UrologiiaUrologiiaУрология1728-29852414-9020Bionika Media281298ArticlesСтатьиResearch ArticleMALE PRECONCEPTION CAREПодготовка мужчины к зачатиюEfremovE. AЕфремовЕ. А

Отдел андрологии и репродукции человека

KasatonovaE. VКасатоноваЕ. В

Отдел андрологии и репродукции человека; научный сотрудник

kasatonova@yandex.ruMel'nikJa. IМельникЯ. И

Отдел андрологии и репродукции человека

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - branch of National Medical Research Radiological Center of Minzdrav of RussiaНИИ урологии и интервенционной радиологии им. Н. А. Лопаткина - филиал ФГБУ НМИРЦ Минздрава России150620153NO3 (2015)№3 (2015)9710425022023Copyright ©; 2015, Bionika MediaCopyright ©; 2015, ООО «Бионика Медиа»2015Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/1728-2985/article/view/281298

Planning pregnancy is very important to ensure the most comfortable and optimal conditions for conception., gestation and the subsequent birth of a healthy child. This review examines the effects and mechanisms of the damaging effect of external factors., social habits and certain diseases on the ejaculate quality., as well as ways to overcome them aiming to optimum preparation of a man to conceive. Several studies have shown an inverse relationship between semen quality and common diseases. Unfavorable environmental conditions., varicocele., endocrine causes., such as diabetes., obesity., and metabolic syndrome., are thought to be among the factors that could adversely affect the quality of sperm. Oxidative stress in the testicular microenvironment may lead to suppression of spermatogenesis and sperm DNA damage resulting in a decrease of their mobility and causing morphological abnormalities.

Этап планирования беременности является очень важным для обеспечения максимально комфортных и оптимальных условий для зачатия, вынашивания и последующего рождения здорового ребенка. В данном обзоре рассмотрены влияние и механизм повреждающего действия внешних факторов, социальных привычек и некоторых заболеваний на качество эякулята, а также пути их преодоления с целью оптимальной подготовки мужчины к зачатию. В ряде исследований показана обратная зависимость между качеством спермы и общими заболеваниями. Среди факторов, которые могут негативно влиять на качество спермы, отмечают агрессивное влияние внешней среды, варикоцеле, системные и эндокринные причины, такие как сахарный диабет, ожирение и метаболический синдром. Оксидативный стресс в микросреде яичек может приводить к угнетению сперматогенеза и повреждению ДНК сперматозоидов, что выражается в снижении их подвижности и аномальной морфологии.

sterile marriagemale infertilityDNA fragmentationoxidative stressmicronutrientsantioxidantsбесплодный бракмужское бесплодиефрагментация ДНКоксидативный стрессмикронутриентыантиоксидантыJungwirth A., Giwercman A., Tournaye H., Diemer T., Kopa Z., Dohle G., Krausz C. Рекомендации Европейской ассоциации урологов (EAU) “Мужское бесплодие”. 2011г. http://uroweb.org/wp-content/uploads/10_ MaleInfertility.pdfMacLeod J. The role of oxygen in the metabolism and motility of human spermatozoa. Am J Physiol. 1943;138:512-518.Aitken R.J., Krausz C. Oxidative stress., DNA damage and the Y chromosome. Reproduction. 2001;122:497-506.Aitken R.J., De Iuliis G.N., McLachlan R.I. Biological and clinical significance of DNA damage in the male germ line. Int J Androl. 