男性不育患者精子形态与精子浓度和活力关系的研究

Study on relationship between sperm morphology and semen concentration or semen motility of male infertile patients

目的研究男性不育患者精子形态与精子浓度和活力的关系，探讨评估男性生育能力的最佳指标。方法90例男性不育患者，年龄25～40岁，身体健康，无特殊病史，精子浓度均在正常范围。利用Prader睾丸计评估患者睾丸容积，根据世界卫生组织标准（第5版）进行精液常规分析。结果90例男性不育患者按照精子形态分析结果分为3组，每组30人。组1为正常形态精子〈4％、组2为正常形态精子≥4％且〈10％、组3为正常形态精子≥10％。三组年龄分别为（31．27±5．32）岁、（32．60±5．36）岁和（32．23±4．53）岁，差异不具统计学意义，（P〉0．05）；左侧睾丸容积分别为（14．27±3．65）ml，（16．90±3．57）ml和（14．57±3．57）ml，组1与组2比较P〉0．01，组1与组3比较P〉0．05和组2与组3比较P〈0．05；右侧睾丸容积分别为（14．60±3．70）ml，（16．60±3．35）ml和（14．67±3．54）ml，P=0．05；精子浓度分别为（55．80±46．34）×10^6／ml，（76．21±58．40）×10^6／ml和（101．73±46．24）×10^6／ml，组1与组2比较P〉0．05，组1与组3比较P〈0．01，组2与组3比较P〉0．05；前向运动分别为（27．51±15．23）％，（42．97±16．93）％和（40．35±18．53）％，组1与组2比较P〈0．01，组1与组3比较P〈0．01，组2与组3比较P〉0．05。结论在精液常规分析3个主要参数（浓度，活力和形态），精子形态学分析结果对评估男性生育能力最重要，正常形态精子百分率高，其精子浓度也高、前向运动精子百分比也高，生育力可能也越强。

Objective To investigate the relationship between sperm morphology and sperm concentration or sperm motility, and find the best parameter for evaluation ofmale reproductive ability. Methods Ninety healthy male infertile patients were recruited in the study. The inclusion criteria was age from 25 to 40 years old, no special medical history, and their sperm concentration was within normal reference value. Testicular volume was evaluated by Prader orchidometer. Semen was analyzed according to WHO laboratory standard （fifth editon）. Results Ninety infertile patients was divided into 3 groups according to semen morphology result including Groupl （normal morphology 〈4%）, Group2（normal morphology ≥ 4% and （10%） and Group3（normal morphology ≥ 10%）. In 3 groups, patient age was 31.27±5.32, 32.60±5.36 and 32.23±4.53 respectively, P〉0.05; Left testis volume （milliliter） was 14.27±3.65, 16.90±3.57 and 14.57±3.57 respectively, Pgroup1.2 =0.006, Pgroup1,3=0.741and Pgroup2.3=0.014; Right testis volume （milliliter）was 14.60±3.70, 16.60±3.35 and 14.67±3.54 respectively, P=O.050; Sperm concentration（~ 106/ml） was 55.80~46.34, 76.21±58.40 and 101.73±46.24 respectively, Pgroup1.2 =0.112, Pgroupl.3=0.001 and Pgroup2,3=0.054; progressive motility（%） was 27.51±15.23, 42.974-16.93 and 40.354-18.53 respectively, Pgroup1.2 =0.001, Pgroupl.3=0.004 and Pgroup2.3=0. 551. Conelusion For three parameters such assperm concentration, motility and morphology, sperm morphology was the most important for evaluation of male reproductive ability. Our results suggested that if better sperm morphology, high sperm concentration and strong progressive motility might be better for male fertility.