抗精子抗体与精子密度、精子活率、精子正常形态及人工授精助孕结局关系

Relationship between anti-sperm antibody positive rate,concentration of sperm,forward motility of sperm,and atypical forms of sperm of the man and their pregnancy outcomes after artificial insemination

目的:探讨抗精子抗体(AsAb)与精子密度、精子活率、精子形态以及人工受精助孕结局的关系。方法:选取本院2017年10月—2020年7月接诊的男性不育患者152例,混合抗球蛋白凝集法检测AsAb,根据检测结果分为AsAb阳性组(57例)、AsAb阴性组(95例)。观察阳性组抗体结合部位分类情况,比较两组精子密度、精子活率、正常形态率、前向活动力并分析人工授精助孕结局,采用Spearman相关性分析AsAb与精液常规参数的相关性。结果:AsAb阳性组阳性粘附率14.0%,其中尾部黏附运动精子5例、头部黏附运动精子2例、颈部黏附运动精子1例;精子密度、精子总活率以及前向活动率及正常形态率均低于AsAb阴性组(P<0.05);人工授精助孕妊娠率、流产率两组未见差异(P>0.05);AsAb与精子密度、精子总活率、前向活动率、正常形态率均呈负相关(P<0.05)。结论:AsAb阳性对男性不育者精子密度、精子总活率、精子正常形态以及人工受精助孕结局有明显影响。

Objective:To investigate the relationship between anti-sperm antibody(AsAb)positive rate,concentration of sperm,forward motility of sperm,and atypical forms of sperm of the man and their pregnancy outcomes after artificial insemination.Methods:152 male infertility patients were selected as study subjects from January 2017 to September 2020.The AsAb positive rate of these patients was detected by Mixed Antiglobulin Reaction(MAR),and these patients were divided into group A(57 patients with AsAb positive)and group B(95 patients with AsAb negative)according to the test results of AsAb.The classification of antibody binding sites of the patients in group A was observed.The concentration of sperm and the rates of motility,normal morphology,and forward motility of sperm of the patients were compared between the two groups.Spearman correlation was used to analyze the correlation between AsAb positive rate of the patients and their seminal parameters.Results:The positive adhesion rate of sperm of the patients in group A was 14.0%,which included 5 cases with tail adhesion of sperm,2 cases with head adhesion of sperm,and 1 case with neck adhesion of sperm.The sperm density,total sperm motility,and forward motility sperm rate of the patients in group A were significant lower than those of the patients in group B,and the normal morphology sperm rate of the patients in group A was significant higher than that of the patients in group B(P<0.05).There were no significant differences in pregnancy rate and abortion rate of the patients after artificial insemination between the two groups(P>0.05).AsAb positive rate was negatively correlated with the sperm density,the total sperm motility rate,the sperm forward motility rate,or normal sperm morphology rate(P<0.05).Conclusion:AsAb positive has significant impact on concentration of sperm,forward motility of sperm,normal morphology of sperm,and pregnancy outcome after artificial insemination.