):3005-13. [Crossref] [PubMed] [PMC]
- Madding CI, Jacob M, Ramsay VP, Sokol RZ. Serum and Semen Zinc Levels in Normozoospermic and Oligozoospermic Men. Ann Nutr Metab. 1986;30(4):213-8. [Crossref] [PubMed]
- Allouche-Fitoussi D, Breitbart H. The Role of Zinc in Male Fertility. IJMS. 2020;21(20):7796. [Crossref] [PubMed] [PMC]
- Egwurugwu JN, Ifedi CU, Uchefuna RC, Ezeokafor EN, Alagwu EA. Effects of zinc on male sex hormones and semen quality in rats. Niger J Physiol Sci. 2013;28(1):17
- Fallah A, Mohammad-Hasani A, Colagar AH. Zinc is an Essential Element for Male Fertility: A Review of Zn Roles in Men's Health, Germination, Sperm Quality, and Fertilization. J Reprod Infertil. 2018;19(2):6-81.
- Osadchuk L, Kleshchev M, Danilenko A, Osadchuk A. Impact of seminal and serum zinc on semen quality and hormonal status: A population-based cohort study of Russian young men. Journal of Trace Elements in Medicine and Biology. 2021;68:126855. [Crossref] [PubMed]