从流行病学观点论精液分析

Semen Analysis from an Epidemiologic Perspective

在《世界卫生组织人类精液分析实验室技术手册》(简称手册)第5版中,首次增加了人类精液特征的参考值范围。现阐述提供这些数据是否有助于平息就某些问题引发的广泛争议,如时间地点不同,精液计数差异明显;能否证实某些假设,如人类活动向环境中排放的化学物质损害男性生殖健康等。也解释了这些参考值并不能解决上述问题的原因。虽然既定的精液特征参考值对流行病学研究的价值有限,但世界卫生组织(WHO)手册对建立合适的研究方案极具价值。尽管精液分析有局限性,但仍然是流行病学研究的有用工具,而且至今尚无其他更好的方法能取而代之。

The fifth edition of the World Health Organization （WHO） manual for semen analysis includes for the first time reference values for human semen characteristics. This paper considers whether such values will help to resolve the intensely debated data indicating temporal and geographical shifts in sperm counts and hypotheses that anthropogenic activities that result in the release of chemicals into the environment are detrimental to male reproductive health. The reasons that these reference values will not fulfil these purposes are also explained. Although established reference values for semen characteristics are of limited value in analytical epidemiologic research, the WHO guidelines are of utmost importance for supporting the development of appropriate research protocols. Moreover, in spite of its limitations, semen analysis is still a useful research tool in epidemiologieal research, and no superior alternatives are on the horizon.