Male autoimmune infertility: analysis of results and prediction of efficacy of low-level laser therapy in infrared spectrum

Abstract

INTRODUCTION: Autoimmune infertility is diagnosed in 5–15% of men. Currently applied methods of medical therapy of autoimmune male infertility are not very effective, which requires the development of new ones and creation of predictive algorithms for their efficacy.

The aim of our study was to evaluate the influence of low-level laser therapy (LLLT) in infrared spectrum on MAR-test rate and sperm fertile properties in men with autoimmune infertility, develop ways to predict the efficacy of this therapy.

PATIENTS AND METHODS: 47 men with autoimmune infertility were examined. 31 of them (1^st group) underwent course of LLLT in infrared spectrum (10 procedures), and 16 patients (2^nd group, comparison) had placebo-laser therapy sessions (10 procedures). MAR-test value, main semen parameters and sperm DNA fragmentation were assessed before and after the treatment. For creation of LLLT efficacy algorithm we used discriminate analysis.

RESULTS: In patients of the 1st group we indicated statistically significant decrease of MAR-test by an average of 19% immediately after the course of procedures, and by 33% – within two months after the end of the treatment, at its initial level 60% or lower. LLLT contributed to improvement of the semen fertile properties, pregnancy developed in the natural reproductive cycle in 19% of couples. We developed math model for prediction the efficacy of LLLT in infrared spectrum of autoimmune male infertility.

CONCLUSION: LLLT in infrared spectrum of male autoimmune infertility leads to MAR-test value decrease at its initial level less than 60%; improves sperm fertile properties. It is appropriate to use before LLLT predictive algorithm of its efficacy developed by us.

Keywords

autoimmune male infertility / MAR-test / low-level laser therapy / infrared spectrum

References

[1] Leung AK., Henry MA, Mehta A. Gaps in male infertility health services research. Transl Androl Urol. 2018;7(3):S303–S309. DOI: 10.21037/tau.2018.05.03

[2] Leung A.K., Henry M.A., Mehta A. Gaps in male infertility health services research // Transl Androl Urol. 2018. Vol. 7, No. 3. P. 303–309. DOI: 10.21037/tau.2018.05.03

[3] Lebedev GS, Golubev NA, Shaderkin IA, et al. Male infertility in the Russian Federation: statistical data for 2000–2018. Experimental and Clinical Urology. 2019;(4):4–12 (In Russ.) DOI: 10.29188/2222-8543-2019-11-4-4-12

[4] Лебедев Г.С., Голубев Н.А., Шадеркин И.А., и др. Мужское бесплодие в Российской Федерации: статистические данные за 2000–2018 годы // Экспериментальная и клиническая урология. 2019. № 4. С. 4–12. DOI: 10.29188/2222-8543-2019-11-4-4-12

[5] Chiu WW, Chamley LW. Clinical associations and mechanisms of action of antisperm antibodies. Fertil Steril. 2004;82(3):529–535. DOI: 10.1016/j.fertnstert.2003.09.084

[6] Chiu W.W., Chamley L.W. Clinical associations and mechanisms of action of antisperm antibodies // Fertil Steril. 2004. Vol. 82, No. 3. P. 529–535. DOI: 10.1016/j.fertnstert.2003.09.084

[7] Pochernikov DG, Gerasimov AM, Guseinova SG, Naumov NP. Elevated level of antisperm antibodies as a risk factor for unfavorable pregnancy outcome after use of assisted reproductive technology. Andrology and Genital Surgery. 2019;20(1):69–74. (In Russ.) DOI: 10.17650/2070-9781-2019-20-1-69-74

[8] Почерников Д.Г., Герасимов А.М., Гусейнова С.Г., Наумов Н.П. Повышенное содержание антиспермальных антител как предиктор неблагоприятного исхода беременности после применения вспомогательных репродуктивных технологий // Андрология и генитальная хирургия. 2019. Т. 20, № 1. С. 69–74. DOI: 10.17650/2070-9781-2019-20-1-69-74

[9] Al-Shukri SH, Borovets SY, Fanardjan SV. To the question of spermatozoa mobility evaluation adjusted for MAR-test results. Urologicheskie vedomosti. 2013;3(4):3–5. (In Russ.) DOI: 10.17816/uroved343-5

[10] Аль-Шукри С.Х., Боровец С.Ю., Фанарджян С.В. К вопросу об оценке подвижности сперматозоидов с учетом показателей MAR-теста // Урологические ведомости. 2013. Т. 3, № 4. С. 3–5. DOI: 10.17816/uroved343-5

[11] Vickram AS, Dhama K, Chakraborty S, et al. Role of Antisperm Antibodies in Infertility, Pregnancy, and Potential for Contraceptive and Antifertility Vaccine Designs: Research Progress and Pioneering Vision. Vaccines (Basel). 2019;7(3):116. DOI: 10.3390/vaccines7030116

