Clinical Significance of Combined Impairments in Ejaculate Quality Parameters and Their Impact on Male Fertility
Year: 2026
Type: article
Study design: Observational Study
Abstract: Male infertility is a pressing issue in reproductive medicine. Standard semen analysis does not always reflect a man’s true reproductive potential. Therefore, additional assessments of deoxyribonucleic acid (DNA) fragmentation, oxidative stress and antisperm antibodies (ASAs) are carried out as key indicators of sperm quality. Materials and methods. 39 patients were examined before using assisted reproductive technologies (ART). A standard spermogram was performed (World Health Organization, 2021), DNA fragmentation, oxidative stress, and ASAs were determined, followed by analysis of their combinations and association with standard sperm counts. Results. Normozoospermia was found in only 12.8% of patients, while the majority were found to have abnormal semen analysis results. Sperm quality abnormalities were detected in 77.0% of those examined; in a significant proportion of cases, these were of a combined nature. The most common abnormality was an elevated level of oxidative stress (66.7% of patients), which was present in all cases of combined abnormalities. A statistically significant reduction in the proportion of actively motile spermatozoa was observed in patients with qualitative abnormalities (p = 0.011), as well as an association between reduced motility and an increased likelihood of such abnormalities (odds ratio (OR) = 1.10; 95% confidence interval (CI) [1.01–1.20]). ROC (Receiver Operating Characteristic) analysis showed moderate predictive ability of the proportion of actively motile spermatozoa for detecting qualitative changes (Area Under the Curve (AUC) = 0.71) with an optimal threshold of < 9%. Age showed a tendency to be associated with the accumulation of combined abnormalities (OR = 1.11; 95% CI [0.98–1.26]). DNA fragmentation exceeding 30% was detected in 18.0% of patients, while ASAs were found in 25.6% of cases. Conclusions. Evaluating only standard spermogram parameters is insufficient to determine a man’s reproductive potential, while a combination of qualitative abnormalities plays a key role. Incorporating indicators of DNA fragmentation, oxidative stress, and ASAs into routine screening can increase diagnostic accuracy and optimize preparation for ART programs.
Source: Health of Man
Institution: Bogomolets National Medical University
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7204522669