ﺑﺮرﺳﯽ ﻣﻮرﻓﻮﻟﻮژي اﺳﭙﺮم در ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ وارﯾﮑﻮﺳﻞ ﺑﺎ درﺟﻪ ﻫﺎي ﻣﺨﺘﻠﻒ ﺑﺎ اﺳﺘﻔﺎده از روش اﺳﺘﺮﯾﻮﻟﻮژي

Evaluation of sperm morphology in patients with different varicocele grades by stereology method

وارﯾﮑﻮﺳﻞ از ﺷﺎﯾﻊ ﺗﺮﯾﻦ ﻋﻠﻞ ﻧﺎﺑﺎروري ﻣﺮدان ﻣﯽ ﺑﺎﺷﺪ ﮐﻪ در آن ﻋﻤﻠﮑﺮد ﺑﯿﻀﻪ و ﻓﺮاﯾﻨﺪ اﺳﭙﺮم ﺳﺎزي دﭼﺎر آﺳﯿﺐ ﻣﯽ ﮔﺮدد. در اﯾﻦ ﻣﻄﺎﻟﻌﻪ، ﭘﺎراﻣﺘﺮﻫﺎي اﺳﭙﺮم و ﻣﻮرﻓﻮﻟﻮژي اﺳﭙﺮم ﺑﯿﻦ ﺑﯿﻤﺎران ﻣﺒﺘﻼ وارﯾﮑﻮﺳﻞ در درﺟﺎت ﻣﺨﺘﻠﻒ ﻣﻘﺎﯾﺴﻪ ﺷﺪ. اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮ روي 55 ﺑﯿﻤﺎر ﻣﺒﺘﻼ ﺑﻪ وارﯾﮑﻮﺳﻞ ﺑﺎ درﺟﻪ1،2و3 ﻫﻤﭽﻨﯿﻦ 32 ﻓﺮد ﺑﺎرور )ﮐﺎﻧﺪﯾﺪﻫﺎي اﻫﺪاي ﺟﻨﯿﻦ ﯾﺎ ﺗﻌﯿﯿﻦ ﺟﻨﺴﯿﺖ( ﺑﻪ ﻋﻨﻮان ﮔﺮوه ﮐﻨﺘﺮل اﻧﺠﺎم ﺷﺪ. ﭘﺲ از ﺟﻤﻊ آوري ﻣﺎﯾﻊ ﻣﻨﯽ از ﺑﯿﻤﺎران، ﭘﺎراﻣﺘﺮﻫﺎي اﺳﭙﺮم )ﺗﻌﺪاد، ﺗﺤﺮك و ﻣﻮرﻓﻮﻟﻮژي اﺳﭙﺮم( و ﻣﯿﺰان زﻧﺪه ﻣﺎﻧﺪن اﺳﭙﺮم در ﻧﻤﻮﻧﻪ ﻫﺎي ﻣﺨﺘﻠﻒ ﻣﺎﯾﻊ ﻣﻨﯽ ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺖ. ﻫﻤﭽﻨﯿﻦ، ﺑﺎ روش اﺳﺘﺮﯾﻮﻟﻮژي ﻣﻮرﻓﻮﻟﻮژي اﺳﭙﺮم )ﺣﺠﻢ ﺳﺮ، ﮔﺮدن و ﻃﻮل دم( در ﮔﺮوه ﻫﺎي ﻣﺨﺘﻠﻒ ﻣﻮرد ارزﯾﺎﺑﯽ ﻗﺮار ﮔﺮﻓﺖ. ﭘﺎراﻣﺘﺮﻫﺎي اﺳﭙﺮﻣﯽ ﺷﺎﻣﻞ ﺗﻌﺪاد، ﺗﺤﺮك و ﻣﻮرﻓﻮﻟﻮژي اﺳﭙﺮم ﺑﻪ ﻃﻮر ﻣﻌﻨﯽ داري در ﺑﯿﻤﺎران وارﯾﮑﻮﺳﻞ ﮐﯿﻔﯿﺖ ﭘﺎﯾﯿﻦ ﺗﺮي ﻧﺴﺒﺖ ﺑﻪ اﻓﺮاد ﺑﺎرورداﺷﺘﻨﺪ و درﺻﺪ ﺣﺮﮐﺖ اﺳﭙﺮم، زﻧﺪه ﻣﺎﻧﯽ، ﺗﻌﺪاد اﺳﭙﺮم در ﮔﺮوه وارﯾﮑﻮﺳﻞ درﺟﻪ ﺳﻪ ﺑﻪ ﻃﻮر ﻣﻌﻨﺎداري ﮐﻤﺘﺮ از ﺳﺎﯾﺮ ﮔﺮوه ﻫﺎ ﺑﻮد. اﺧﺘﻼف ﻣﻌﻨﺎداري در ﻣﻘﺎﯾﺴﻪ ﺣﺠﻢ ﺳﺮ اﺳﭙﺮم و ﻃﻮل ﻗﻄﻌﻪ ﻣﯿﺎﻧﯽ ﺑﯿﻦ ﮔﺮوه ﻫﺎي وارﯾﮑﻮﺳﻞ درﺟﻪ 1 ،2و 3 وﺟﻮد ﻧﺪاﺷﺖ، وﻟﯽ اﻧﺪازه ﻃﻮل دم در ﮔﺮوه وارﯾﮑﻮﺳﻞ درﺟﻪ ﺳﻪ ﺑﻪ ﻃﻮر ﻣﻌﻨﺎداري از ﺳﺎﯾﺮ ﮔﺮوه ﻫﺎي ﻣﻮرد ﻣﻄﺎﻟﻌﻪ ﮐﻤﺘﺮ ﺑﻮد. وارﯾﮑﻮﺳﻞ، در ﺗﻤﺎم درﺟﻪ ﻫﺎي آن، از ﻧﻈﺮ ﻣﻮرﻓﻮﻟﻮژﯾﮑﯽ و ﺗﻌﺪاد اﺳﭙﺮم ﻫﺎ ﺑﺎ ﮐﺎﻫﺶ ﻫﻤﺮاه اﺳﺖ. ﻫﻤﭽﻨﯿﻦ، ﻣﻄﺎﻟﻌﻪ ﻣﺎ ﻧﺸﺎن ﻣﯽ دﻫﺪ ﮐﻪ درﺟﻪ وارﯾﮑﻮﺳﻞ ﺑﺮ ﺗﺤﺮك، ﻣﻮرﻓﻮﻟﻮژي و زﻧﺪه ﻣﺎﻧﺪن اﺳﭙﺮم و اﻧﺪازه ﻃﻮل دم اﺳﭙﺮم ﺗﺄﺛﯿﺮ ﻣﯽ ﮔﺬارد.

Varicocele is one of the most common causes of male infertility in which testicular function and sperm production process are impaired. In this study, sperm parameters and sperm morphology were compared between patients with different varicocele grades. This study was performed on 55 patients with grade 1, 2 and 3 varicocele as well as 32 fertile individuals (candidates for embryo donation or sex determination) as a control group. After collecting semen from patients, sperm parameters (number, motility and morphology of sperm) and sperm viability in different semen samples were examined. Also, sperm morphology (head, neck and tail length) was evaluated in different groups by stereology technique. Sperm parameters including sperm count, motility and morphology were significantly lower in varicocele patients in comparison to control group and also sperm motility, survival, sperm count in the third degree varicocele group were significantly lower than other groups. There was no significant difference in sperm head volume and midline length between grade 1, 2 and 3 varicocele groups, but tail length in grade 3 varicocele group was significantly shorter than the other groups. Varicocele, in all its degrees, is associated with a decrease in morphology and sperm count. Also, our study shows that the degree of varicocele affects sperm motility, morphology and viability, and sperm tail length.