رسائل ماجيستير
English
2024
Immunological and Viral Markers in Male Infertility Among Al Najaf Patients
تغريد فاضل المحبوبي , محمد باقر رشاد فخر الدين, محمد سعود هادي
كلية الطب-جامعة جابر بن حيان الطبية · العراق
Male infertility appears to be a major clinical problem among men of reproductive age in all societies. Nowadays, there is a marked increase in the infertility rates mainly in males. Idiopathic male infertility is considered to be a multifactorial disorder affected by genetic, environmental, and hormonal factors. In fact, ethnic characteristics also have been suggested to be of clinical interest in the evaluation of this disorder. Infertility is defined as a failure of couples to achieve pregnancy following 12 months of unprotected sexual life. Infertility affects 13–18% of couples, and male factor accounts for up to 50% of all the cases. Viruses, as well as many other microorganisms, are able to interfere with the reproductive function and are suspected to be involved in the development of infertility. Cytomegalovirus (CMV) and human herpes virus type-6 (HHV-6) are also frequently discovered in sperm samples.
If cytokine production is disturbed, the reproductive system functions may be damaged; this leads to male infertility. Pro-inflammatory cytokines like IL-6 have direct effects on spermatogenic cell differentiation, testicular steroidogenesis, and spermatogenesis, whereas anti-inflammatory cytokines like IL-10 are also linked to testicular development.
This case-control study was done on one hundred specimens collected from male patients subjected to primary and secondary infertility and an apparently healthy control group from Al Sader Medical City / Infertility Center / Al-Najaf Al-Ashraf. The study included 71 infertility patients and 29 controls aged between 22 to 48 years. Utilizing a specific ELISA commercial kit, semen samples and PCR were used for detection of allele-specific polymorphism.
Increase in pro-inflammatory cytokines (IL-6), and decrease in immunosuppressive (IL-10), could alter the tolerance to sperm cells in male tracts and reduce the favorable conditions to reach the fecundation and implantation. The results show a significant difference (P<0.05) in CMV. The current study showed a highly significant difference (P<0.001) between control and patient groups in each of CMV and HHV-6 (21.57 ± 11.61 vs. 42.89 ± 17.43), IL-6 (5.91 ± 1.28 vs. 7.86 ± 1.95), and IL-10 (14.54 ± 6.23 vs. 20.54 ± 7.90), respectively.
The present study has detected the IL-6 polymorphisms, rs1800795 G/C variant, and -590 C/T genotype frequency distribution in infertile male patients. This study revealed the presence of a significant difference in the CC, GC, and GG genotypes between the patient group and the control group. This difference is represented by the p-value calculated as (0.03). Regarding the type of infertility according to genotype in the patient group, it showed a non-significant difference in CC, GC, and GG genotypes in primary and secondary types of infertility (P=0.82).
This study revealed that IL-6 most probably has a role in male infertility cases which are associated with infection, immuno-infertile cases, and with varicocele. Moreover, the simultaneous determination of IL-6 allele-specific polymorphisms provides a sensitive and useful marker of silent infection and inflammation of the male genital tract.