The impact of COVID-19 on the male reproductive system.

OBJECTIVE: The relevance of the study is determined by the deepening understanding of the global consequences of the coronavirus pandemic, which affect not only lung health but also a wide range of other body systems. In light of new data on the long-term effects of coronavirus infection, this study is highly significant. The purpose of this study is to investigate the impact of coronavirus infection on the male reproductive system and assess its potential influence on male fertility to refine the mechanisms of damage and provide recommendations for medical care. METHODS: The study utilised a combination of methods, including a meta-analysis of medical organisation databases, analysis of clinical cases, representative sample method, and quantitative survey method. These approaches allowed for a comprehensive and multifaceted view of the problem. RESULTS: The samples of sperm showed a noticeable decrease in progressive motility, sperm concentration, and volume, especially in patients with moderate and severe symptoms of COVID-19, whereas patients with mild symptoms only experienced a decrease in progressive motility and overall sperm motility. The survey identified symptoms of male reproductive system dysfunction after recovering from COVID-19. Predominant symptoms included decreased libido (15%), impotence (13%), and infections of the genital organs (12%). Most surveyed men lacked sufficient awareness of other aspects of male reproductive health, including infections, genetic defects, chronic diseases, and available medical services. CONCLUSIONS: As a result of the study, it was concluded that coronavirus infection can have a negative impact on the male reproductive system. The practical value of this study lies in improving approaches to medical care for men who have recovered from COVID-19 and creating preventive programmes.

Establishment of a Unified Register of Donor Sexual Gametes in the Republic of Kazakhstan.

OBJECTIVE: The purpose of this narrative review paper was to review the state and development of the field of donor gametes in Kazakhstan, compare its legislative and technical capabilities with other countries and identify key steps towards the establishment of a unified register of donor gametes in the Republic. MATERIALS AND METHODS: The narrative review paper conducted an analysis of scientific publications and legal documents to examine the implementation of Assisted Reproductive Technologies (ART), focusing on Donor Sexual Gametes (DSG), globally. It utilized medical publications from 2019 to 2023, legal acts, and recommendations from global health organizations to analyze eligibility criteria, legal regulations, and the social aspects of ART across different regions. RESULTS: In Kazakhstan, ART is regulated by legislation, with DSG procedures governed by age limits, medical screening, and restrictions on the number of children born from donated gametes. Worldwide, practices vary, but there is growing interest in establishing a unified register of reproductive donor material to enhance transparency and accountability. However, legal gaps and ethical considerations must be addressed. CONCLUSION: The study identifies gaps in Kazakhstan's legislation compared to Western countries, emphasizing the necessity for enhanced legal rights for donors and recipients, including options for anonymity. Ethical concerns highlight the importance of confidentiality and data security in accessing the donor registry. Overall, implementing such a register promises to enhance transparency, safety, and accountability in reproductive medicine.

Assisted Reproductive Technologies in the Republic of Kazakhstan: A 6-Year Trend Analysis from Efficacy to Availability.

Background: The first child after in vitro fertilization (IVF) in the country was born in 1996. However, registering and recording data on assisted reproductive technologies (ARTs) in Kazakhstan is not mandatory. The purpose of the current study was to assess the treatment outcomes, availability, regulations, and ART cycles trends between 2011 and 2016. Methods: Cycle-based data were collected from voluntarily participating ART centers and then descriptive analysis was performed. The study included 10470 ART cycles using different ART methods during 2011-2016. The availability rate of ART in the country was calculated by dividing the number of treatment cycles per million of the population. Results: The availability of ART per million inhabitants increased by 53.6%, from 236.9/million in 2011, to 364.0/million in 2016. In IVF cycles, clinical pregnancy rates (PRs) per aspiration remained stable, on average 37.1%. After ICSI, the average PR was 42.5%. In frozen embryo replacement cycles, there was an increase in the PR per transfer from 37.0% in 2011, to 42.5% in 2016, on average 39.2%. Conclusion: Assisted reproductive technologies are developing rapidly in Kazakhstan; therefore, ART monitoring should be improved and become mandatory. Although the data is not yet representative, the most compelling evidence points to low access to ART. Since the use of ART in Central Asian countries is infrequent in comparison to European countries, there is a need to combine IVF data across different nations. This will allow for a deeper assessment of the scientific evidence and reduction of infertility burden through joint efforts.

