影响北京地区11973份精液标本质量的多因素分析

Multivariate data analysis of 11,973 male semen qualities in Beijing area

目的分析年龄、取精季节和禁欲天数等多个因素对北京地区男性精液质量的潜在影响,探讨男性最佳取精时机。方法选取2016年12月至2020年11月首都医科大学附属北京朝阳医院泌尿外科门诊行精液分析的男性作为研究对象,比较精液质量正常与异常者的精液质量参数特征,并分别按年龄段(10~岁、20~岁、30~岁、40~岁和50~岁)、取精季节[春季(3~5月)、夏季(6~8月)、秋季(9~11月)和冬季(12~2月)]和禁欲天数(≤2d、3d、4d、5d、6d、7d和≥8d)作分层比较,分析上述因素对男性精液质量的影响。结果11973例研究对象中精液质量完全正常者占比为37.8%;20~岁精液正常者占比高达40.9%,此后精液正常占比及精液量、精子活力和正常形态率等均随男性年龄增加而下降;夏季取精时研究对象的精液正常人数比例最高达41.0%,且精子浓度和精子总数较高;禁欲5d和6d时男性精液正常占比最高,均为35.7%,在禁欲7d内随禁欲时间的延长,男性的精液量、精子浓度和精子总数等指标均明显提高。结论男性精液质量在20~岁、夏季及禁欲5~6d时最佳,优化取精时机对提高男性生殖健康水平有重要指导意义。

Objective To investigate the potential effects of age,semen retrieval season and abstinence days on male semen qualities in Beijing area and to explore the optimal timing of semen extraction.Methods Men who underwent semen analysis in the Department of Urology,Beijing Chao-yang Hospital,Capital Medical University from December 2016 to November 2020 were selected as research subjects,and the characteristics of semen quality parameters of normal and abnormal semen quality were compared.They were stratified by age(10-,20-,30-,40-,and 50-),semen collection season[spring(March-May),summer(June-August),autumn(September-November),and winter(December-February)]and abstinence days(≤2 d,3 d,4 d,5 d,6 d,7 d,and≥8 d).The influence of above factors on semen quality was analyzed.Results 37.8% of 11,973 subjects had normal semen quality.The proportion of men with normal semen quality in the 20-year-olds subgroup was as high as 40.9%,and the proportion of normal semen,semen volume,sperm motility and normal morphology decreased with the increase of age of men.In summer,the proportion of men with normal semen quality was up to 41.0%,and the sperm concentration and total sperm count were higher than in other seasons.The highest proportion of men with normal semen quality was 35.7% when abstinence for 5 d and 6 d,and within 7 d of abstinence,the levels of semen volume,sperm concentration,and total sperm count were significantly increased with the extension of abstinence time.Conclusions Men have the best semen quality when they are in the 20-year-olds,semen retrieved in summer and abstinence for 5-6 d.Optimizing sperm extraction conditions has important significance for improving male reproductive health.