Thyroid disorders and pathospermia in the ART clinic patients.

OBJECTIVE: Over the past decade, a decrease in the semen quality in men of reproductive age, along with an increase in the incidence of thyroid diseases among young patients have been clearly noticed. The study was designed to determine various forms of pathospermia in the ART clinic patients with thyroid disorders. MATERIALS AND METHODS: 168 men of reproductive age in infertile marriage were examined. Men with male infertility factor associated with erectile dysfunction and normospermia (9 patients, 5.3%) were excluded. The study included 159 men and the patients were divided into three groups: the 1st study group consisted of men with non-obstructive azoospermia - 11 men (6.9%); the 2nd study group included men with other forms of pathospermia - 38 men (23.9%) and the control group consisted of men in infertile marriage with normospermia - 110 men (69.2%). All patients had anthropometric measurements, laboratory tests, thyroid and testicular ultrasonography. Spermogram was analyzed in accordance with the WHO classification, 5th revision, 2010. RESULTS: Among all examined men with pathospermia (n = 49 patients), 51.02% had various thyroid disorders, while it was firstly verified in 34.7% men. In 45.5% patients with non-obstructive azoospermia, previously undiagnosed nodular goiter with normal values of thyroid-stimulating hormone and free thyroxine were found, and a significant correlation between nodular goiter and the presence of azoospermia was revealed: r = 0.610, p = .01. CONCLUSION.: Men with various forms of pathospermia and patients of the ART clinic had higher risks of thyroid disorders than in general population that could possibly affect fertility. Patients of the ART clinic with non-obstructive azoospermia are at risk for nodular thyroid disorders, even with normal values of thyroid function tests, and require thyroid ultrasonography.

Mental state assessment of recipients in the IVF donor programs and psychotherapeutic methods of its correction.

The management of infertility with assisted reproductive technologies (ART) could solve a medical problem but still leave psychosocial problems, associated with both long-term infertility and specific treatment, unaddressed in a number of cases. Evaluation of the mental state of recipients in the IVF donor programs and its dynamics when mid-term multimodal psychotherapy has been used. The study was conducted in the Family Medicine Center - an ART clinic of the city of Ekaterinburg, Russia between 2016 and 2017. Mental state assessment of 200 potential female candidates for the IVF programs was made with the following methods: figures test and color test of relations, a method for the self-assessment of the emotional state by Hans Eysenck, a method for assessing neuropsychic stress by Nemchin, an original questionnaire for patients of the ART clinic. In our study, it was revealed that women requiring donor oocytes with indirect motivation to have a child demonstrated predominantly a high and moderate level of anxiety, frustration, aggression, rigidity, and neuropsychic stress. The vast majority of women had partial compliance for treatment. With psychotherapeutic approach using mid-term multimodal psychotherapy, patients' compliance for treatment could be improved, resulting in a reduction in negative mental states and development of adequate motivation for oocyte donation in the IVF programs.