Background: Azoospermia is the most severe form of male infertility, affecting approximately 1% of all men and 10–15% of infertile men. Previous studies have identified several risk factors, including smoking, alcohol consumption, hormonal disorders, testicular injury, and inflammatory diseases of the male reproductive system. Aim: To investigate selected risk factors associated with azoospermia-related infertility in Mongolian men. Materials and Methods: A case–control study was conducted to identify and estimate risk factors for azoospermia among Mongolian men. The case group included men diagnosed with azoospermia between 2019 and 2021 at the First Central Hospital of Mongolia and the “RMC” National Center for Assisted Reproduction. The control group consisted of men with normal semen parameters according to World Health Organization (WHO) guidelines, with a case-to-control ratio of 1:2. Data were collected using a structured questionnaire, and semen analysis was performed and evaluated in accordance with WHO standards. Result: A total of 180 participants were included, comprising 57 cases with azoospermia and 123 controls with normal semen analysis. The mean age was 35.56 ± 6.95 years (35.80 ± 7.79 in controls and 35.04±4.66 in cases). Socioeconomic and lifestyle factors were not significantly associated with azoospermia risk. However, a history of inflammatory diseases of the male reproductive system increased the risk by 6.4-fold (χ²=22.87, p<0.01). A history of mumps infection was associated with a 2.3-fold increased risk (χ²=6.43, p<0.01). Sexually transmitted infections, particularly gonorrhea, increased the risk by 1.8-fold (p<0.05). Conclusion Among Mongolian men, inflammatory conditions of the male reproductive system, sexually transmitted infections, and a history of mumps are significant risk factors for azoospermia-related infertility, whereas socioeconomic factors appear to have no significant effect.

Background: Sleep is essential for maintaining the body’s internal balance, as well as psychological stability and cognitive performance. In particular, it is a fundamental process for maintaining physical and mental health by promoting axonal repair and memory consolidation. Consequently, sleep disturbances may lead not only to physiological dysfunction but also to behavioral and psychological risks. Aim: To evaluate sleep disturbances and determine selected associated risk factors. Materials and Methods: A cross-sectional study was conducted among individuals receiving treatment at the “BogdUul” sanatorium for reasons other than insomnia between December 2024 and March 2025. A total of 209 participants aged 18 years and older were randomly selected regardless of sex. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Anxiety was measured using the State–Trait Anxiety Inventory (STAI; Spielberger–Hanin), and depression was evaluated using the Center for Epidemiologic Studies Depression Scale (CES-D). Lifestyle factors that could potentially influence sleep were assessed using a structured questionnaire. A PSQI score greater than 5 indicated the presence of sleep disturbance. According to the STAI scale, scores of 0–1.4 indicated no anxiety, 1.5–1.9 mild anxiety, 2.0–2.9 moderate anxiety, 3.0–3.4 severe anxiety, and 3.5–4.0 profound anxiety. Depression based on the CES-D scale was classified as no depression (0–15), moderate depression (16–21), and severe depression (≥22). Result: The study included 209 participants aged 18–89 years, with a mean age of 49.61±17.64 years (men: 52.23±2.52; women: 48.65±1.39). Of the participants, 25.4% (n=53) were men and 74.6% (n=156) were women. Based on the PSQI results, 45.9% (n=96) had normal sleep quality, while 54.1% (n=113) had sleep disturbances. Among those with sleep disturbances, 79.6% (n=90) were women and 20.4% (n=23) were men. Psychological assessment showed that 23.4% (n=49) reported frequent exposure to stress, 70.8% (n=148) had state anxiety, 85.6% (n=179) had trait anxiety, and 23.4% (n=49) were identified as having depressive symptoms. When comparing the groups, participants with normal sleep were more likely to have no anxiety (42.7%) or only mild anxiety (37.5%). In contrast, more than 70% of those with sleep disturbances had mild (34.5%) or moderate (36.3%) anxiety, and severe anxiety (11.5%) was observed 2.6 times more frequently than in the normal sleep group. A similar trend was observed for trait anxiety. Among individuals with normal sleep, the majority had no (28.1%) or mild anxiety (46.9%), whereas moderate (41.6%) and severe (20.4%) levels were more common among those with sleep disturbances. While 85.5% of participants with normal sleep had no depression, more than 30% of those with sleep disturbances had moderate or severe depression (15.9% each). Sleep disturbance showed a moderate positive correlation with state anxiety (r=0.309; p < 0.001), trait anxiety (r=0.451; p<0.001), and depression (r=0.312; p<0.001). Weak but significant associations were also found with evening intellectual workload (Phi=0.216; χ²=9.754, p=0.002), irregular sleep patterns (Phi=0.181; χ²=6.880, p=0.009), and frequent exposure to stress (Phi=0.254; χ²=13.470, p<0.001). Risk factor analysis indicated that intellectually demanding work in the evening (OR=6.660; 95% CI: 1.501–29.546), frequent exposure to stress (OR=4.904; 95% CI: 1.973–12.189), consumption of strong tea or coffee in the evening (OR=3.288; 95% CI: 1.010–10.700), irregular sleep schedules (OR=2.096; 95% CI: 1.122–3.916), trait anxiety (OR=1.088; 95% CI: 1.041–1.137), and state anxiety (OR=1.038; 95% CI: 1.000–1.076) were associated with an increased risk of sleep disturbances. Conclusion Evening intellectual workload, frequent exposure to stress, consumption of strong tea or coffee in the evening, irregular sleep patterns, and both state and trait anxiety were identified as risk factors for sleep disturbances.