2009;32:46-56.Sedgh G., Singh S., Hussain R. Intended and unintended pregnancies worldwide in 2012 and recent trends. Stud Fam Plann. 2014 Sep;45(3):301-14.Кулаков В.И., Фролова О.Г. Репродуктивное здоровье в Российской Федерации. Народонаселение. 2004;3:60-66.Репродуктивное здоровье населения России 2011. Итоговый отчет. А. Авдеев, В. Елизаров, И. Троицкая, и. др. - Фонд ООН в области народонаселения. М., 2013. С. 344.Wyrobek A.J., Eskenazi B., Young S. Advancing age has differential effect on DNA damage., chromatin integrity., gene mutations., and aneuploidies in sperm. Proc Natl Acad Sci USA. 2006;103:9601-9606.Paulson R.J., Milligan R.C., Sokol R.Z. The lack of influence of age on male fertility. Am J Obstet Gynecol. 2001;184:818-822.Eskenazi B., Wyrobek A.J., Sloter E. The association of age and semen quality in healthy men. Hum Reprod. 2003;18:447-454.Ford W.C., North K., Taylor H. Increasing paternal age is associated with delayed conception in a large population of fertile couples: evidence for declining fecundity in older men. The ALSPAC Study Team (Avon Longitudinal Study of Pregnancy and Childhood). Hum Reprod. 2000;15:1703-1708.Saha S., Barnett A.G., Foldi C., Burne T.H., Eyles D.W., Buka S.L., McGrath J.J. Advanced paternal age is associated with impaired neurocognitive outcomes during infancy and childhood. PLoS Med. 2009;10:6(3):e40.Mathieu C., Ecochard R., Bied V., Lornage J., Czyba J.C. Cumulative conception rate following intrauterine artificial insemination with husband's spermatozoa: influence of husband's age. Hum Reprod. 1995;10(5): 1090-97.Zhou L., Shi X., Wang X., Liu D. Analysis of correlative factois of sterility in males undergoing routine sperm inspection by masturbation. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2012;37(7):725-9.Bhongade M.B., Prasad S., Jiloha R.C., Ray P.C., Mohapatra S., Koner B.C. Effect of psychological stress on fertility hormones and seminal quality in male partners of infertile couples. Andrologia. 2015;47(3):336-42.Sahin E., Gümüqlü S. Stress-dependent induction of protein oxidation., lipid peroxidation and anti-oxidants in peripheral tissues of rats: comparison of three stress models (immobilization., cold and immobilization-cold). Clin Exp Pharmacol Physiol. 2007;34(5-6):425-31.Овчарова Р. В. Родительство как психологический феномен: учебное пособие. М.: изд. МПСИ., 2006.Hauser R. The environment and male fertility: recent research on emerging chemicals and semen quality. Semin Reprod Med. 2006;24(3):156-67.Calogero A.E., La Vignera S., Condorelli R.A., Perdichizzi A., Valenti D., Asero P., Carbone U., Boggia B., De Rosa N., Lombardi G., DAgata R., Vicari LO., Vicari E., De Rosa M. Environmental car exhaust pollution damages human sperm chromatin and DNA. J Endocrinol Invest. 2011;34(6):e139-43.Zhai Q., Narbad A., Chen W. Dietary strategies for the treatment of cadmium and lead toxicity. Nutrients. 2015;14:7(1):552-71.Naziroglu M., Yüksel M., Köse S.A., Özkaya MO. Recent reports of Wi-Fi and mobile phone-induced radiation on oxidative stress and reproductive signaling pathways in females and males. J Membr Biol. 2013;246(12):869-75.Mailankot M., Kunnath A.P., Jayalekshmi H., Koduru B., Valsalan R. Radio frequency electromagnetic radiation (RF-EMR) from GSM (0.9/1.8GHz) mobile phones induces oxidative stress and reduces sperm motility in rats. Clinics (Sao Paulo). 