Epididymal and accessory sex gland function and semen quality

Detta är en avhandling från Medicinsk Informationsteknik, Malmö

Sammanfattning: Infertility, defined as the inability to conceive after one year of unprotected regular intercourse, affects up to 15% of all couples of reproductive age. The infertility can originate from female, male or both partners. In up to 50% of the affected couples, a male factor is the cause of infertility. Semen analysis is the cornerstone of male infertility assessment and an abnormal result often triggers a referral for a specialist opinion. It has been hypothesized that epididymal and accessory sex gland dysfunction are involved in pathophysiologies affecting male fertility. However, our knowledge within this area is still very limited. The aims of this study were, therefore, 1) To examine the association between the markers of epididymal (neutral ?-glucosidase [NAG]), prostatic (prostate-specific antigen [PSA] and zinc), and seminal vesicles (fructose) function and the motility of spermatozoa; 2) To examine the association between the function of these organs and semen visco-elasticity, the length of sexual abstinence and the impact of these two factors on sperm motility in men under infertility assessment; 3) To assess the association between 5?-reductase type 2 gene (SD2R5A) polymorphisms and semen parameters in men from the general population; 4) Finally, to explore the association between exposure to persistent organohalogen pollutants (POPs) and epididymal and accessory sex gland function in a group of Swedish fishermen , fertile men from Greenland, Warsaw, (Poland) and Kharkiv, (Ukraine). Our study demonstrated a positive association between the epididymal marker NAG as well as the prostatic marker PSA and the motility of spermatozoa. Hyperfunction of seminal vesicles was associated with high visco-elasticity and lower proportion of motile spermatozoa. Compared to men delivering semen samples after 4?5 days, those having 2?3 days abstinence presented with lower NAG, zinc and proportion of motile sperm whereas those who delivered samples after 6?7 days exhibited higher percentage spermatozoa with tail defects and lower percentage motile sperm. SD2R5A polymorphism analysis showed, that subjects with the AT genotype had significantly higher sperm concentration compared to those having the AA genotype. Men bearing the V allele showed higher proportion of motile sperms compared to those being homozygotes for the L allele. We demonstrated a negative impact of POPs on the epididymal function, which might help us to understand the previously reported negative impact of POPs on sperm motility. Epididymis and accessory sex glands are potential targets for infertility assessment, therapy and for male contraception. Therefore, an insight into the function of these organs may help us to understand the mechanism behind male infertility and may lead to the development of new therapeutic and contraceptive modalities.

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