Background: Chronic kidney disease (CKD) is a major global public health problem, affecting more than 10% of the world’s population, over 850 million people worldwide. Protein-energy wasting (PEW), which is observed in 28–54% of patients undergoing hemodialysis, is closely associated with reduced muscle mass and has been shown to double the risk of mortality within 5 years. Chronic inflammation and hemodynamic instability during hemodialysis are considered key mechanisms contributing to muscle mass loss in CKD. Aim: To determine muscle mass and the intensity of inflammatory response in hemodialysis patients, and evaluate their association Materials and Methods: Skeletal muscle mass (SMM) was assessed after hemodialysis using bioelectrical impedance analysis (InBody 770, USA). The skeletal muscle mass index (SMMI) was calculated as muscle mass (kg) divided by height squared (m²). Blood samples were obtained from the participants prior to hemodialysis, and the intensity of the inflammatory response was assessed using the level of C-reactive protein (CRP) and the CRP-to-albumin ratio (CRP/Alb). In addition, based on complete blood count parameters, the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), as well as the systemic immune–inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) were calculated and evaluated. Results: A total of 128 hemodialysis patients were enrolled, including 50.8% males and 49.2% females, with a mean age of 55.37±14.87 years. No statistically significant differences in SMM (F=2.22, p=0.113) or SMMI (F=7.47, p=0.48) were observed across age groups. However, when stratified by duration of hemodialysis (≤3 years vs >3 years), independent samples t-test demonstrated significant differences in both SMM (26.2±5.2 vs 22.8±4.4; t=2.645, p=0.009) and SMMI (24.9±10.2 vs 22.9±9.7; t=3.020, p=0.003). Pearson correlation analysis showed that SMMI was significantly inversely correlated with CRP (r=−0.368, p<0.0001), MLR (r=−0.321, p<0.0001), SIRI (r=−0.210, p=0.02), AISI (r=−0.252, p=0.004), and CRP/Alb (r=−0.260, p=0.003). Conclusion In hemodialysis patients, increased inflammatory response intensity was associated with reduced skeletal muscle mass and may represent one of the underlying pathophysiological mechanisms (SMMI vs. CRP, r=−0.368, p<0.0001; SMMI vs. MLR, r=−0.321, p<0.0001; SMMI vs. SIRI, r =−0.210, p=0.02; SMMI vs. AISI, r=−0.252, p=0.004; SMMI vs. CRP/Alb, r=−0.260, p=0.003).

