DYNAMICS OF EJACULATE CHANGES IN MEN FROM INFERTILE COUPLES IN 2013–2020 WITH AN EMPHASIS ON THE PERIOD OF COVID-19

Introduction. According to the Russian Society of Urology, the frequency of infertile marriages, one of the causes of which is the male factor, ranges from 8 to 17.2% in various regions of Russia. The genesis of male infertility is multifactorial and one of the possible causes of fertility disorders can currently be COVID-19. Since SARS-CoV-2 enters the body through the angiotensin-converting enzyme 2 receptor, high expression of this enzyme in testicular cells may contribute to impaired spermatogenesis. Aim of the Research. To study changes in the spermiological status of men from infertile couples over the period of 2013–2020 with an emphasis on the COVID-19 pandemic period. Materials and methods. Design — observational, retrospective, cross-sectional study. The analysis of case histories of 1006 men living in Novosibirsk from couples with infertility in marriage was carried out. The samples were divided into 4 groups: 1 (n = 696) — 2013–2017; 2 (n = 68) — 2018; 3 (n = 163) — 2019; 4 (n = 79) — 2020. We have carried out an analysis of spermograms, spermatozoa morphology according to Kruger strict criteria, MAR test. Results are presented as median, 25 and 75 percentiles. Results. In the total sample, a reduced proportion of morphologically normal forms relative to the reference was revealed (median of 2.5% with reference values > 4.0%). Progressive sperm motility decreases from group 1 to group 3 and is stable in groups 3 and 4: 40.0 (25.0–52.0); 37.5 (22.5–53.0); 30.0 (19.4–42.3) and 30.0 (21.5–41.2); p1–3. 1–4 < 0.005. The proportion of morphologically normal spermatozoa decreases from group 1 to 2, then it is stable: 4.0 (2.0–6.0); 2.5 (1.5–3.0); 2.0 (1.5–3.0); 2.0 (1.0–3.0); p1–2, 1–3, 1–4 < 0.005. For the MAR test, a gradual decrease from group 1 to 3 and an increase in group 4 were revealed: 2.0 (0.0–6.0); 0.75 (0.0–2.8); 0.5 (0.0–2.5); 1.5 (0.0–4.0), p2–3 < 0.005. Conclusion. Within the period of 2013–2020, in men from infertile couples, a gradual increase in the incidence of astheno- and teratozoospermia was revealed, while the concentration and number of spermatozoa did not change, the prevalence of the immune form of male infertility increased. Considering the decrease in spermogram indicators for 2013–2020 with minimal indicators in 2020, it can be assumed that COVID-19 is one of the factors affecting fertility, but is not the main one, which requires continued research aimed at clarifying the genesis of male infertility.