The mechanisms of formation of male infertility are increasingly becoming immune dependent. This study aims to study the role of pro-inflammatory and anti-inflammatory cytokines in seminal fluid to clarify their role in spermatogenesis. This research is carried out at rheumatology and urology departments of Danylo Halytsky Lviv National Medical University (Ukraine). 45 infertile men aged 22–48 were examined. They were divided into 2 groups: first group – 22 men with a systemic autoimmune disease – rheumatoid arthritis; second group – 23 somatically healthy patients with idiopathic infertility. The control group included 27 fertile healthy men aged 22–48 years. Student's t-test was used to compare the significant difference in mean values between groups. Patients with autoimmune diseases (rheumatoid arthritis) had the highest rate of leukocytospermia, indicating a possible long-term inflammatory process. The TGF-β1 level was higher in men with idiopathic infertility, and in patients with autoimmune pathology was reduced compared to the control group, however these changes were not significant. At the same time in patient of both group the level a pro-inflammatory cytokine IL-18 increased approximately by 2.5 times.
In patients with idiopathic infertility and patients with autoimmune pathology, a simultaneous increase in the IFN-γ level and a decrease in the IL-1β level were found. The ІL-6 level in seminal plasma of infertile men of both groups was increased. The ratio IL-10/TNF-α was decreased in seminal plasma of infertile men with rheumatoid arthritis. It was found that in autoimmune pathology, the increased level of IL-1β in blood serum compared to controls was associated with its reduced level in seminal fluid (r=-0.51, p<0.05). In idiopathic infertility, a low level of IL-1β in seminal fluid was also associated with a low concentration of this cytokine in blood serum (r=0.62, p<0.05). The functioning of the immune and reproductive systems of the male body is closely related and interdependent. Disorders of immune reactivity, which accompany the development of autoimmune pathology associated with disorders of reproductive function in men. The largest number of deviations of immune reactivity was found in infertile men with concomitant autoimmune diseases.