The expression of paternal genes is activated at the blastocyst stage and contributes to the further development of the embryo, the formation of the trophoblast and placenta. Defects in the paternal genome can negatively affect the stages of embryogenesis and cause both sporadic and reccurrent reproductive losses (RRLs).

OBJECTIVE

Is to determine the role of the male factor in the implementation of early RRLs.

MATERIALS AND METHODS

A retrospective observational non-combined case-control study was conducted, in which the main group consisted of married couples (n1=212) with a history of early gestational losses, and the control group (n2=100) with a successful completion of pregnancy. The survey of men included questionnaires, diagnosis of genital infections, examination of ejaculate and determination of the sperm DNA fragmentation (SDF) index with logistic regression and ROC analysis.

RESULTS

The significant risk male factors for early RRLs in married couples are chronic diseases of the genitourinary system (chronic prostatitis), obesity, as well as nicotine addiction (using more than a pack of cigarettes per day). Prognostic significant criteria for recurrent miscarriage in married couples are SDF index >21.6% (p=0.005; AUC 0.742; 95% CI 0.56—0.87), the number of sperm with progressive movement ≤26% (p<0.001; AUC 0.847; 95% CI 0.73—0.93), body mass index >28 kg/m2 (p<0.001; AUC 0.819; 95% CI 0.65—0.93).

CONCLUSIONS

The represented data indicate a significant role of the male factor in the realization of early RRLs. With their timely elimination, it is possible to increase the effectiveness of pre-conception care and the chances for successful termination of pregnancy.