复发性流产男性精浆弹性蛋白酶与精液参数及DNA碎片率的相关性分析

The correlative analysis of seminal elastase on semen parameters and DNA fragmentation in the male patients of recurrent pregnancy loss

目的我们探讨2019年6月—2020年1月复发性流产夫妇男性患者精浆弹性蛋白酶同精液参数及DNA碎片率的可能关系。方法研究对象纳入80例复发性流产的男性患者及25例因女方输卵管因素行IVF-ET正常生育的男性患者。精液标本用来进行精浆弹性蛋白酶、精液常规分析、精子核染色质分析及精子形态学等参数分析。结果结果表明同正常生育男性相比,复发性流产的弹性蛋白酶是增高(P=0.010)。我们将复发性流产男性患者分为正常组(<600 ng/mL)及异常组(≥600 ng/mL)。结果表明异常组患者的精子前向运动比例(P=0.002)及正常形态百分率(P=0.009)均降低,而精子DNA碎片率(P=0.002)增高。Spearman相关性分析发现精浆弹性蛋白酶同精子前向运动比例(r=-0.43,P<0.001)及正常形态百分率(r=-0.39,P<0.001)负相关,而同精子DNA碎片率(r=0.36,P=0.001)正相关。结论精浆弹性蛋白酶可能影响复发性流产男性患者的精子活力、形态及DNA碎片率。复发性流产男性患者的生殖道隐性感染值得重视,其相关临床探讨性值得深入研究。

Objective Our study is aim to investigate the possible relationship of seminal elastase,on semen parameters and DNA fragmentation in male patients of recurrent pregnancy loss(RPL)between June 2019 and January 2020.Methods The patients included 80 male patients of RPL couple and 25 male patients from couples with clinical pregnancy through in vitro fertilization due to the female tubal factor.The semen samples were used to determine the seminal elastase,computed assisted semen analysis,sperm dispersion test and sperm morphology analysis.Results Compared to the control group,the levels of seminal elastase was increased in the RPL group.The RPL group was divided into the normal group(Elastase<600 ng/mL)and abnormal group(Elastase≤600 ng/mL).The abnormal group exhibited the lower percentage of progressive sperm(P=0.002)and normal morphology(P=0.009),but higher precentage of DNA fragmentation(P=0.002).Meanwhile,the seminal elastase was positively associated with DNA fragmentation(r=0.36,P=0.001),but was inversely associated with the sperm motility(r=-0.43,P<0.001)and normal morphology(r=-0.39,P<0.001).Conclusion Our study may unveil the possible effects of the seminal elastase on the semen parameters and DNA fragmentation in the male patients of RPL couples.Further studies should put more emphasis on the silent genital tract inflammation of the patients.