Pathogenetic significance of the male factor in an uncompleted pregnancy

Abstract

Introduction. When pregnancy failure occurs, not only the woman should be examined, but also her partner. Purpose of the study — to evaluate the significance of spermogram values in the partners of patients with an uncompleted pregnancy. Materials and methods. A retrospective comparative cohort study was conducted. A total of 197 married couples were ncluded in the study. Group 1 consisted of 71 couples with a history of miscarriag. Chromosomal abnormalities (CA) were detected during embryo cytogenetic examination in 45 cases; these patients were included in subgroup 1a; the rest constituted subgroup 1b. The control group (group 2) consisted of 126 couples without a history of pregnancy loss. A detailed anamnesis and general clinical examinations were performed in all the couples. Spouses of the patients underwent spermogram analysis. Results. The proportion of men who abused alcohol was higher in group 1 than in group 2 — 40.8% vs. 19% (p<0.01). In subgroup 1b chronic diseases were noted in 61.5% of men, in group 2 — only 28.6% (p<0.001). Differences in the number of men with normal spermogram were found between group 2 and subgroup 1b, 65.1% and 35.3%, respectively (p=0.036). In group 1, 45% of men had teratozospermia (43.5% in subgroup 1a, 47.1 in subgroup 1b) and in group 2, only 16.3% (p=0.004). Discussion. In most cases, the leading etiological factor in pregnancy failure is a chromosomal abnormality n the embryo (fetus). The role of the "male" factor is increasing in the genesis of pregnancy failure. Examination of thspouse should be an integral component of pre-conceptional preparation. Conclusion. Spousal alcohol abusrisk factor for CA in the embryo and for pregnancy failure. The presence of chronic diseases in the spouse is also a risk factor for pregnancy failure. Among the spermogram parameters, the number of spermatozoa with normal morphology is the most significant in assessing the ririsk of pregnancy failure in a married couple, teratozoospermia significantly increases the risk of non-pregnancy.