2009;64(6):561-65.Guney M., Ozguner F., Oral B., Karahan N., Mungan T. 900 MHz radiofrequency-induced histopathologic changes and oxidative stress in rat endometrium: protection by vitamins E and C. Toxicol Ind Health. 2007 ;23(7) :411-20.Rago R., Salacone P., Caponecchia L., Sebastianelli A., Marcucci I., Calogero A.E., Condorelli R., Vicari E., Morgia G., Favilla V., Cimino S., Arcoria A.F., La Vignera S. The semen quality of the mobile phone users. J Endocrinol Invest. 2013;36(11):970-74.Yousefniapasha Y., Jorsaraei G., Gholinezhadchari M., Mahjoub S., Hajiahmadi M., Farsi M. Nitric oxide levels and total antioxidant capacity in the seminal plasma of infertile smoking men. Cell J. 2015;17(1): 129-36.Garcia P.C., Piffer R.C., Gerardin D.C., Sankako M.K., Alves de Lima R.O., Pereira O.C. Could zinc prevent reproductive alterations caused by cigarette smoke in male rats? Reprod Fertil Dev. 2012;24(4):559-67.Sofikitis N., Miyagawa I., Dimitriadis D., Zavos P., Sikka S., Hellstrom W. Effects of smoking on testicular function., semen quality and sperm fertilizing capacity. J Urol 1995;154:1030-1034.Ramlau-Hansen C.H., Thulstrup A.M., Bonde J.P., Olsen J., Bech B.H. Semen quality according to prenatal coffee and present caffeine exposure: two decades of follow-up of a pregnancy cohort. Hum Reprod. 2008;23(12):2799-805.Horak S., Polanska J., Widlak P. Bulky DNA adducts in human sperm: relationship with fertility., semen quality., smoking., and environmental factors. Mutat Res 2003;537:53-65.Sobreiro B.P., Lucon A.M., Pasqualotto F.F., Hallak J., Athayde K.S., Arap S. Semen analysis in fertile patients undergoing vasectomy: reference values and variations according to age, length of sexual abstinence, seasonality, smoking habits and caffeine intake. Sao Paulo Med J 2005;123:161-166.Svartberg J., Midtby M., Bonaa K.H., Sundsfjord J., Joakimsen R.M., Jorde R. The associations of age., lifestyle factors and chronic disease with testosterone in men: the Tromso Study. Eur J Endocrinol 2003;149:145-152.Jurewicz J., Radwan M., Sobala W., Radwan P., Jakubowski L., Hawuła W., Ulańska A., Hanke W. Lifestyle factors and sperm aneuploidy. Reprod Biol. 2014;14(3):190-99.Jensen T.K., Gottschau M., Madsen J.O., Andersson A.M., Lassen T.H., Skakkebæk N.E., Swan S.H., Priskorn L., Juul A., Jørgensen N. Habitual alcohol consumption associated with reduced semen quality and changes in reproductive hormones; a cross-sectional study among 1221 young Danish men. BMJ Open. 2014;4(9):e005462.Jensen T.K., Swan S., Jørgensen N., Toppari J., Redmon B., Punab M., Drobnis E.Z., Haugen T.B., Zilaitiene B., Sparks A.E., Irvine D.S., Wang C., Jouannet P., Brazil C., Paasch U., Salzbrunn A., Skakkebæk N.E., Andersson A.M. Alcohol and male reproductive health: a cross-sectional study of 8344 healthy men from Europe and the USA. Hum Reprod. 2014;29(8):1801-19.Ahmad G., Moinard N., Esquerré-Lamare C., Mieusset R., Bujan L. Mild induced testicular and epididymal hyperthermia alters sperm chromatin integrity in men. Fertil Steril. 2012;97(3):546-53.Rao M., Zhao X.L., Yang J., Hu S.F., Lei H., Xia W., Zhu C.H. Effect of transient scrotal hyperthermia on sperm parameters, seminal plasma biochemical markers, and oxidative stress in men. Asian J Androl. 2015.Kaur S., Bansal M.P. Protective role of dietary-supplemented selenium and vitamin E in heat-induced apoptosis and oxidative stress in mice testes. Andrologia. 