Reproductive health of the Russian Federation navy personnel

OBJECTIVE. To assess the development of the subject, regarding the impact of factors of the military professional activity on reproductive health of the Navy personnel.

MATERIALS AND METHODS. There was the analysis of 65 Russian and foreign scientific publications in databases PubMed, Cochrane, elibrary.ru over the past 25 years, 14 of which were included in the review, meeting the inclusion and exclusion criteria.

RESULTS. Reproductive health of the Navy personnel is regularly exposed to a number of adverse factors of the military professional activity. The article presents analysis of studies, showing the effect of such factors as service on nuclear-powered submarines, work under high temperature conditions, exposure to radiofrequency electromagnetic field as well as sexual deprivation, related to forced sexual abstinence. It provides data, reflecting high prevalence of infections of sexually transmitted diseases in the Navy personnel. At the same time, it should be noted that the analyzed sources do not contain information concerning integrated assessment of military professional factors, allowing to predict changes of reproductive health.

DISCUSSION. The results of the conducted systematic analysis of studies correspond to the works which study the issue above from a broader perspective. Thus, the literature presents data on the negative impact on overload fertility, experienced by servicemen of military aviation, shows a high prevalence of infertility in men, involved in hostilities, finds a link between exposure to electromagnetic radiation and much lower number of spermatozoa in the ejaculate. A high prevalence of prostatitis and varicocele in military personnel are noted in a series of papers.

COCNLUSION. The analysis of scientific publications showed insufficient development of the issue both in Russian and foreign literature that dictates the need to carry out further research, regarding the issue of reproductive health in individuals of the above categories.

marine medicine, reproductive health of the Navy personnel, medical and psychological rehabilitation, male infertility in military personnel, risk factors of male infertility, military professional activity, spermogram, sexual function in military personnel

1. Practice Committee of American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss: a committee opinion. Fertil Steril, 2013, Vol. 99, No. 1, P. 63. doi: 10.1016/j.fertnstert.2012.09.023

2. Vander Borght M., Wyns C. Fertility and infertility: Definition and epidemiology. Clin Biochem, 2018, Vol. 62, P. 2–10. doi: 10.1016/j.clinbiochem.2018.03.012

3. Inhorn M. C., Patrizio P. Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century. Human Reproduction Update, 2015, Vol. 21, No. 4, P. 411–426. doi: 10.1093/humupd/dmv016

4. Babakhanzadeh E., Nazari M., Ghasemifar S., Khodadadian A. Some of the factors involved in male infertility: a prospective review. Int. J. Gen. Med, 2020, Vol. 13, P. 29–41. doi: 10.2147/IJGM.S241099

5. Agarwal A., Mulgund A., Hamada A., Chyatte M. R. A unique view on male infertility around the globe. Reprod. Biol. Endocrinol, 2015, Vol. 13, P. 37. doi: 10.1186/s12958-015-0032-1

6. Pathak U. I., Gabrielsen J. S., Lipshultz L. I. Cutting-edge evaluation of male infertility. Urol. Clin. North Am, 2020, Vol. 47, No. 2, P. 129–138. doi: 10.1016/j.ucl.2019.12.001

7. Лебедев Г. С., Голубев Н. А., Шадеркин И. А., Шадеркина В. А., Аполихин О. И., Сивков А. В., Комарова В. А. Мужское бесплодие в Российской Федерации: статистические данные за 2000–2018 годы // Экспериментальная и клиническая урология. 2019. № 4. С. 4–12 [Lebedev G. S., Golubev N. A., Shaderkin I. A., Shaderkina V. A., Apolikhin O. I., Sivkov A. V., Komarova V. A. Male infertility in the Russian Federation: statistical data for 2000-2018. Experimental and clinical urology, 2019, No. 4, P. 4–12 (In Russ.)]. doi: 10.29188/2222-8543-2019-11-4-4-12

8. Magalhães J. A., Ribeiro L. S., Rego J. P. A., de Andrade C. R. Current markers for infertility in men. JBRA Assist Reprod, 2021, Vol. 25, No. 4, P. 592–600. doi: 10.5935/1518-0557.20210013

9. Kuhtz J., Schneider E., El Hajj N., Zimmermann L., Fust O., Linek B., Seufert R., Hahn T., Schorsch M., Haaf T. Epigenetic heterogeneity of developmentally important genes in human sperm: implications for assisted reproduction outcome. Epigenetics. 2014, Vol. 9, No. 12, P. 1648–1658. doi: 10.4161/15592294.2014.988063