[12] Vickram A.S., Dhama K., Chakraborty S., et al. Role of Antisperm Antibodies in Infertility, Pregnancy, and Potential for Contraceptive and Antifertility Vaccine Designs: Research Progress and Pioneering Vision // Vaccines (Basel). 2019. Vol. 7, No. 3. P. 116. DOI: 10.3390/vaccines7030116

[13] Barbonetti A, Castellini C, D’Andrea S, et al. Prevalence of anti-sperm antibodies and relationship of degree of sperm auto-immunization to semen parameters and post-coital test outcome: a retrospective analysis of over 10000 men. Hum Reprod. 2019;34(5):834–841. DOI: 10.1093/humrep/dez030

[14] Barbonetti A., Castellini C., D’Andrea S., et al. Prevalence of anti-sperm antibodies and relationship of degree of sperm auto-immunization to semen parameters and post-coital test outcome: a retrospective analysis of over 10000 men // Hum Reprod. 2019. Vol. 34, No. 5. P. 834–841. DOI: 10.1093/humrep/dez030

[15] Bozhedomov VA, Suhih GT. Immunnoe muzhskoe besplodie: uchebnoe posobie. Moscow: E-noto; 2018. 80 p. (In Russ.)

[16] Божедомов В.А., Сухих Г.Т. Иммунное мужское бесплодие: учебное пособие. М.: Е-ното, 2018. 80 с.

[17] Cui D, Han G, Shang Y, et al. Antisperm antibodies in infertile men and their effect on semen parameters: a systematic review and meta-analysis. Clin Chim Acta. 2015;15(444):29–36. DOI: 10.1016/j.cca.2015.01.033

[18] Cui D., Han G., Shang Y., et al. Antisperm antibodies in infertile men and their effect on semen parameters: a systematic review and meta-analysis // Clin Chim Acta. 2015. Vol. 15, No. 444. P. 29–36. DOI: 10.1016/j.cca.2015.01.033

[19] WHO laboratory manual for the examination and processing of human semen. 5th ed. Cambridge: University Press, 2010.

[20] Bozhedomov VA, Nikolaeva MA, Ushakova IV, et al. Functional deficit of sperm and fertility impairment in men with antisperm antibodies. J Reprod Immunol. 2015;112:95–101. DOI: 10.1016/j.jri.2015.08.002

[21] Bozhedomov V.A., Nikolaeva M.A., Ushakova I.V., et al. Functional deficit of sperm and fertility impairment in men with antisperm antibodies // J Reprod Immunol. 2015. Vol. 112. P. 95–101. DOI: 10.1016/j.jri.2015.08.002

[22] Munuce MJ, Berta CL, Pauluzzi F, et al. Relationship between antisperm antibodies, sperm movement, and semen quality. Urol Int. 2000;65(4):200–203. DOI: 10.1159/000064876

[23] Munuce M.J., Berta C.L., Pauluzzi F., et al. Relationship between antisperm antibodies, sperm movement, and semen quality // Urol Int. 2000. Vol. 65, No. 4. P. 200–203. DOI: 10.1159/000064876

[24] Lu JC, Huang YF, Lu NQ. Antisperm immunity and infertility. Expert Rev Clin Immunol. 2008;4(1):113–126. DOI: 10.1586/1744666X.4.1.113

[25] Lu J.C., Huang Y.F., Lu N.Q. Antisperm immunity and infertility // Expert Rev Clin Immunol. 2008. Vol. 4, No. 1. P. 113–126. DOI: 10.1586/1744666X.4.1.113

[26] Shevyrin AA. Modern view on treatment of male infertility. Russian Medical Review. 2018;(12):30–35. (In Russ.)

[27] Шевырин А.А. Современный взгляд на лечение нарушений мужской фертильной функции // РМЖ. Медицинское обозрение. 2018. № 12. С. 30–35.

[28] Potapova MK, Borovets SY, Sokolov AV, et al. Regarding the efficacy of low-level laser therapy in infrared spectrum in male secretory infertility. Urologicheskie vedomosti. 2019;9(4):11–17. (In Russ.) DOI: 10.17816/uroved9411-17

[29] Потапова М.К., Боровец С.Ю., Соколов А.В., и др. К вопросу об эффективности низкоинтенсивной лазерной терапии в инфракрасном спектре при секреторном бесплодии у мужчин // Урологические ведомости. 2019. Т. 9, № 4. C. 11–17. DOI: 10.17816/uroved9411-17

[30] Shheplev PA, editor. Andrologija. Klinicheskie rekomendacii. Moscow: Medpraktika-M; 2012. (In Russ.)

[31] Андрология. Клинические рекомендации / под ред. П.А. Щеплева. М.: Медпрактика-М, 2012.

[32] Mel’nikov VL, Mitrofanova NN, Mel’nikov LV. Autoimmunnye zabolevanija: uchebnoe posobie. Penza: PGU; 2015. 68 p. (In Russ.)

[33] Мельников В.Л., Митрофанова Н.Н., Мельников Л.В. Аутоиммунные заболевания: учебное пособие. Пенза: ПГУ, 2015. 68 с.