2014.National Collaborating Centre for Women's and Children's Health (UK). Fertility: Assessment and Treatment for People with Fertility Problems. London: Royal College of Obstetricians & Gynaecologists (UK); 2013:P. 74-75Al-Azemi M.K., Omu A.E., Fatinikun T., Mannazhath N., Abraham S. Factors contributing to gender differences in serum retinol and alpha-tocopherol in infertile couples. Reprod Biomed Online 2009;19:583-590.Ramlau-Hansen C.H., Thulstrup A.M., Nohr E.A. Subfecundity in overweight and obese couples. Hum Reprod. 2007;22:1634-1637.Kapoor D., Clarke S., Channer K.S., Jones T.H. Erectile dysfunction is associated with low bioactive testosterone levels and visceral adiposity in men with type 2 diabetes. Int J Androl 2007;30:500-507Bakos H.W., Mitchell M., Setchell B.P., Lane M. The effect of paternal diet-induced obesity on sperm function and fertilization in a mouse model. Int J Androl 2011;34:402-410.Sallmen M., Sandler D.P., Hoppin J.A., Sallmén M., Sandler D.P., Hoppin J.A., Blair A., Baird D.D. Reduced fertility among overweight and obese men. Epidemiology 2006;17:520-523.Omu A.E., Kehinde E., Al-Azemi M.K. The effects of diabetes mellitus on the ontogeny of human sperm: the role for antioxidants. Androl Update. 2007;1:157-164.Agbaje M., Rogers D.A., McVicar C.M. Insulin dependent diabetes mellitus: implications for male reproductive function. Hum Reprod. 2007;22:1871-1877.Faloia E., Michetti G., De Robertis M. Inflammation as a link between obesity and metabolic syndrome. J Nutr Metab. 2012;2012:476380.Kasturi S.S., Tannir J., Brannigan R.E. The metabolic syndrome and male infertility. J Androl. 2008;29:251-259.Kirkman-Brown J., Barratt C.L.R., Publicover S.J. Nifedipine reveals the existence of two discrete components of the progesterone-induced [Ca (2+)]i transient in human spermatozoa. Dev Biol. 2003;259:71-82.Muciaccia B., Pensini S., Culasso F., Padula F., Paoli D., Gandini L., Di Veroli C., Bianchini G., Stefanini M., D'Agostino A. Higher clusterin immunolabeling and sperm DNA damage levels in hypertensive men compared with controls. Hum Reprod 2012;27:2267-2276.Omu A.E., Al-Othman S., Mohammad A.S. Antibiotics therapy for seminal infection: effect on antioxidant activity and T-helper cytokines. J Reprod Med 1998;43:857-864.Lorusso F., Palmisano M., Chironna M., Vacca M., Masciandaro P., Bassi E., Selvaggi Luigi L., Depalo R. Impact of chronic viral diseases on semen parameters. Andrologia. 2010;42:121-126.Garolla A., Pizzol D., Bertoldo A., Menegazzo M., Barzon L., Foresta C. Sperm viral infection and male infertility: focus on HBV, HCV, HIV, HPV., HSV, HCMV, and AAV. J Reprod Immunol. 2013;100(1):20-29.Steinbrenner H., Al-Quraishy S., Dkhil M.A., Wunderlich F., Sies H. Dietary selenium in adjuvant therapy of viral and bacterial infections. Adv Nutr. 2015;6(1):73-82.Fiorino S., Bacchi-Reggiani L., Sabbatani S., Grizzi F., di Tommaso L., Masetti M., Fornelli A., Bondi A., de Biase D., Visani M., Cuppini A., Jovine E., Pession A. Possible role of tocopherols in the modulation of host microRNA with potential antiviral activity in patients with hepatitis B virus-related persistent infection: a systematic review. Br J Nutr. 2014;112(11): 1751-68.Eisenberg M.L., Lipshultz L.I. Varicocele-induced infertility: Newer insights into its pathophysiology. Indian J Urol. 2011;27:58-64.Sheehan M.M., Ramasamy R., Lamb D.J. Molecular mechanisms involved in varicocele-associated infertility. J Assist Reprod Genet. 