不育男性精子DFI、HDS与精子畸形程度及患者年龄的相关性研究

Correlation of sperm DNA fragmentation index and high DNA stainability with teratospermia severity and the patient’s age: A study of 1 393 infertile males

目的:探讨男性不育患者精子畸形程度及患者年龄与精子DFI、HDS的关系。方法:选取2021年7~12月来湖南省妇幼保健院就诊的1 393例男性不育患者精液标本,按照WHO《人类精液检查与处理实验室手册》第5版标准行精子形态分析,采用流式细胞术检测精子DNA碎片指数(DFI)、高可染性指数(HDS),并根据精子畸形程度及年龄分组,探讨精子畸形严重程度及患者年龄对精子DFI、HDS的影响。结果:1 393例不育男性中极度、重度、中度、轻度畸形精子症患者及精子形态正常患者分别为124例(8.90%)、214例(15.36%)、235例(16.87%)、163例(11.70%)、657例(47.16%),各组之间DFI、HDS相比有统计学差异(P<0.05),精子DFI、HDS与正常精子形态百分率负相关;1 393例不育男性中<35岁、35~<40岁、40~<45岁、≥45岁分别为822例(59.00%)、306例(21.97%)、223例(16.01%)、42例(3.02%),各年龄组之间DFI、HDS相比有统计学差异,精子DFI、HDS与患者年龄呈正相关。结论:畸形精子百分率增高、年龄增加与精子DFI、HDS增加相关,精子核染色质完整性及成熟度检测是评估男性生育力的重要指标。

Objective: To investigate the correlation of the severity of teratospermia and the age of the patient with sperm DNA fragmentation index(DFI) and high DNA stainability(HDS) in male infertility patients. Methods: We collected semen samples from 1 393 infertile males from July to December 2021. Based on the WHO Laboratory Manual for the Examination and Processing of Human Semen(5th Ed), we performed sperm morphology analysis, examined perm DFI and HDS by flow cytometry, and analyzed the impacts of the severity of teratospermia and the age of the patients on sperm DFI and HDS. Results: Among the 1 393 male infertility patients, 124(8.90%) were found with extremely severe, 214(15.36%) with severe, 235(16.87%) with moderate, 163(11.70%) with mild teratospermia, and 657(47.16%) with morphologically normal sperm(MNS), with statistically significant differences in sperm DFI and HDS among the five groups, and 822(59.00%) were aged <35 years, 306(21.97%) 35-<40 years, 223(16.01%) 40-<45 years and 42(3.02%) ≥45 years, with statistically significant differences in sperm DFI and HDS among different age groups(P < 0.05). Sperm DFI and HDS were correlated negatively with the percentage of MNS(P > 0.05), but positively with the age of the patients(P < 0.05). Conclusion: Increased severity of teratospermia and age of the patient can increase sperm DFI and HDS, and sperm nuclear chromatin integrity and maturity are important indicators of male fertility.