Clinical and Laboratory Characteristics of Primary and Secondary Infertility in Married Couples
Keywords:
infertility, primary infertility, secondary infertility, reproductive health, clinical and laboratory diagnostics, hormonal disorders, hyperprolactinemia, ovarian reserve, FSH, LH, spermogram, spermatogenesis disorders, oligozoospermia, asthenozoospermia, male infertility, female infertility, risk factors, reproductive medicineAbstract
Infertility is a pressing issue in modern medicine and has a significant impact on demographic indicators and quality of life. According to the World Health Organization, approximately 15% of couples experience difficulties conceiving, highlighting the importance of timely diagnosis and treatment of this condition [1,2]. The aim of this study was to investigate the clinical and laboratory characteristics of primary and secondary infertility in married couples.
The study included 50 married couples. All patients underwent a comprehensive clinical and laboratory examination, including hormonal testing, sperm analysis, and clinical assessment. Primary infertility was detected in 40% of the subjects, secondary infertility in 40%, and the control group comprised 20%. The study results showed that hormonal imbalances, including hyperprolactinemia, elevated FSH and LH levels, and decreased ovarian reserve, play a leading role in women, which is consistent with current research data [3,4]. In men, spermatogenesis disorders were most frequently detected, including oligozoospermia and asthenozoospermia, accompanied by a decrease in sperm concentration, which is also confirmed by literary data [2,8].
Additionally, it was established that the development of infertility is influenced by concomitant factors, including inflammatory diseases of the reproductive system, as well as the lifestyle of patients (bad habits, stressful working conditions), which is consistent with the results of other studies [6,16]. Thus, the obtained data confirm the multifactorial nature of infertility and the need for a comprehensive approach to its diagnosis [3,4]. The use of clinical and laboratory research methods allows for increased accuracy in identifying the causes of infertility and facilitates the selection of optimal treatment strategies.
References
1. World Health Organization. Infertility definitions and terminology. Geneva: WHO; 2020.
2. World Health Organization. Infertility prevalence estimates, 1990–2021. Geneva: WHO; 2023.
3. Agarwal A., Baskaran S., Parekh N., et al. Male infertility. The Lancet. 2021;397(10271):319–333. https://doi.org/10.1016/S0140-6736(20)32667-2
4. Mascarenhas MN, Flaxman SR, Boerma T., Vanderpoel S., Stevens GA National, regional, and global trends in infertility. PLoS Medicine. 2012;9(12):e1001356. https://doi.org/10.1371/journal.pmed.1001356
5. Vander Borght M., Wyns C. Fertility and infertility: Definition and epidemiology. Nature Reviews Endocrinology. 2018;14(12):722–734. https://doi.org/10.1038/nrendo.2018.90
6. Practice Committee of the American Society for Reproductive Medicine. Diagnostic evaluation of infertility. Fertility and Sterility. 2021;116(5):1255–1265. https://doi.org/10.1016/j.fertnstert.2021.08.003
7. Inhorn MC, Patrizio P. Infertility around the globe: New thinking on gender, reproductive technologies and global movements. Human Reproduction Update. 2015;21(4):411–426. https://doi.org/10.1093/humupd/dmv016
8. Esteves SC, Sharma RK, Gosálvez J., Agarwal A. A translational medicine assessment of specialized andrology testing. Asian Journal of Andrology. 2012;14(1):128–140. https://doi.org/10.1038/aja.2011.65
9. Broekmans FJ, Kwee J., Hendriks DJ, Mol BW, Lambalk CB A systematic review of tests predicting ovarian reserve. Human Reproduction Update. 2006;12(6):685–718. https://doi.org/10.1093/humupd/dml034
10. Zegers-Hochschild F., Adamson GD, Dyer S., et al. The International Glossary on Infertility and Fertility Care. Human Reproduction. 2017;32(9):1786–1801. https://doi.org/10.1093/humrep/dex234
11. Thoma ME, McLain AC, Louis JF, et al. Prevalence of infertility in the United States. Fertility and Sterility. 2013;99(5):1324–1331. https://doi.org/10.1016/j.fertnstert.2012.09.023
12. Balen AH, Morley LC, Misso M, et al. The management of infertility in women with polycystic ovary syndrome. Human Reproduction Update. 2016;22(6):687–708. https://doi.org/10.1093/humupd/dmw025
13. World Health Organization. WHO Laboratory Manual for the Examination and Processing of Human Semen. 6th ed. Geneva: WHO; 2021.
14. Guzick DS, Overstreet JW, Factor-Litvak P, et al. Sperm morphology, motility, and concentration in fertile and infertile men. New England Journal of Medicine. 2001;345(19):1388–1393. https://doi.org/10.1056/NEJM200111083451904
15. Carlsen E., Giwercman A., Keiding N., Skakkebaek NE Evidence for decreasing sperm quality. BMJ. 1992;305(6854):609–613. https://doi.org/10.1136/bmj.305.6854.609
16. Schmidt L. Social and psychological consequences of infertility. Human Reproduction. 2009;24(4):912–920. https://doi.org/10.1093/humrep/dep036
