Personified correction of micronutrient deficiency as a therapeutic tactic for improving the quality of ejaculate in idiopathic infertility

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Abstract


Introduction. Marital infertility is one of the key medical problems. Almost 50% of infertility in marriage is caused by male infertility. The proportion of idiopathic male infertility is 30–40%.

Material and methods. 157 patients with idiopathic infertility were randomized into 2 groups. The main group (MG) (n = 82): conducted a correction of the level of micronutrients in case of their deficiency by the appointment of monocomponent drugs in the maximum permitted daily doses. The control group (n = 75) (empirical therapy with complex drugs) was randomized to subgroup 1 (CG1) (n = 38): complex preparations with L-carnitine were used; and subgroup 2 (CG2) (n = 37): complex multivitamin preparations without L-carnitine were used. To identify micronutrient deficiencies, 93 healthy volunteers who realized a fertile function were examined (their partners were in the third trimester of pregnancy).

Results. Deficiencies of micronutrients were determined: selenium, zinc, vitamins C and E. Correction was carried out for three months with monocomponent preparations. In the exhaust gas, there was a positive dynamics in all parameters of the spermogram. In the control subgroups the ejaculate volume, concentration, total sperm count did not change, an increase in the general and progressive motility was revealed. The proportion of normal spermatozoa increased in MG, CG1 and CG2 groups by 61.9%, 28.6% (in comparison with MG p < 0.01) and 20.0% (in comparison with MG p < 0.001), respectively. Total mobility increased – by 44.5%, 24.5% (compared to MG p < 0.05), by 12.0% (compared to exhaust gas p < 0.001), respectively. Progressive mobility – by 60.4%, 54.5% (compared with MG p > 0.05), 14.7% (compared with MG p < 0.001), respectively. Pregnancy in MG was 21.9%, in CG1 – 5.2% (p < 0.05) and CG2 – 2.7% (p < 0.05).

Conclusion. Personified correction of micronutrient deficiency in order to improve the quality of ejaculate in idiopathic male infertility was an effective therapeutic tactic. The results obtained suggest that this approach is more pathogenetically justified, which requires further study.


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About the authors

Anton Yu. Tsukanov

Omsk State Medical University of the Ministry of Healthcare of the Russian Federation

Author for correspondence.
Email: autt@mail.ru
ORCID iD: 0000-0002-3497-5856
SPIN-code: 9310-1220
Scopus Author ID: 57194497218

Russian Federation, Omsk

Doctor of Medical Science, Professor, Head of the Department of Surgical Diseases and Urology of Postgraduate Education

Danijar A. Satibaldin

Omsk State Medical University of the Ministry of Healthcare of the Russian Federation

Email: danijar87@mail.ru
ORCID iD: 0000-0002-3978-1778

Russian Federation, Omsk

Assistant of the Department of Surgical Diseases and Urology of Postgraduate Education

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