Quality-of-Life Assessment of Women Undergoing In Vitro Fertilization in Kazakhstan.

Infertility is a problem that affects millions of couples worldwide and has a significant impact on their quality of life. The recently introduced "Fertility Quality of Life Questionnaire (FertiQoL)" quickly became a gold standard for evaluation of the quality of life of patients suffering from infertility. The aim of this study was to determine the quality of life of Kazakhstani women coping with infertility problems by FertiQoL and assess the validity of the questionnaire. This cross-sectional study involved women of reproductive age undergoing an in vitro fertilization (IVF) cycle at a large IVF center in Kazakhstan in the period from 1 September 2020 to 31 September 2021. A total of 453 women out of 500 agreed to participate in the study, and the response rate was 90.6%. The overall Core FertiQoL was 56.95 ± 14.05, and the Treatment FertiQoL was 66.18 ± 11.13 points. Respondents with secondary infertility had statistically significantly higher Emotional (p < 0.001), Mind-body (p = 0.03), Social (p < 0.001), Environment (p = 0.02), and Treatment (p < 0.001) domains of FertiQoL than women with primary infertility. Respondents with a low income had the lowest levels of Total FertiQoL (56.72 ± 11.65). The longer duration of infertility of women undergoing IVF treatment presented the worse scale of Treatment and Total FertiQoL. Cronbach's alpha revealed good internal reliability for all FertiQoL subscales on the Kazakhstan women's questionnaire and averaged 0.8, which is an indicator of a high degree of reliability. The Total FertiQoL of Kazakhstan women undergoing IVF treatment was 59.6 ± 11.5, which is considerably lower than European countries. We identified statistically significant differences across medical and demographic groups. As this questionnaire had validity in Kazakhstan survey it possibly be used for both medical counseling and future investigation in our country.

Vitamin D deficiency in Kazakhstan: Cross-Sectional study.

Vitamin D deficiency (VDD) is one of the serious and highly debatable public health problems affecting at least one billion of world population. This study objected to evaluate Vitamin D status in adult population of both sexes residing in different geographical areas of Kazakhstan and to elucidate the possible contributing factors related to VDD. This cross-sectional study covered 6 regions of Kazakhstan and applied the systematic random sampling to recruit 1347 healthy adults (of whom 819 were females) with mean age 44 ±â€¯14 years. The concentration of 25-hydroxy vitamin D (25-OHD) was measured from May 2018 to August 2018 with Architect 25OH Vitamin D assay (Abbott Ireland Diagnostics Division Lisnamuck, Longford Co. Longford Ireland). Vitamin D deficiency was defined as 25-OHD values not exceeding 20 ng/mL as a reference threshold in healthy population. The median serum 25(OH)D concentrations in all studied regions of Kazakhstan were below the reference threshold (20 ng/mL). The lowest range of vitamin D (<10 ng/mL) was observed more commonly in females (34.6 % - 283) as compared to males (16.7 % - 88) and was significantly higher in Asians (33.2 % - 352) in contrast with Caucasians (6.7 % - 19) (χ2 = 177,939; D.f. = 3; p-value=<0,001). The proportion of severe VDD was higher in individuals with low body mass index (31.1 % - 188) vs. individuals with high body mass index (18.7 % - 50). In this study individuals aged 60 years and older had the most favorable situation with 25-OHD concentrations since these were normal in 14.4 % of observations (χ2 = 26,589; D.f. = 6; p-value=<0001). Studying the prevalence of VDD is an important public health task. Further research is needed to understand the epidemiology of VDD in more details to tailor intervention programs.