بررسی ارتباط مصرف سیگار، الکل ومواد مخدر بر پارامترهای سیمن در مردان مراجعه کننده به مرکز درمان ناباروری یزد سال 1395

ﻣﻘﺪﻣﻪ: ﻧﺎﺑﺎروری در ﻣﺮدان در ﻃﻮل ﺳﺎل ﻫﺎی اﺧﯿﺮ در ﺳﺮاﺳﺮ دﻧﯿﺎ و از ﺟﻤﻠﻪ در اﯾﺮان اﻓﺰاﯾﺶ ﯾﺎﻓﺘﻪ، ﻋﻮاﻣﻞ ﻓﯿﺰﯾﮑﯽ ﺷﯿﻤﯿﺎﯾﯽ،ﺑﯿﻮﻟﻮژﯾﮑﯽ و اﺟﺘﻤﺎﻋﯽ ﻣﺘﻌﺪدی ﺷﻨﺎﺧﺘﻪ ﺷﺪه اﻧﺪ ﮐﻪ در ﮐﺎﻫﺶ ﮐﯿﻔﯿﺖ ﺳﯿﻤﻦ ﻧﻘﺶ دارﻧﺪ . در اﯾﻦ ﺑﯿﻦ از ﻋﻮاﻣﻞ اﺟﺘﻤﺎﻋﯽ ﻣﻄﺮح ﺷﺪه در اﯾﻦ زﻣﯿﻨﻪ ﻣﺼﺮف ﺳﯿﮕﺎر، اﻟﮑﻞ و ﻣﻮاد ﻣﺨﺪر ﻣﯽ ﺑﺎﺷﺪ ﮐﻪ در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺘﻪ اﺳﺖ. روش ﺑﺮرﺳﯽ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﻪ ﺻﻮرت ﻣﻮرد- ﺷﺎﻫﺪی و ﮔﺬﺷﺘﻪ ﻧﮕﺮ از اﺑﺘﺪای اردﯾﺒﻬﺸﺖ ﺗﺎ ﭘﺎﯾﺎن ﻣﻬﺮ ﻣﺎه 1395روی 600ﻧﻔﺮ، 300 ﻧﻔﺮ ﺑﺎ ﮐﯿﻔﯿﺖ ﺳﯿﻤﻦ ﻃﺒﯿﻌﯽ و300 ﻧﻔﺮ ﺑﺎ ﮐﯿﻔﯿﺖ ﺳﯿﻤﻦ ﻣﻌﯿﻮب اﻧﺠﺎم ﺷﺪ. در ﮔﺮوه ﻣﻮرد، ﻣﺮدان ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ ﻣﺮﮐﺰ درﻣﺎن ﻧﺎﺑﺎروری ﯾﺰد ﮐﻪ در ﺑﺮرﺳﯽ و آﻧﺎﻟﯿﺰ ﺳﯿﻤﻦ آﻧﻬﺎ ﺣﺪاﻗﻞ ﯾﮑﯽ از ﭘﺎراﻣﺘﺮﻫﺎی ﻣﻮرد ﺑﺮرﺳﯽ، ﻏﯿﺮ ﻃﺒﯿﻌﯽ ﮔﺰارش ﺷﺪه ﺑﻮد و در ﮔﺮوه ﺷﺎﻫﺪ، ﻣﺮدان ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ ﻫﻤﯿﻦ ﻣﺮﮐﺰ ﮐﻪ آﻧﺎﻟﯿﺰ ﺳﯿﻤﻦ آﻧﻬﺎ ﻃﺒﯿﻌﯽ اﻋﻼم ﺷﺪه ﺑﻮد، ﻗﺮار ﮔﺮﻓﺘﻨﺪ. اﺑﺰار ﺟﻤﻊ آوری ﺑﻪ ﺻﻮرت ﭼﮏ ﻟﯿﺴﺖ ﺳﺎﺧﺘﻪ و ﻫﻢ ﭼﻨﯿﻦ آزﻣﺎﯾﺶ آﻧﺎﻟﯿﺰ ﻣﺎﯾﻊ ﺳﯿﻤﻦ ﺑﻮد. ﯾﺎﻓﺘﻪﻫﺎ: ﻣﯿﺎﻧﮕﯿﻦ ﺳﻦ در ﮔﺮوه ﻣﻮرد 7/03±34/71 ﺳﺎل، و درﮔﺮوه ﺷﺎﻫﺪ6/41± 33/82ﺳﺎل و ﻣﯿﺎﻧﮕﯿﻦ ﺳﻦ ازدواج در ﮔﺮوه ﻣﻮرد5/01± 26/28 و در ﮔﺮوه ﺷﺎﻫﺪ 5/03± 26/28 و ﻣﯿﺎﻧﮕﯿﻦ ﻣﺪت ﻧﺎﺑﺎروری در ﮔﺮوه ﻣﻮرد 4/60± 6/30 در ﮔﺮوه ﺷﺎﻫﺪ 3/88±5/15 ﺑﺪﺳﺖ آﻣﺪ. ﻣﯿﺎﻧﮕﯿﻦ ﺳﻦ (0/084=p) و ﺳﻦ ازدواج (p=0/489) در دو ﮔﺮوه ﺗﻔﺎوت ﻣﻌﻨﯽ داری ﻧﺪاﺷﺖ، اﻣﺎ ﻣﯿﺎﻧﮕﯿﻦ ﻣﺪت ﻧﺎﺑﺎروری (0/001=p) در دو ﮔﺮوه ﺗﻔﺎوت ﻣﻌﻨﯽ داری داﺷﺖ. ﻓﺮاواﻧﯽ ﻣﺼﺮف ﺳﯿﮕﺎر در دو ﮔﺮوه اﺧﺘﻼف ﻣﻌﻨﯽ داری داﺷﺖ (0/032=p). در راﺑﻄﻪ ﺑﺎ ﻣﻘﺪار ﻣﺼﺮف روزاﻧﻪ ﺳﯿﮕﺎر بیشترین فراوانی در هردو گروه،11-20 نخ در روز مشاهده شد (گروه مورد 21.7 درصد و در گروه شاهد 15.3 درصد). مقدار p برابر 0.018 بود. نتیجه گیری: در این مطالعه مصرف سیگار و الکل از عوامل پیشگویی کننده کیفیت سیمن محسوب نشدند، اما بین مصرف تریاک و سن شروع مصرف واختلالات سیمن رابطه معنی داری وجود داشت.