2014;31:521-26.Y. Sakamoto, T. Ishikawa, Y. Kondo, K. Yamaguchi, M. Fujisawa. “The assessment of oxidative stress in infertile patients with varicocele,” British Journal of Urology International. 2008;101(12): 1547-1552.Smit M., Romijn J.C., Wildhagen M.F., Veldhoven J.L., Weber R.F., Dohle G.R. Decreased sperm DNA fragmentation after surgical varicocelectomy is associated with increased pregnancy rate. J Urol. 2010;183(1):270-274.T. Mostafa, T. H. Anis, A. El-Nashar, H. Imam, I. A. Othman. Varicocelectomy reduces reactive oxygen species levels and increases antioxidant activity of seminal plasma from infertile men with varicocele,” International Journal of Andrology. 2001;24(5):261-265.Cervellione R.M., Cervato G., Zampieri N., Corroppolo M., Camoglio F., Cestaro B., Ottolenghi A. Effect of varicocelectomy on the plasma oxidative stress parameters. J Pediatr Surg. 2006 Feb;41(2):403-06.Mancini A., Milardi D., Conte G., Festa R., De Marinis L., Littarru G.P. Seminal antioxidants in humans: preoperative and postoperative evaluation of coenzyme Q10 in varicocele patients. Horm Metab Res. 2005 Jul;37(7):428-32.Evenson D.P., Jost L.K., Marshall D., Zinaman M.J., Clegg E., Purvis K., de Angelis P., Claussen O.P. Utility of the sperm chromatin structure assay as a diagnostic and prognostic tool in the human fertility clinic. Hum Reprod. 1999 Apr; 14(4):1039-49.Showell M.G., Brown J., Yazdani A., Stankiewicz M.T., Hart R.J. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2011;(1):CD007411.Szostak-Węgierek D. Nutrition and fertility. Med Wieku Rozwoj. 2011; 15(4):431-36.Abd-Allah A.R., Helal G.K., Al-Yahya A.A., Aleisa A.M., Al-Rejaie S.S., Al-Bakheet S.A. Pro-inflammatory and oxidative stress pathways which compromise sperm motility and survival may be altered by L-carnitine. Oxid Med Cell Longev. 2009;2:73-81.Agarwal A., Nallella K.P., Allamaneni S.S., & Said T.M. Role of antioxidants in treatment of male infertility: An overview of the literature. Reprod. Biomed Online. 2004;8:616-627.Costa M., Canale D., Filicori M., D’Lddio S., & Lenzi A. L-carnitine in idiopathic asthenozoospermia: A multicenter study. Andrologia. 1994;26:155-159.DeRouchey J.E., Rau D.C. Role of amino acid insertions on intermolecular forces between arginine peptide condensed DNA helices: implications for protamineDNA packaging in sperm. J Biol Chem. 201;286(49):41985-92.Scibona M., Meschini P., Capparelli S., Pecori C., Rossi P., Menchini Fabris G.F. L-arginine and male infertility. Minerva Urol Nefrol. 1994;46:251-3.Förstermann U., Sessa W.C. Nitric oxide synthases: regulation and function. Eur Heart J. 2012;33(7):829-37., 837a-837d.Safarinejad M.R., Safarinejad S., Shafiei N., Safarinejad S. Effects of the reduced form of coenzyme Q10 (ubiquinol) on semen parameters in men with idiopathic infertility: a double-blind., placebo controlled., randomized study. J Urol. 2012;188(2):526-31.Littarru G.P., Tiano L. Bioenergetic and antioxidant properties of coenzyme Q10: recent developments. Mol Biotechnol. 2007;37(1):31-37.Abad C., Amengual M.J., Gosálvez J., Coward K., Hannaoui N., Benet J., García-Peiró A., Prats J. Effects of oral antioxidant treatment upon the dynamics of human sperm DNA fragmentation and subpopulations of sperm with highly degraded DNA. Andrologia. 2013;45(3):211-16.Павлов А.Р., Ревина А.А., Дупин А.М., Болдырев А.А., Ярополов А.