Background: Cardiovascular disease is the leading cause of death in Mongolia, and atherosclerosis is its main pathogenic factor. The cardio-ankle vascular index (CAVI) is a marker of arterial stiffness, and measuring it allows atherosclerosis to be detected before clinical symptoms appear. This study was based on the need to assess CVD risk in older adults and to plan prevention accordingly. Aim: To determine whether CAVI independently predicts CVD mortality in older adults. Materials and Methods: This prospective cohort study included 1,403 adults aged 55–95 years from five regions of Mongolia who had participated in the study “Factors Influencing Population Longevity,” (2011–2015). CAVI was measured with a VaSera VS-1000 device (Fukuda Denshi, Japan). Mortality data as of December 20, 2025 were obtained from the Center for Health Development by linking participants’ national registration numbers to the death registry. Deaths coded I00–I99 under the International Classification of Diseases, 10th revision, were classified as CVD deaths. Participants were divided into four equal groups by CAVI value (quartiles: Q1 <8.0, Q2 8.0–8.8, Q3 8.9–9.7, Q4 ≥9.8), and the cumulative incidence of CVD mortality was estimated with the Aalen–Johansen method. Cox regression analysis was adjusted for age, sex, hypertension, smoking, LDL cholesterol, HDL cholesterol and estimated glomerular filtration rate. A Fine–Gray sensitivity analysis was also performed. Results: The mean age of participants was 66.8±7.9 years. During follow-up (median 13.2 years), 121 CVD deaths (8.6%) and 127 deaths from other causes (9.1%) were recorded. The cumulative incidence of CVD mortality rose stepwise from 3.3% in Q1 to 6.0% in Q2, 9.3% in Q3 and 14.1% in Q4 (Gray’s test p<0.001). Compared with Q1, the hazard of CVD death was higher in Q3 (HR 2.03 [95% CI 1.04–3.98]) and Q4 (HR 2.42 [95% CI 1.23–4.76]) (p-trend=0.012). Per 1-unit increase in CAVI, the HRs were: crude: 1.42 [95% CI 1.24–1.63], age- and sex-adjusted: 1.19 [95% CI 1.03–1.38] and fully adjusted: 1.17 [95% CI 1.00–1.36], p=0.045. Hypertension was an independent risk factor for CVD mortality (HR 1.53 [95% CI 1.06–2.21]). Conclusion In older adults, higher CAVI predicts CVD mortality independently of age, sex and traditional risk factors, and the risk of CVD death rises stepwise with higher CAVI quartiles.

Background: Azoospermia is the most severe form of male infertility, affecting approximately 1% of male population and 10–15% of infertile men. In azoospermia cases, sperm retrieval from the testis or epididymis through surgical procedures is used for assisted reproductive treatments. When no sperm is retrieved, recent approaches in medicine suggest using immunohistochemical methods to evaluate spermatogenesis in testicular tissue and plan further treatments. Aim: To evaluate spermatogenesis in testicular tissue of azoospermic patients using immunohistochemistry and compare the findings with the clinical outcomes of sperm retrieval procedures. Materials and Methods: This study included 71 azoospermic men who underwent micro-TESE procedures at the IVF center (RMC) between 2019 and 2023. The excised testicular tissues were fixed, processed histologically, and evaluated using Johnson’s score. The presence of spermatozoa in seminiferous tubules was detected by immunohistochemical and immunofluorescence staining, using markers such as TEX101 and LDHC. Results: Johnson’s score was categorized into three groups: poor, moderate, and good spermatogenesis. These were statistically compared with hormonal levels and surgical sperm retrieval outcomes. There were significant differences in Johnson’s scores and serum FSH and LH levels among the three groups (p < 0.005). TEX101 and LDHC proteins were strongly expressed in the good group, weakly in the moderate group, and absent in the poor group. The success rate of sperm retrieval was 100% (17/17) in the good group, 96.29% (26/27) in the moderate group, and only 29.62% (8/27) in the poor group. Conclusion Histological evaluation of spermatogenesis in azoospermic patients can help predict the outcome of surgical sperm retrieval, indicating its clinical value in treatment planning.

