Features of the spermogram in couples with pregnancy loss

Abstract

DOI: 10.52705/2788-6190-2026-03-21
УДК 618.3-058.883-02:611-013.11-076/.078-039

Objective of the study. To evaluate spermogram features in couples with pregnancy loss.
Materials and methods. We conducted a comprehensive study of the spermogram in 72 couples with a history of pregnancy loss (main group). The comparison group consisted of 22 couples who became parents of healthy children during the reporting period without a burdened reproductive history. According to WHO recommendations (2020), the physicochemical characteristics of the ejaculate (volume, color, odor, consistency, liquefaction time, viscosity, pH) were assessed. The complex of studies included clinical, laboratory, and instrumental methods.
Results. Spermogram data in men were also analyzed depending on the number of reproductive losses in the couple: with one spontaneous miscarriage (n=29) and with recurrent pregnancy loss (n=43). In cases of sporadic miscarriage in the couple, pathological deviations in spermogram indicators were recorded in 22 (75.9%) men; in cases of recurrent miscarriage — in 38 (88.4%) men р=0,204. The obtained data indicate that, with the exception of leukocyte count in the ejaculate and sperm motility, the spermogram parameters in the three compared groups did not differ significantly. Comparative analysis of quantitative indicators revealed no statistically significant differences in the ejaculate of male partners of women with sporadic miscarriage and those with recurrent pregnancy loss. Compared to the indicators of men with proven fertility (n=22), a statistically significant increase in leukocyte levels (p=0,010 and p=0,015, respectively) and a decrease in sperm motility, especially progressive motility (p=0,010 and p<0,001, respectively), were diagnosed in the spermograms of men from couples with both sporadic miscarriage and recurrent pregnancy loss.
Assessment of sperm pathology in men depending on the number of gestational losses in the couple showed that asthenozoospermia was more pronounced in the male partners of women with recurrent pregnancy loss.
Decreased sperm motility was diagnosed in 14 (48,3%) men from couples with one spontaneous abortion and 24 (55,8%) men from couples with recurrent miscarriage, but this difference was statistically insignificant, p=0,112. Leukocytospermia was present in the ejaculate of 14 (48,3%) men with sporadic miscarriage in the couple and 19 (44,2%) men from couples with 2 or more gestational losses (p=0,733).
Conclusion. In male partners of women with pregnancy loss, pathological deviations from normal spermogram values were diagnosed in 83.3% of cases. In the ejaculate of men in the main group, a statistically significant decrease in sperm motility (mainly the number of spermatozoa with progressive motility) and an increase in the frequency of leukocytospermia were established; a tendency towards more frequent detection of viscosipathy, teratozoospermia, and sperm agglutination was also noted compared to the indicators of men with successfully realized fatherhood. Among couples experiencing reproductive failures, asthenozoospermia was diagnosed in 52.8% of men, and leukocytospermia in 45.8%. In the comparison group, these rates were 13.6% and 18.2%, respectively.
Pathological abnormalities in spermogram parameters showed no statistically significant differences between men in cases of sporadic miscarriage and those with recurrent pregnancy loss in the couple.