The Relationship of Smoking, Alcohol, and Drugs Consumption on the Quality of Semen Parameters in Males referring to the Infertility Center of Yazd in 2016

Introduction: Male infertility has increased during recent years in countries of the world including Iran. Among many factors that influence the infertility, smoking, alcohol, and addictive drugs were investigated in this study.Methods: This casecontrol retrospective study was conducted on 600 male patients consisting of 300 individuals with natural semen and 300 people with defective semen. The first step in investigation of infertility in each couple was to conduct a spermogram to detect the male infertility. The case group included men who referred to the Yazd Infertility Treatment Center and had at least one abnormal test result among considering the parameters of semen test. The control group included the men who referred to the same center and had normal semen test result. The data collection tools were a researchermade checklist based on the parameters required for the study with epidemiological and observational design, as well as the semen analysis test. Results: The age mean in the case and control groups were 34.71 and 33.82 years with the standard deviation of ± 7.3 and ± 6.41, respectively. The means of marriage age in the case and control groups were 26.28 and 26.28 ±5.3 years, respectively. The mean duration of infertility in the case group was 6.30 ± 4.60 and in the control group was 5.15 ± 3.88. No significant difference was observed between the mean age (P = 0.084) and marital age (P = 0.448) in two groups, but the mean duration of infertility (P <0.001) was significantly different between the two groups .The prevalence of smoking was significantly different between the two groups (P = 0.032). Considering the daily frequency of smoking, the highest rate was 1120 cigarettes in both groups (case group 21.7% and control group 15.3%). The P value was set at 0.018.Conclusion: In this study, smoking and consumption of alcohol were not considered as the predictive factors of semen quality, but consumption of drugs and the age of starting consumption of drugs had a significant relationship with the semen disorders.