Background: This study examines the role of health status and social support in the relationship between stress, depression, anxiety, and sleep disturbance, both in intermittent and chronic sleep disturbances. Aim: Assessing sleep disturbance, identifying some risk factors, and examining the relationship with blood glucose levels. Materials and Methods: A cross-sectional study was conducted between December 2024 and March 2025. Data were collected from 209 healthy adults aged over 18 years, who either experienced normal sleep patterns or sleep maintenance issues. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). State and trait anxiety, as well as depression, were measured using the State-Trait Anxiety Inventory (STAI) and the Center for Epidemiologic Studies Depression Scale (CES-D), respectively. The PSQI scale indicates sleep disturbances if the score is 5 or higher. For detecting anxiety, the STAI (State-Trait Anxiety Inventory, or Spielberger-Hanin) scale is used with the following classifications: 1.4-0 no anxiety, 1.5-1.9 mild anxiety, 2.0-2.9 moderate anxiety, 3.0-3.4 severe anxiety, 3.5-4.0 very severe anxiety for detecting depression, the CES-D (Center for Epidemiologic Studies Depression Scale) scale is used with the following classifications: below 15Results: The average age of participants was 49.61±17.64 years. According to the PSQI global score (≥5), 54.1% (n=113) reported poor sleep quality, while 45.9% (n=96) were categorized as normal sleepers. The mean PSQI score for those with sleep disturbances was 6.21±3.56, compared to 3.10±1.61 in the normal sleep group. In the sleep disturbance group (n=89), blood glucose levels were measured as 6.15±1.88 mmol/l after fasting and 6.82±2.70 mmol/l before bedtime (p=0.001). Among all subjects, 70.8% (n=147) exhibited state anxiety, 85.6% (n=179) showed trait anxiety, and 23.4% (n=49) had symptoms of depression. Sleep disturbance was significantly associated with state anxiety (OR=1.038; p=0.049) and trait anxity (OR=1.088; p=0.000). Conclusion This study demonstrates that state and trait anxiety are independent factors contributing to sleep disturbance. Additionally, the current state of anxiety is directly correlated with the fasting blood glucose lev

Background: Osteoporotic fractures remain a major concern for public health and the economy. Osteoporosis is a chronic disease characterized by reduced bone density due to genetic, hormonal, mineral, and lifestyle factors. Although often asymptomatic, its primary complication is fractures, which lead to disability and loss of work capacity, impacting individuals, families, and society. In Mongolia, no long-term study has examined bone density changes and fracture risk factors, which forms the basis of this research. Aim: To assess 10-year changes in bone density and identify risk factors for fractures. Materials and Methods: This prospective cohort study was conducted at the Department of Pathophysiology, School of Biomedicine, MNUMS. We have re-enrolled 133 adults from Ulaanbaatar between November 2023 and January 2024, originally part of the ‘Study of some risk and pathophysiological factors of osteoporosis in the Mongolian population’ funded by the Ministry of Health and the Science and Technology Fund of Mongolia. Data collection included questionnaires, anthropometric measurements, bone mineral density assessments using the ‘Sunlight Mini-Omni’ bone sonometer (Beammed, USA) Results: The mean age of participants was 54.4±9.6 years (N=133), with 33.1% (n=44) male and 66.9% (n=89) female. Among the participants, 51.1% had a history of bone fractures, with forearm fractures comprising 10.5% and other types of fractures accounting for 40.7%. The bone fractures was significantly higher among elderly individuals and those diagnosed with osteoporosis (p<0.05). The T-score was significantly lower in the fracture group than in the non-fracture group (p<0.05). Vitamin D deficiency was identified as a significant risk factor for fractures (p<0.05). Conclusion All participants’ bone density has decreased over the decade. Bone fractures are more common in elderly and people with osteoporosis. Inadequate vitamin D intake is a significant risk factor for bone fractures.

