糜蛋白酶对改善精液不液化的体外实验及恢复生育的临床观察

Clinical observation of chymotrypsin to improve nonliquefaction of semen in vitro and to recover fertility through endovaginal medication

目的探讨糜蛋白酶改善精液不液化及性生活时阴道内使用的方法及恢复生育的效果。方法选取精液不液化致不育的门诊患者76例,3～7d后重新检查其精液,并在其内加入糜蛋白酶4 000U,通过精液质量分析,了解其对精液不液化的改善情况。并将糜蛋白酶能改善精液的患者,采用糜蛋白酶4 000U用生理盐水3mL稀释后,于夫妻性生活过程中自行阴道内注射,了解受孕情况。另选用精液质量正常的健康志愿者15例及液化正常的异常精液志愿者17例,同样在3～7d后重新检查其精液,并在其内加入糜蛋白酶4 000U,通过精液质量分析,了解糜蛋白酶对正常精液及液化正常的异常精液有无影响。结果 76例患者加入糜蛋白酶后30min内精液完全液化,并能改善精子的活率与活力。76例患者均采用糜蛋白酶于夫妻性生活过程中自行阴道内注射治疗,其配偶受孕37例,受孕率48.7%;未受孕7例,未受孕率9.2%;24例因夫妻双方嫌操作麻烦,试用1～4次后放弃,放弃率31.6%;8例失访,失访率10.5%。糜蛋白酶对正常精液及液化正常的异常精液无明显影响。结论糜蛋白酶能有效改善精液不液化和精子的活率与活力。通过夫妻性生活过程中自行注射糜蛋白酶可恢复生育,但阴道内用药方式有待改进。

Objective To investigate the effect of improving nonliquefaction with chymotrypsin and recovering fertility through endovaginal medication. Methods 76 infertility sufferers of nonliquefaction of semen who come from clinic service were selected to recheck their semen with chymotrypsin for 4 000 international unit in 3-7 days, then through semen quality analysis we got the message about the improvement of nonliquefaction of semen. Choosing the patients whose semen could be improved by chymotrypsin to use 4 000 international unit of chymotrypsin with physiological saline for 3 milliliter to inject vagina in sexual activity to know the conceive situation. At the same time, 15 health volunteers and 17 volunteers of abnormity semen with normal liquefaction were selected and their semens were rechecked after 3-7 days. We put 4 000 international unit of chymotrypsin in them to know the effects of chymotrypsin on health screens and abnormity semens with normal liquefaction to act as control. Results All of 76 nonliquefaction of semen sufferers got improve to their semen when added chymotrypsin in vitro and it could improve the motility rate and vitality of spermatozoa. And all of them got treated by chymotrypsin through inject vagina in sexual activity. 37 patients spouses got pregnant the conception rate was 48.7%. 7 did not got pregnant,the rate was 9.2 %;0.24 gave up under the treatment because of the failure to insist,and the rate was 31.6%. 8 lost follow,the rate was 10.5%. It was no significant effect to normal semen and abnormity semen with normal liquefaction. Conclusion Chymotrypsin Could improve nonliquefaction of semen and the motility rate and vital cation Is ity of spermatozoa effectively. And it could recover fertility through inject vagina in sexual activity, while endovaginal medi to be improved.