Introduction. Infertility in married couples is one of the urgent and socially significant problems. However, obstruction of the seminal tract is rarely discussed as a cause of reproductive dysfunction, which is characterized by impaired patency of the male genital tract.
The purpose of the study was performed in an attempt to determine how partial seminal tract obstruction affects the reproductive status of patients.
Materials and methods. The study included 128 patients with partial seminal tract obstruction with oligozoospermia without other causes of spermiologic abnormalities, normal levels of sex hormones, and testicular size greater than 10 cm3. Biochemical analysis of ejaculate, MAR-test, sperm DNA fragmentation analysis by TUNEL method, ultrasound examination of scrotal organs, prostatovesicular complex and kidneys were performed. Fisher's exact test was performed to identify potential predictors of the leading reproductive syndrome among patients with obstructive changes in the seminal tracts. In univariate analysis, variables were selected and then used for logistic regression analysis.
Results. Sperm DNA fragmentation index of less than 15% was the only potential predictor of long-term couple pregnancy absence in partial seminal tract obstruction in men, couples with this index were more likely to have problems such as habitual couple pregnancy failure and assisted reproductive technology procedure failure. Multivariate analysis showed that the simultaneous presence of distal and proximal obstruction were significant prognostic factors for habitual non-pregnancy.
Conclusion. Sperm degradation and DNA damage during prolonged presence in obturated and retention-altered segments of the seminal tract in the presence of distal and proximal obstruction can lead to an increased risk of pregnancy failure and failure of assisted reproductive technology.