Background: Cardiovascular disease (CVD) is currently the leading cause of morbidity and mortality worldwide. CVD risk increases significantly even in the early stages of chronic kidney disease (CKD) and CVD deaths account for more than half of all known causes of death in patients with end stage renal disease. Cardiovascular risk factors such as hypertension, anemia, hyperphosphatemia, volume overload and uremic toxins usually occur when eGFR is below 60 ml/min/1.73m2, while the subclinical atherosclerosis starts to develop in early stages of CKD. Serum N-terminal pro B type netriuretic peptide (NT-proBNP) is important for predicting subclinical heart failure in patients with CKD. Methods: Plasma NT-proBNP concentrations were measured in 37 patients with CKD (mean age = 54 years, female 48.6%). Renal function was assessed by estimated glomerular filtration rate (eGFR; ml/min/1.73m2) and the subjects were classified into five stages of CKD. Pearson correlation analysis was used to analyze he relationship between renal function and serum NT-proBNP levels. Results: The mean serum NT-proBNP level was in CKD stage I ( <50pg/ml, p<0.0001), CKD stage II (64.86±21.79 pg/ml, p<0.0001), CKD stage III(119.56±158.1pg/ml, p<0.0001), CKD stage IV (5801.8±7213.7 pg/ml, p<0.0001), CKDstage V (6993.1±9029.9 pg/ml l, p<0.0001). Serum NT-proBNP level was inversely correlated significantly with eGFR (r = -0.464, р = 0.004). Conclusion Our findings indicate the circulating levels of NT-proBNP increased with deteriorating kidney function and these values were highest in patients with CKD IV and CKD V stages.

Background: Thyroid hormone disorders have an adverse effect on human spermatogenesis. Thyroid function has regulated by hypothalamic-pituitary-thyroid axis and thyroid stimulation hormone is a critical measurement of thyroid disorders. This study aimed to investigate the relationship between thyroid stimulating hormone and sperm parameters. Methods: This study has conducted 99 man who have visited RMC and Ojinmed IVF centers. Serum level of thyroid stimulating hormone (TSH) was measured by automated immunoassay analyzer (TOSOH AIA-360, Japan). Semen analysis was done in all the participants and evaluated by World Health Organization’s guidelines(2010). Results were calculated by SPSS 26 program. Results: The average age was 35.2±5.76. The mean serum TSH level was 1.37±0.57 and 1.85±1.16 normal subjects and spermatogenesis dysfunction group, respectively. Furthermore, serum TSH level and sperm parameters were significantly different between two groups (p<0.05). Logistical regression analysis showed that increased TSH level negatively affected the motility (r=-0.28; p<0.05) and progressive motility (r=-0.34;p<0.05) of sperm more than other parameters (r=-0.34; p=0.035). There was no correlation between serum TSH and other sperm parameters. We analyzed binary logistic regression for TSH with spermatogenesis dysfunction in case control groups. According to the analysis, elevation of serum TSH level increases the risk of spermatogenesis dysfunction by 5.0 times (OR=5.06, p<0.05). Conclusions Subclinical hypothyroidism adversely affect some sperm parameters, including motility and progressive motility. Subclinical hypothyroidism increases the risk of spermatogenesis dysfunction.

Purpose: Researchers suggest that the prevalence of infertility varies between developing and developed countries, with differences in infertility care, socioeconomic status, lifestyle, and reproductive disorders such as pelvic inflammatory disease and sexually transmitted infections being the main risk factors. The research project aims is to define risk factors for female fertility in the Mongolian population. Methods: This study was conducted between 2016-2018 using a cross-sectional survey of analytical research. Participants were randomly selected from Ulaanbaatar and the Central, Western, Eastern, and Khangai provinces according to Mongolia’s regional geographic model. The contents of a questionnaire were comprised of 5 units with 95 questions including socio-economic, geographical, lifestyle, health education, reproductive health indicators, sexual behavior. General physical characteristics were measured according to the standard. Results: The prevalence of the female fertility rate in the Mongolian population is 7.4%. Female participants were classified into 2 groups, namely infertile and fertile, and we developed a case-control study. Among the socio-economic factors influencing infertility, primary education aOR: 1.6 (95% CI 0.98-2.66), monthly household income lower than the average aOR: 1.1 (95% CI 0.77- 1.66), living in rural areas OR: 2.3 ( 95% CI 1.46-3.68) were crucial risk factors. As for reproductive and general health indicators, STIs aOR: 1.8 (95% CI 0.98-3.50), especially gonorrhea OR: 2.8 (95% CI 1.14-6.91), and thyroid disorders OR: 1.7 (95% CI 1.03). -2.97), grade 3 obesity OR: 3.8 (95% CI 1.05-13.95) are estimated risk factors for infertility. Conclusions Of all potential socio-economic factors, residence status, education and financial situation are significant for female infertility meanwhile reproductive health indicators include sexually transmitted infections, thyroid disease, and obesity.