[The role of electron microscopy of ejaculate in the diagnosis of infertility associated with human papillomavirus infection].

INTRODUCTION: The problem of male infertility is multifactorial. However, in recent years, the question of the involvement of viruses, in particular human papillomaviruses (HPV), in the development of this condition has been actively discussed. PURPOSE OF THE STUDY: To study the role of ejaculate electron microscopy in the diagnosis of infertility associated with human papillomavirus infection. MATERIALS AND METHODS: The analysis of the results of electron microscopic examination of the ejaculate in 51 patients aged 22 to 40 years (mean age 32.3 +/- 6.4) with a diagnosis of infertility and pathospermia, combined with human papillomavirus infection (PVI), but with the absence of other risk factors, was carried out. RESULTS: Various variants of pathozoospermia were found in the ejaculate: asthenozoospermia (35.3%), asthenoteratazoospermia (31.4%), oligoasthenoteratazoospermia (19.6%), oligoasthenozoospermia (13.7%). Among the studied HPV types of high oncogenic risk prevailed (16, 18). More often (88.2%), HPV was registered as part of associations with dominance of types 16 and/or 18 and 33, as well as types 18 and 33. In electron microscopy, in 80.3% of cases, HPV was fixed on spermatozoa with localization on the acrosome (76.4%) and in the sperm plasma (52.9%). CONCLUSIONS: PVI, regardless of the type of HPV and the localization of virions on spermatozoa, significantly impairs the progressive motility and morphology of spermatozoa. The electron microscopy method allows not only to detect HPV in the ejaculate, but also to clarify its localization on the spermatozoon and determine those negative changes in the spermatozoon that are caused by the virus.

[Idiopathic infertility and human papillomavirus infection].

INTRODUCTION: Infertility is the complex and urgent problem in reproductology. Now HPV involvement in male infertility is considered proven. OBJECTIVES: of the study: To study the etiological structure of human papillomavirus infection (HPV) in ejaculate in men with infertility, as well as to assess the effect of HPV on the parameters of sperm (motility, quantity, morphology). MATERIALS AND METHODS: The analysis of the results of the examination of 71 patients aged 22 to 44 years with a diagnosis of infertility, combined with PVI, with the absence of other risk factors. The assessment of the fertilizing ability of the ejaculate was carried out in accordance with the data and parameters recommended by the WHO (2010) in the clinical diagnostic laboratory. To identify the type of virus used amplification method of DNA - diagnostics (polymerase chain reaction - PCR). The material for the study was ejaculate. RESULTS: The analysis of the ejaculate: asthenozoospermia was detected in 56% cases, asthenoteratozoospermia - 21%, oligoasthenoterozoospermia - 16%, oligoastenozoospermia - 6%. The most frequent HPV types were 16 (60,7%), 18 (54,9%), 33 (49,3%). The most frequent HPV types combinations were 16 with 18 (33,8%), 16 with 33 (35,2%), 18 with 33 (28,2%). The number of virus types has a statistically significant weak correlation with sperm motility (r=-0.267; p=0.0244). Combinations of types 6 and 11, 11 and 16, 16 and 33, 31 and 33 of HPV types more often than others worsened several sperm parameters rather than one. The combination of 6 and 11 HPV types significantly decreases progressive (6.20+/-4.18% and 10.52+/-5.66, p=0.026) and total (11.10+/-5.95% and 17.90+/-6.92%, p=0.0056) motility compared with other combinations of HPV types. The combination of 31 and 33 HPV types was characterized by a large decrease in the total sperm count (12.78 +/- 8.81 million and 21.82+/-9.92 million, p=0.011) and the count of sperm in 1 ml (29.11+/-21.54 million and 53, 35+/-22.13 ppm, p=0.0052) compared with other combinations of HPV types. CONCLUSIONS: According to the results of the study, patients with idiomatic infertility, combined with PVI, have different variants of pathozoospermia.

[The efficacy of recombinant interferon -2b in the treat ment of male infertility caused by human papilloma- virus].

INTRODUCTION: The involvement of human papillomavirus (HPV) in male infertility is becoming increasingly evident. There are no approved treatment for male infertility associated with human papillomavirus infection (HPV). RESEARCH OBJECTIVE: To study the effectiveness of interferon therapy (recombinant interferon -2b with an antioxidant complex of vitamins E and C) in the treatment of male infertility associated with HPV MATERIALS AND METHODS: An analysis of the results of a survey of 103 patients aged 28 to 46 years with a diagnosis of infertility associated with HPV was carried out. Ejaculate was assessed in accordance with the WHO recommendations (2010); the amplification method of DNA diagnostics, polymerase chain reaction (PCR), was used to identify the type of virus. The material for the study was ejaculate. Depending on the therapy, the patients were divided into two groups: the 1st control group (n=54) - were under observation. Group 2 (n=49) - received treatment with recombinant interferon -2b with an antioxidant complex of vitamins E and C (Viferon), (rectal suppositories), which was prescribed at a dosage of 3,000,000 IU per rectum 2 times a day with an interval of 12 hours for 20 days. The observation period is 1 year. The end point of the study was the onset of pregnancy. RESULTS: When comparing the characteristics of the groups obtained, no statistically significant difference was found. Almost all of the studied patients had various types of pathospermia. When identifying the virus, 6, 16, 18, 31, 33 types of HPV were most often detected in the ejaculate. The most common disorder in the studied groups is asthenozoospermia. The association of several types of virus had a statistically significant weak inverse correlation with morphological changes in the ejaculate, in comparison with the ejaculate where one type of virus was detected (r=0.257, p=0.0853). The more types of the virus were registered in the ejaculate in associative relationships, the more the expression of morphological changes in the ejaculate. CONCLUSIONS: Male infertility may be due to the presence of HPV in the ejaculate. The more types of HPV present in the ejaculate, the lower the total sperm motility. For the treatment of infertility caused by PVI, it is recommended to use recombinant interferon -2b with an antioxidant complex of vitamins E and C.

[A comparative analysis of the effectiveness of serenoa repens and serenoa repens in combination with urtica dioiccus for lower urinary symptoms suggestive of benign prostatic hyperplasia associated with chronic inflammation in prostate tissue].

INTRODUCTION: Benign prostatic hyperplasia (BPH) is the most common proliferative disease of the prostate gland in the elderly. MATERIALS AND METHODS: The results of an open, randomized comparative study of the effectiveness of Serenoa repens in the combination with Urtica dioiccus (Prostagut-forte) are presented in the article. All patients were divided into two groups, depending on the therapy. In group I (n=51) Serenoa repens in combination with Urtica dioiccus 160/120 mg twice daily for 3 months was given, while in Group II (n=51) patients were prescribed to Serenoa repens 320 mg once a day, for 3 months. RESULTS: According to the results, herbal preparations, like Serenoa repens, are effective for the medical treatment of BPH, which is confirmed by a decrease in LUTS severity, an increase in Qmax, a decrease in postvoid residual urine volume and an intensity of the inflammatory process in the prostatic tissue. However, in patients with BPH associated with chronic inflammation, it is preferable to use Serenoa repens in combination with Urtica dioiccus.