A Preliminary Study On The Relationship Between Sperm Reactive Oxygen Species,Mitochondrial Membrane Potential And Seminal Fluid Quality In Infertile Varicocele Male

ObjectiveExplore the effect of varicocele（VC）on sperm reactive oxygen species（ROS）and mitochondrial membrane potential（MMP）in infertile men by comparing semen parameters between healthy married men and infertile men with different degrees of varicocele,and analyze the correlation between sperm ROS,sperm MMP,sperm DNA fragment index（DFI）and routine semen parameters.Besides,explore the possible mechanism of the effect of varicocele on semen quality combined detection of various indexes for in vitro diagnostic efficacy,and explore the indication of early intervention in order to provide help for the diagnosis and treatment of infertile patients with varicocele.MethodsThrough a retrospective analysis of semen samples of infertile men and 40 healthy married fertile persons who came to the hospital for physical examination in Subei people’s Hospital of Jiangsu Province from December 2019 to December 2021,a total of 189 cases were included according to the inclusion and exclusion criteria.According to the degree of varicocele,189 men were divided into group A（healthy people without varicocele）,group B（infertile men without varicocele）,group C（infertile men with first degree varicocele）,group D（infertile men with second degree varicocele）and group E（infertile men with third degree varicocele）.Semen samples of all case were examined by semen routine parameters,sperm ROS,sperm MMP and sperm DFI.All results were analyzed by SPSS26.0 statistical software,the difference among groups was analyzed by single factor analysis of variance,and the correlation among groups was analyzed by Person test.Results1.There was no significant difference in age,body mass index（BMI）,days of abstinence and semen volume among groups A,B,C,D and E.2.Compared with group A,sperm concentration,sperm motility,sperm normal shape rate,sperm forward motility rate and MMP decreased significantly in group B,C,D and E,while sperm ROS and DFI increased significantly in group B,C,D and E.3.There was no significant difference in sperm concentration,sperm motility,sperm normal shape rate,sperm ROS,MMP and DFI among group B,C and D（P>0.05）.4.Compared with group B,there was no significant difference in sperm motility,sperm forward motility and sperm MMP,but sperm ROS and sperm DFI increased significantly in E group（P<0.05）.5.Compared with group C,there was no significant difference in sperm motility,sperm ROS and DFI between group E and group C.Sperm concentration,sperm normal shape rate and MMP were significantly decreased（P<0.05）.6.Compared with group D,there was no significant difference in sperm motility,ROS,MMP and DFI between group E and group D.The sperm concentration and the rate of normal sperm shape decreased significantly（P<0.05）.7.The degree of varicocele was positively correlated with sperm ROS,while sperm ROS was negatively correlated with sperm concentration,sperm motility,sperm normal shape rate and MMP.Sperm ROS was positively correlated with sperm DFI,but there was no significant correlation between sperm ROS and semen volume.8.MMP in spermatozoa was positively correlated with sperm motility and normal sperm shape,while MMP in spermatozoa was negatively correlated with sperm ROS and DFI.There was no significant correlation between sperm MMP and semen volume.9.The area under the ROC curve of the change of ROS to MMP was 0.715,and the corresponding threshold was 20.61 when the Jordan index reached the maximum.10.The area under the ROC curve of sperm motility diagnosed by MMP change was 0.751（P<0.05）.After calculation,the threshold value of 55.11 for forward sperm motility diagnosis ROC curve was 0.763（P<0.05）,and the threshold value was 44.82 at the maximum of Yoden index.Conclusion1.The results of ROS,MMP,DFI and routine semen analysis in infertile patients with varicocele were different from those in married men without varicocele.2.With the aggravation of the degree of varicocele,sperm ROS and DFI increased,sperm MMP decreased,semen routine parameters were abnormal,and semen quality decreased.3.Sperm ROS and MMP are correlated with sperm motility and normal shape rate.Sperm ROS and MMP may be rapid,economical and reliable markers of semen quality for semen quality evaluation.The evaluation of these parameters may provide valuable information for the infertility treatment strategies.