10. Al-Otaibi S. T. Male infertility among bakers associated with exposure to high environmental temperature at the workplace. J. Taibah. Univ. Med. Sci, 2018, Vol. 13, No. 2, P. 103. doi: 10.1016/j.jtumed.2017.12.003

11. Carré J., Gatimel N., Moreau J., Parinaud J., Léandri R. Does air pollution play a role in infertility?: a systematic review. Environ Health, 2017, Vol. 16, No. 1, P. 82. doi: 10.1186/s12940-017-0291-8

12. Hammoud A., Carrell D. T., Gibson M., Sanderson M., Parker-Jones K., Peterson C.M. Decreased sperm motility is associated with air pollution in Salt Lake City. Fertil Steril, 2010, Vol. 93, No. 6, P. 1875–1879. doi: 10.1016/j.fertnstert.2008.12.089

13. Галимов Ш. Н., Гизатуллин Т. Р., Фархутдинов Р. Р., Галимова Э. Ф., Сивочалова О. В. Молекулярные маркеры фертильности эякулята у сотрудников спецподразделений МВД в условиях боевого стресса // Медицина труда и промышленная экология. 2009. № 10. С. 36–39 [Galimov Sh. N., Gizatullin T. R., Farkhutdinov R. R., Galimova E. F., Sivochalova O. V. Molecular markers of ejaculate fertility in officers of Internal Affairs Ministry Special Forces, if under battle stress. Occupational Medicine and Industrial Ecology, 2009, No. 10, P. 36–39 (In Russ.).].

14. Li Y., Li Y., Zhou N. Socio-psycho-behavioural factors associated with male semen quality in China: results from 1346 healthy men in Chongqing. J. Fam. Plann. Reprod Health Care, 2013, Vol. 39, No. 2, P. 102–110. doi: 10.1136/jfprhc-2011-100276

15. Berger M. H., Messore M., Pastuszak A. W., Ramasamy R. Association between infertility and sexual dysfunction in men and women. Sex. Med. Rev., 2016, Vol. 4, No. 4, P. 353–365. doi: 10.1016/j.sxmr.2016.05.002

16. Evans-Hoeker E. A., Eisenberg E., Diamond M. P. Major depression, antidepressant use and male and female fertility. Fertil Steril, 2018, Vol. 109, No. 5, P. 879–887. doi: 10.1016/j.fertnstert.2018.01.029

17. Starc A., Trampuš M., Jukić D. P., Rotim C., Jukić T., Mivšek A. P. Infertility and sexual dysfunctions: a systematic literature review. Acta Clin. Croat., 2019, Vol. 58, No. 3, P. 508–515. doi: 10.20471/acc.2019.58.03.15

18. Ma J., Zhang Y., Bao B., Chen W., Li H., Wang B. Prevalence and associated factors of erectile dysfunction, psychological disorders, and sexual performance in primary vs. secondary infertility men. Reprod. Biol. Endocrinol., 2021, Vol. 19, No. 1, P. 43. doi: 10.1186/s12958-021-00720-5

19. Demirkol M. K., Yıldırım A., Gıca Ş. Evaluation of the effect of shift working and sleep quality on semen parameters in men attending infertility clinic. Andrologia, 2021, Vol. 53, No. 8: e14116. doi: 10.1111/and.14116

20. Makara-Studzińska M., Limanin A., Anusiewicz A., et al. Assessment of quality of life in men treated for infertility in Poland. Int. J. Environ Res. Public. Health., 2022, Vol. 19, No. 5, P. 2950. doi: 10.3390/ijerph19052950

21. Тришкин Д. В., Крюков Е. В., Агафонов П. В. и др. Военно-полевая терапия. Национальное руководство / Сер. Национальные руководства. (2-е издание, переработанное и дополненное). М.; 2023. 736 с. [Trishkin D. V., Kryukov E. V., Agafonov P. V., et al. Military Field Therapy. National leadership / Ser. national guides. (2nd edition, revised and enlarged), Moscow, 2023, 736 p. (In Russ.)]. doi: 10.33029/9704-8023-6-vpt-2023-1-736

