Preliminary Analysis Of Male Factors Of Abortion

BACKGROUND :Abortion because of unknown causes not only seriously damage patients'good health, but also makes significant harm to patients'mentality, and have a fear of pregnancy in the next time. Therefore, investigating its causes and providing valuable treatment programs have important theoretical, clinical, and practical values. At present, several researches for learning about the causes of abortion mainly focused on female factors that are quite related to immune factors, but relatively less studied are male factors. In addition to abortion of unknown causes, the main factors are: genetic, immune, infection, and sperm factors. Research on genetic factors is karyotype abnormalities, research on immune factors are blocking antibody and antisperm antibody, research on infection factors are ureaplasma urealyticum and chlamydia trachomatis, and for sperm factor and its relationship with abortion, the current study involved sperm morphology, sperm DNA, etc., without any unanimous conclusion.OBJECTIVE:There are lots of causes of abortion, many of them are unknown. At present, research studies are mainly focused on the factors of women, but relatively less studied for the factor of men. So in this paper, we mainly study male factor of abortion, study the husbands of abortion patients and normal fertility, by comparing the two groups (abortion group and control group) on the basis of conventional semen parameters, the rate of karyotype abnormalities, rate of Y chromosome microdeletions, the rate of sperm DNA integrity, the positive rate of Ureaplasma urealyticum, positive rate of Chlamydia trachomatis and positive rate of antisperm antibodies differences. Providing a preliminary theoretical basis for unknown abortion and looking for etiological factor for infertility offers rational basis, guides the clinical diagnosis, prevention and treatment of abortion.METHODS:The cases of the study were the patients who came to The Clinical Hospital of Jilin University for abortion from March 2008 to September 2008. Among examining 156 cases, some of their wives had unexplained spontaneous abortion or artificial abortion once to four times. At the same time, it was also collected 78 cases of fertile men as controls. Women of these two groups were found clinically normal; hence excluding female factor abortion, male factors of abortion are mainly studied. semen samples of the subjects were taken and examined using the semen routine analysis, acridine orange fluorescent staining, biochemistry enzymic method, cultivation and euzyme-linked immunosorbent assay, then semen samples of two groups were compared at the conventional semen parameters, the rate of sperm DNA integrity, the positive rate of Ureaplasma urealyticum, Chlamydia trachomatis-positive rate and positive rate of antisperm antibodies differences; peripheral blood samples of the subjects were also taken and examined using karyotype analysis, PCR technology, and two groups were compared at the rates of karyotype abnormalities, Y chromosome microdeletions.RESULTS:1. The basic informationBetween abortion group and the control group, regarding age, smoking history, history of alcohol consumption there were no statistical differences. (P>0.05).2. Conventional semen analysisAbortion group and the control group, at the rate of sperm motility of grade A and grade (A+B), the sperm density, sperm motility rate and density of leucocyte, there were statistical differences. (P<0.05); the semen volume between the two groups, there were no statistical differences. (P>0.05). 3. Analysis of sperm morphologyAbortion group and the control group, at the rate of normal sperm morphology, abnormal sperm morphology and sperm tail abnormalities there were statistical differences. (P<0.05).4. Detection of sperm DNA integrityAbortion group and the control group, at the rate of sperm DNA integrity, had significant statistical differences. (P<0.05)..5. Karyotype analysisThe abortion group and the control group, at the rate of abnormal karyotype, were statistically different. (P<0.01). Of 28 cases of abortion patients, husbands of 7 cases were found with abnormal karyotype. Among them, 2 cases with balanced translocation, 5 cases with chromosome karyotype polymorphism. These 5 cases included 1 case of the extended secondary constriction, 2 cases having pericentric inversion of chromosome 9, 1 case with D, G group satellite mutation, and 1 case with large Y chromosome.6. Detection of Y chromosome microdeletionsOne case from Abortion Group had Y chromosome microdeletions, missing site was sY255 (located in AZFc). However, statistical analysis of the control group and abortion group, it was found that the rate of Y chromosome microdeletions made no significant differences, (P>0.05).7. Ureaplasma urealyticum, Chlamydia trachomatis detectionOf 43 cases of abortion group, UU (+) found in 10 cases, while compared with the control group, two groups had some statistically difference. (P<0.05).Of 43 cases of abortion group, CT (+) found in 12 cases, while compared with the control group, two groups had some statistically difference. (P<0.05).Of 43 cases of abortion group, 8 cases were found with both UU (+) and CT (+), while compared with the control group, two groups had some statistically difference. (P<0.05).8. Detection of anti-sperm antibodiesOf 43 cases of abortion group, anti-sperm antibodies (AsAb) (+) found in 11 cases, while compared with the control group, there was statistically significant difference between the two groups.(P<0.05).CONCLUSIONS:1. The abortion group and the control group, at the rate of sperm motility of grade A and grade (A+B), the sperm density, and sperm motility rate, density of leukocyte, normal sperm morphology, abnormal sperm morphology and sperm tail abnormalities, there were statistically differences. So sperm motility parameters, sperm morphology dynamic parameters, that is, the quality of semen could have relationships with abortion.2. The abortion group and the control group, at the rate of sperm DNA integrity had significant statistical differences. So, sperm DNA damage maybe lead to abortion.3. The abortion group and the control group, at the rate of abnormal karyotype had statistically differences. So chromosomal abnormalities may lead to abortion, and have some association with chromosome polymorphism.4. Between the abortion group and the control group, regarding the rate of Y chromosome microdeletions there was no significant differences; So Y chromosome microdeletions may have no association with abortion.5. The rate of UU (+), CT (+), UU (+) and CT (+) were statistically different between the abortion group and the control group. So, male UU, CT infection may cause abortion.6. The rate of AsAb positive was statistically different between the abortion group and the control group. Hence, there is a relationship between abortion and AsAb positive male patients.