И. Взаимодействие карнозина с супероксидными радикалами в водных растворах. Бюл. эксперим. биологии и медицины. 1990;110(10):391-93.Hipkiss A.R: Carnosine and its possible roles in nutrition and health. Adv Food Nutr Res 2009;57:87-154.Haeri S.A., Rajabi H., Fazelipour S., Hosseinimehr S.J. Carnosine mitigates apoptosis and protects testicular seminiferous tubules from gamma-radiation-induced injury in mice. Andrologia. 2014 Nov;46(9): 1041-46.MacPhreson A., Scott R., Yates R. The effect of selenium supplementation in subfertile males. In: Anke M., Meissner D., Mills CF., editors. Proceedings of the Eighth International Symposium on Trace Elements in Man and Animals 1993. Jena (Germany): Verlag Media Turistik; 1993. pp. 566-569.Klein E.A. Selenium: epidemiology and basic science. J Urol. 2004; 171(2 Pt 2):S50-S53. discussion S53.Ceremelli C., Portolani M., Cotombari B., Castelli M., Baggio G., Galatulas I. Activity of glycyrrhizin and its diasterioisomers against two new human herpes virus: HHV-6 and HHV-7. Phyto Res.1996;10:527-528.Watanabe S.I., Chey W.Y., Lee K.Y., Chang T.M. Shiratori K., Watanabe S., Takeuchi T. Effect of licorice extract (Fm100) on release of secretin and exocrine pancreatic secretion in humans. Pancreas. 1986;1(6):483-87.Dirican E., Turkez H. In vitro studies on protective effect of Glycyrrhiza glabraroot extracts against cadmium-induced genetic and oxidative damage in human lymphocytes. Cytotechnology. 2014;66(1): 9- 16.Prasad A.S. Zinc deficiency. British Med J. 2008;326:409-410.Merker H.J., Günther T. Testis damage induced by zinc deficiency in rat. J Trace Element. 1997;11:19-22.Miura T., Yamauchi K., Takahashi H., Nagahama Y. Hormonal induction of all stages of spermatogenesis in vitro in the male Japanese eel (Anguilla japonica) Proc Natl Acad Sci USA.1991;88:5774-5778.Bunk M.J., Dnistrian A.M., Schwartz M.K., Rivlin R.S. Dietary Zn deficiency decreases plasma concentrations of vitamin E. Proc Soc Exp Biol Med. 1989;190:379-384.Smith J.C. The vitamin A-zinc connection: a review. Ann NY Acad Sci. 1980;355:62-75.Momeni H.R., Eskandari N. Effect of vitamin E on sperm parameters and DNA integrity in sodium arsenite-treated rats. Iranian Journal of Reproductive Medicine. 2012;10(3):249-256.Zu K., Ip C. Synergy between selenium and vitamin E in apoptosis induction is associated with activation of distinctive initiator caspases in human prostate cancer cells. Cancer Res. 2003;63(20):6988-95.Bieri J.G. Effect of excessive vitamins C and E on vitamin A status. Am J Clin Nutr. 1973;26(4):382-83.Hogarth C.A., Griswold M.D. The key role of vitamin A in spermatogenesis. J Clin Invest.2010;120:956-962.Камалов А.А., Абоян И.А., Ситдыкова М.Э., Цуканов А.Ю., Теодорович О.В., Медведев В.Л., Комяков Б.К., Журавлев В.Н., Новиков А.И., Еркович А.А., Охоботов Д.А., Карпов В.К., Зубков А.Ю. Применение биологически активного комплекса Андродоз® у пациентов с патоспермией и иммунологическим фактором инфертильности. Результаты мультицентрового клинического исследования. Фарматека. 2014;4 (277):32-44.Дендеберов Е.С., Виноградов И.В. Опыт применения биокомплекса АндроДоз для фертилизации больных с идиопатической патоспермией. Эффективная фармакотерапия. Урология и Нефрология. 2014;4(41):24-26.Жуков О.Б., Уколов В.А., Жуков А.А. Комплексная терапия патоспермии у больных после рентгенэндоваскулярной склеротерапии тестикулярных вен. Андрология и генитальная хирургия. 2012;13(4):70-77