22. Тришкин Д. В., Крюков Е. В., Алексеев Д. Е. и др. Военно-полевая хирургия. Национальное руководство. Сер. Национальное руководство (2-е издание, переработанное и дополненное). М.; 2024. 1056 с. [Trishkin D. V., Kryukov E. V., Alekseev D. E., et al. Military field surgery. National leadership. Ser. National leadership (2nd edition, revised and expanded), Moscow, 2024, 1056 p. (In Russ.)]. doi: 10.33029/9704-8036-6-VPX-2024-1-1056

23. Тришкин Д. В. Медицинское обеспечение Вооруженных Сил Российской Федерации в условиях проведения специальной военной операции и частичной мобилизации: итоги деятельности и задачи на 2023 год // Военнo-медицинский журнал. 2023. № 1. С. 4–24 [Trishkin D. V. Medical support of the Armed Forces of the Russian Federation in the conditions of a special military operation and partial mobilization: results of activities and tasks for 2023. Military Medical Journal, 2023, No. 1, P. 4–24 (In Russ.)].

24. Долгих С. В., Остроухов А. Е., Плюснина Е. В. Изменения нормативно-правовой базы в организации проведения медико-психологической реабилитации военнослужащих // Военно-медицинский журнал. 2021. Т. 342, № 12. С. 23–28 [Dolgikh S. V., Ostroukhov A. E., Plyusnina E. V. Changes in the regulatory framework in the organization of medical and psychological rehabilitation of military personnel. Military Medical Journal, 2021, Vol. 342, No. 12, P. 23–28 (In Russ.)].

25. Долгих С. В., Ковлен Д. В., Кирсанова А. А., Пронин В. Д., Обрезан А. Г., Сюрис Н. А., Ищук В. Н., Абусева Г. Р., Хозяинова С. С., Иващев В. В., Шишкин Ю. М., Адхамов Б. М. Персонализированная медико-психологическая реабилитация военнослужащих в военных санаторно-курортных организациях // Современные проблемы науки и образования. 2022. № 2. С. 102–118 [Dolgikh S. V., Kovlen D. V., Kirsanova A. A., Pronin V. D., Obreban A. G., Syuris N. A., Ishchuk V. N., Abuseva G. R., Khozainova S. S., Ivashchev V. V., Shishkin Yu. M., Adhamov B. M. Personalized medical and psychological rehabilitation of servicemen in military sanatorium-resort organizations. Modern problems of science and education, 2022, No. 2, P. 102–118 (In Russ.)].

26. Velez de la Calle J. F., Rachou E., le Martelot M. T., Ducot B., Multigner L., Thonneau P. F. Male infertility risk factors in a French military population. Hum. Reprod., 2001, Vol. 16, No. 3, P. 481–486. doi: 10.1093/humrep/16.3.481

27. Baste V., Riise T., Moen B. E. Radiofrequency electromagnetic fields; male infertility and sex ratio of offspring. Eur. J. Epidemiol., 2008, Vol. 23, No. 5, P. 369–377. doi: 10.1007/s10654-008-9236-4

28. Møllerløkken O. J., Moen B. E. Is fertility reduced among men exposed to radiofrequency fields in the Norwegian Navy? Bioelectromagnetics, 2008, Vol. 29, No. 5, P. 345–352. doi: 10.1002/bem.20400

29. Sharma R., Harlev A., Agarwal A., Esteves S. C. Cigarette smoking and semen quality: a new meta-analysis examining the effect of the 2010 World Health Organization laboratory methods for the examination of human semen. Eur. Urol., 2016, Vol. 70, No. 4, P. 635–645. doi: 10.1016/j.eururo.2016.04.010

30. Yarnall N. J., Hughes L. M., Turnbull P. S., Michaud M. Evaluating the effectiveness of the US Navy and Marine Corps Tobacco Policy: an assessment of secondhand smoke exposure in US Navy submariners. Tob. Control, 2013, Vol. 22(e1), e66-72. doi: 10.1136/tobaccocontrol-2012-050488

31. Shulman A., Shohat B., Gillis D., Yavetz H., Homonnai Z. T., Paz G. Mumps orchitis among soldiers: frequency, effect on sperm quality, and sperm antibodies. Fertil Steril, 1992, Vol. 57, No. 6, P. 1344–1346. doi: 10.1016/s0015-0282(16)55099-7

