Lökositosperminin semen ve intrasitoplazmik sperm enjesksiyonu parametreleri üzerine etkileri
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Date
2004
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Kadir Has Üniversitesi
Abstract
İnfertilite, korunmasız olarak cinsel ilişkiye girilmesine rağmen, bir yılı aşan süreyle çiftlerin çocuk sahibi olamamasıdır. İnfertilite nedeniyle başvuran çiftlere yapılan araştırmalar sonunda, gerekirse yardımla üreme tekniklerinden yararlanılır. Bu yöntemlerden biri olan İntrasitoplazmik Sperm Enjeksiyonu (ICSI), ciddi erkek infertilitesi nedeniyle çocuk sahibi olamayan çiftler için sıkça başvurulan bir yöntemdir ve yumurtaların in vitro koşullarda spermatozoon hücreleri ile biraraya getirilip embriyo elde edilmesi ve anne uterusuna transfer edilmesi esasına dayanmaktadır. İnfertilite nedenini belirlemek için yapılan araştırmalardan önemli biri olan semen analizi ile birçok semen parametresinin belirlenmesinin yanısıra, lökositler gibi spermatozoon olmayan diğer hücreler de belirlenir. Semendeki lökositleri tanımlamak için peroksidaz boyama yöntemi gibi çeşitli yöntemler kullanılır. Bir mililitre semende bir milyon ve üzerinde lökosit belirlenmesi durumu, "lökositospermi" olarak adlandırılır. Lökositosperminin klinik önemi ve yardımla üreme teknikleri üzerine etkileri henüz tam olarak aydınlatılamamasına rağmen, genelde semen parametrelerini olumsuz yönde etkilediği düşünülmektedir. Bu hücrelerin, ICSI parametrelerine etkileri konusunda ise çok az şey bilinmektedir. Bu çalışma, lökositosperminin, semen ve ICSI parametreleri üzerine etkilerini incelemek amacıyla yapılmıştır. Androlojik nedenle ICSI uygulanan 70 çift çalışmaya alınmıştır. Hastalar, lökositospermi belirlenen 34 çift ve lökositospermi belirlenmeyen 36 çift olarak iki gruba ayrılmıştır. Bulgularımıza göre, lökositospermi varlığında, semende A motiliteye sahip (hızlı ve ileri hareketli) spermatozoon oranı ve spermatozoon konsantrasyonu azalmış, spermatozoonların toplam motilite oranında değişiklik gözlenmemiştir. Lökositospermi belirlenen grubun fertilizasyon ve embriyo elde etme oranlan da kontrol grubuna göre anlamlı derecede düşük bulunmuştur. Embriyo kaliteleri, embriyo bölünme ve gebelik oranları ise iki grup arasında bir farklılık göstermemiştir.Çalışmanın bulguları doğrultusunda, lökositosperminin, spermatozoonun fertilizasyon potansiyelini etkileyen bazı semen parametrelerini ve ICSI sonuçlarını etkileyen bazı ICSI parametrelerini olumsuz yönde etkilediği sonucuna ulaşılmıştır. Sonuç olarak, lökositosperminin kısa ve uzun dönem olumsuz etkileri Önemle değerlendirilmeli ve bu durumdaki çiftler ICSI programına alınmadan önce bilgilendirilmelidirler.
Infertility is defined as inability to conceive after one year of unprotected intercourse. After the investigation of the couple, assisted reproduction techniques are carried out if necessary. ICSI is one of these techniques that is successfully used especially for couples having male factor infertility. This technique includes injecting a spermatozoa into the cytoplasm of an oocyte under in vitro conditions, having embryos and transferring them back into the mother's uterus. During the investigation of the infertile couple, semen analysis is performed to determine semen parameters including the determination of other cells in semen like leukocytes. Different methods are used to identify the leukocytes present in semen like peroxidase staining method. Presence of 1 million or higher leukocytes in 1 mililiter semen is defined as leukocytospermia. Clinical importance and effects of leukocytospermia on the assisted reproduction techniques' outcome is controversial but the traditional view is, it negatively affects the semen parameters. The effects of these cells on ICSI parameters is also not well known. This study is designed to investigate the effects of leukocytospermia on semen and ICSI parameters. Seventy couples undergoing ICSI treatment because of andrologic reasons were included in the study. These couples were divided into two groups as 34 couples of leukocytospermic and 36 couples of nonleukocytospermic group. According to our results, A motility rate (rapid progressive motility) of spermatozoa and spermatozoa concentration of semen were reduced in the leukocytospermic group although total motility rate was not affected. ICSI parameters including fertilization and embryo development rate in the leukocytospermic group were significantly lower than the control group although there were no statistical difference in embryo quality, embryo cleavage and pregnancy rates between the groups. These results indicate that, some semen parameters affecting the fertilizing potential of spermatozoa and some ICSI parameters affecting the ICSI outcome were affected negatively by the presence of leukocytospermia.As a result, great care should be taken about the short and long term affects of leukocytospermia and couples should be counselled about this situation before the ICSI programme.
Infertility is defined as inability to conceive after one year of unprotected intercourse. After the investigation of the couple, assisted reproduction techniques are carried out if necessary. ICSI is one of these techniques that is successfully used especially for couples having male factor infertility. This technique includes injecting a spermatozoa into the cytoplasm of an oocyte under in vitro conditions, having embryos and transferring them back into the mother's uterus. During the investigation of the infertile couple, semen analysis is performed to determine semen parameters including the determination of other cells in semen like leukocytes. Different methods are used to identify the leukocytes present in semen like peroxidase staining method. Presence of 1 million or higher leukocytes in 1 mililiter semen is defined as leukocytospermia. Clinical importance and effects of leukocytospermia on the assisted reproduction techniques' outcome is controversial but the traditional view is, it negatively affects the semen parameters. The effects of these cells on ICSI parameters is also not well known. This study is designed to investigate the effects of leukocytospermia on semen and ICSI parameters. Seventy couples undergoing ICSI treatment because of andrologic reasons were included in the study. These couples were divided into two groups as 34 couples of leukocytospermic and 36 couples of nonleukocytospermic group. According to our results, A motility rate (rapid progressive motility) of spermatozoa and spermatozoa concentration of semen were reduced in the leukocytospermic group although total motility rate was not affected. ICSI parameters including fertilization and embryo development rate in the leukocytospermic group were significantly lower than the control group although there were no statistical difference in embryo quality, embryo cleavage and pregnancy rates between the groups. These results indicate that, some semen parameters affecting the fertilizing potential of spermatozoa and some ICSI parameters affecting the ICSI outcome were affected negatively by the presence of leukocytospermia.As a result, great care should be taken about the short and long term affects of leukocytospermia and couples should be counselled about this situation before the ICSI programme.