[34] Bozhedomov VA, Nikolayeva MA, Ushakova IV, et al. Etiology of autoimmune male infertility. Obstetrics and Gynecology. 2013;(2): 68–76. (In Russ.)

[35] Божедомов В.А., Николаева М.А., Ушакова И.В., и др. Этиология аутоиммунного мужского бесплодия // Акушерство и гинекология. 2013. № 2. С. 68–76.

[36] Mussttaf RA, Jenkins DFL, Jha AN. Assessing the impact of low level laser therapy (LLLT) on biological systems: a review. Int J Radiat Biol. 2019;95(2):120–143. DOI: 10.1080/09553002.2019.1524944

[37] Mussttaf R.A., Jenkins D.F.L., Jha A.N. Assessing the impact of low level laser therapy (LLLT) on biological systems: a review // Int J Radiat Biol. 2019. Vol. 95, No. 2. P. 120–143. DOI: 10.1080/09553002.2019.1524944

[38] Moskvin SV. Jeffektivnost’ lazernoj terapii. Serija “Jeffektivnaja lazernaja terapija”. Vol. 2. Moscow, Tver’: Triada; 2014. (In Russ.)

[39] Москвин С.В. Эффективность лазерной терапии. Серия «Эффективная лазерная терапия». Т. 2. М., Тверь: Триада, 2014.

[40] Al-Shukri SH, Kuzmin IV, Slesarevskaya MN, Sokolov AV. The effect of low-intensity laser radiation on semen parameters in patients with chronic prostatitis. Urologicheskie vedomosti. 2015;5(4):8–12. (In Russ.) DOI: 10.17816/uroved548-12

[41] Аль-Шукри С.Х., Кузьмин И.В., Слесаревская М.Н., Соколов А.В. Влияние низкоинтенсивного лазерного излучения на показатели эякулята у больных хроническим простатитом // Урологические ведомости. 2015. Т. 5, № 4. С. 8–12. DOI: 10.17816/uroved548-12

[42] Moskvin SV, Borovets SJ, Toropov VA. Experimental justification of laser therapy efficiency of men’s infertility. Urologicheskie vedomosti. 2017;7(4):44–53. (In Russ.) DOI: 10.17816/uroved7444-53

[43] Москвин С.В., Боровец С.Ю., Торопов В.А. Экспериментальное обоснование эффективности лазерной терапии мужского бесплодия // Урологические ведомости. 2017. Т. 7, № 4. С. 44–53. DOI: 10.17816/uroved7444-53

[44] Potapova MK, Borovets SY, Slesarevskaya MN, Al-Shukri SK. Our experience of application of low-level laser therapy in red spectrum in male idiopathic secretory infertility. Urology reports (St. Petersburg). 2020;10(3):209–216. (In Russ.) DOI: 10.17816/uroved41756

[45] Потапова М.К., Боровец С.Ю., Слесаревская М.Н., Аль-Шукри С.Х. Наш опыт применения низкоинтенсивной лазерной терапии в красном спектре при идиопатическом секреторном бесплодии у мужчин // Урологические ведомости. 2020. Т. 10, № 3. C. 209–216. DOI: 10.17816/uroved41756

[46] Tadakuma T. Possible application of the laser in immunobiology. Keio J Med. 1993;42(4):180–182. DOI: 10.2302/kjm.42.180

[47] Tadakuma T. Possible application of the laser in immunobiology // Keio J Med. 1993. Vol. 42, No. 4. P. 180–182. DOI: 10.2302/kjm.42.180

[48] Aljaev JG, Glybochko PV, Pushkar’ DJ, editors. Urologija. Rossijskie klinicheskie rekomendacii. Moscow: Medforum: 2017. 544 p. (In Russ.)

[49] Урология. Российские клинические рекомендации / под ред. Ю.Г. Аляева, П.В. Глыбочко, Д.Ю. Пушкаря. М.: Медфорум, 2017. 544 с.

[50] Borovets SY, Egorova VA, Gzgzian AM, Al-Shukri SK. Fragmentation of sperm DNA: clinical significance, reasons, methods of evaluation and correction. Urology reports (St. Petersburg). 2020;10(2):173–180. (In Russ.) DOI: 10.17816/uroved102173-180

[51] Боровец С.Ю., Егорова В.А., Гзгзян А.М., Аль-Шукри С.Х. Фрагментация ДНК сперматозоидов: клиническая значимость, причины, методы оценки и коррекции // Урологические ведомости. 2020. Т. 10, № 2. С. 173–180. DOI: 10.17816/uroved102173-180

[52] Coughlan C, Clarke H, Cutting R, et al. Sperm DNA fragmentation, recurrent implantation failure and recurrent miscarriage. Asian J Androl. 2015;17(4):681–685. DOI: 10.4103/1008-682X.144946

[53] Coughlan C., Clarke H., Cutting R., et al. Sperm DNA fragmentation, recurrent implantation failure and recurrent miscarriage // Asian J Androl. 2015. Vol. 17, No. 4. P. 681–685. DOI: 10.4103/1008-682X.144946

RIGHTS & PERMISSIONS

Eco-Vector