32. Ивченко Е. В., Шмидт А. А., Овчинников Д. В., Захаров И. С., Попов А. С., Тимошкова Ю. Л., Гаджиев С. З. Влияние новой коронавирусной инфекции на показатели репродуктивного здоровья курсантов // Вестник Российской военно-медицинской академии. 2022. Т. 24, № 4. С. 667–674 [Ivchenko E. V., Schmidt A. A., Ovchinnikov D. V., Zakharov I. S., Popov A. S., Timoshkova Yu. L., Gadzhiev S. Z. Effect of the COVID-19 on the reproductive health indicators of cadets. Bulletin of the Russian Military Medical Academy, 2022, Vol. 24, No. 4, P. 667–674 (In Russ.)]. doi: 10.17816/brmma111164

33. Gaydos J. C., McKee K. T., Faix D. J. Sexually transmitted infections in the military: new challenges for an old problem. Sex Transm. Infect., 2015, Vol. 91, No. 8, P. 536–537. doi: 10.1136/sextrans-2015-052256

34. Korzeniewski K., Juszczak D., Paul P. Sexually transmitted infections in the military environment. Int. Marit. Health., 2020, Vol. 71, No. 3, P. 207–212. doi: 10.5603/IMH.2020.0037

35. Duron S., Panjo H., Bohet A., et al. Prevalence and risk factors of sexually transmitted infections among French service members. PLoS One, 2018, Vol. 13, No. 4: e0195158. doi: 10.1371/journal.pone.0195158

36. Pérez-Soto E., Medel-Flores M. O., Fernández-Martínez E. High-Risk HPV with Multiple Infections Promotes CYP2E1, lipoperoxidation and pro-inflammatory cytokines in semen of asymptomatic infertile men. Antioxidants (Basel), 2022, Vol. 11, No. 6, P. 1051. doi: 10.3390/antiox11061051

37. Horseman T. S., Crecelius E. M., Miller M. A., et al. Prevalence and epidemiology of mycoplasma genitalium in a Pacific-Region military population. Sex Transm. Dis., 2021, Vol. 48, No. 8, P. 578–582. doi: 10.1097/OLQ.0000000000001393

38. Сухих Г. Т., Божедомов В. А. Мужское бесплодие. М.; 2008. 240 c. [Sukhikh G. T., Bozhedomov V. A. Male infertility. Moscow; 2008, 240 p. (In Russ.)].

39. Lund L., Rasmussen H. H., Ernst E. Asymptomatic varicocele testis. Scand. J. Urol. Nephrol., 1993, Vol. 27, No. 3, P. 395–398. doi: 10.3109/00365599309180452

40. Zou Z., Hu H., Song M., et al. Semen quality analysis of military personnel from six geographical areas of the People’s Republic of China. Fertil Steril, 2011, Vol. 95, No. 6, P. 2018–2023. doi: 10.1016/j.fertnstert.2011.02.052

41. Кутелев Г. М., Зайцев А. Г. Удовлетворенность половой жизнью у военнослужащих ВМФ по данным сексологического обследования // Морская медицина. 2016. Т. 2, № 1. С. 81–85 [Kutelev G. M., Zaitsev A. G. Satisfaction with sex life among navy personnel according to sexologic survey. Marine Medicine, 2016, Vol. 2, No. 1, P. 81–85 (In Russ.)].

42. Jequier A. M. High-performance aircraft – a possible cause of male infertility. Br J Urol, 1996, Vol. 77, No. 6, P. 920–922. doi: 10.1046/j.1464-410x.1996.06631.x

43. Kobeissi L., Inhorn M. C., Hannoun A. B., Hammoud N., Awwad J., Abu-Musa A. A. Civil war and male infertility in Lebanon. Fertil Steril, 2008, Vol. 90, No. 2, P. 340–345. doi: 10.1016/j.fertnstert.2007.06.061

44. Martini A. E., Doyle J. O. Fertility Preservation Before Deployment: Oocyte and Sperm Freezing in Members of the Active Duty Military. Semin Reprod Med, 2019, Vol. 37, No. 5–6, P. 232–238. doi: 10.1055/s-0040-1701633

45. Weyandt T. B., Schrader S. M., Turner T. W., Simon S. D. Semen analysis of military personnel associated with military duty assignments. Reprod Toxicol, 1996, Vol. 10, No. 6, P. 521–528. doi: 10.1016/s0890-6238(96)00139-6

46. Choi S. Y., Yoon C. G. Urologic diseases in Korean military population: a 6-year epidemiological review of medical records. J Korean Med Sci, 2017, Vol. 32, No. 1, P. 135–142. doi: 10.3346/jkms.2017.32.1.135