精液采集地点对精液质量影响的实验研究

Location of semen collection and semen quality: Clinic-collected versus home-collected samples

目的:调查在医院门诊和在家中通过自慰法收集的精液质量之间的差异。方法:对342例男性患者在医院门诊和在家中通过手淫法收集的精液样本,按WHO第5版操作标准常规分析精液,并测量反映附睾、前列腺和精囊腺功能状态的精浆标志物,即精浆中性α-葡糖苷酶(NAG)、锌(Zn)和果糖(FRU)含量。按照取精地点分成两组:在医院门诊和在家中,软件分析取精地点与精液参数的关系。结果:在家中收集的精液在精液量、精子浓度、精子总数和前向运动精子百分率(PR)方面均明显优于在医院门诊收集的精液;而精子形态、NAG、Zn和FRU在两组之间无显著性差异。精子浓度异常(<20×106/ml)和精子活动率异常[PR<32%]的精液样本,在家中获得的样本率[18%(62/342);64%(219/342)]均明显低于在医院门诊取精室获得的样本率[30%(103/342);75%(256/342)],两组之间均有显著差异。结论:与在医院门诊取精液相比,在家中手淫法取精液能获得更好的精液质量。在不孕症评估过程中,应该考虑取精液的环境因素。

Objective： To investigate the differences in semen quality between samples collected by masturbation in the clinic and at home. Methods： Based on the WHO guidelines,we analyzed the ejaculates collected by masturbation in the clinic and at home from 342 men under infertility assessment and measured the contents of such biochemical markers in the seminal plasma as neutral α-glucosidase,zinc,and fructose. According to the location of semen collection,we divided the samples into two groups,cliniccollected and home-collected,and analyzed the differences in the semen parameters between the two groups with the SPSS 16. 0 software. Results： Compared with the clinic-collected semen,the home-collected samples had significantly higher mean values in semen volume（ 4. 0 vs 4. 9%）,sperm concentration（ 41 vs 64 × 106/ ml）,total sperm count（ 175 vs 270 × 106 per ejaculate）,progressive sperm motility（ 40 vs 52 %）,total count of progressively motile sperm（ 82 vs 135 × 106 per ejaculate）（ all P〈0. 05）. No significant differences were found between the two groups in normal sperm morphology（ 4. 0 vs 5. 0%） and the contents of neutral α-glucosidase（ 26 vs 24 m U per ejaculate）,zinc（ 8. 0 vs 8. 0 μmol per ejaculate）,and fructose（ 62 vs 60 μmol per ejaculate）（ all P〉 0. 05）. Abnormal sperm concentration（ 〈20 × 106/ ml） was observed in significantly fewer of the home-collected samples than the clinic-collected ones（ 18% [62 /342] vs 30% [103 /342],P〈0. 05）,and so was abnormal progressive sperm motility（ 〈32%）（ 64% [219 /342] vs 75% [256 /342],P〈0. 05）. Conclusion： Our findings show that semen samples collected by masturbation at home has a higher quality than those collected in the clinic. So the location of semen collection should be taken into consideration in infertility investigation.