内蒙古地区不育症病人精液常规检验结果分析

ASSESSMENT OF MALE INFERTILITY IN INNER MONGOLIA AND RELATIONSHIP OF SPERM MORPHOMETRY ANALYSIS WITH SPERM DEFORMITY INDEX

目的:统计了解内蒙古地区男性不育病人精子的一般性状,并探讨常规精子形态学分析中,离心洗涤步骤对分析结果的影响。方法:按照《WHO精液分析手册》,对619例精液进行密度和活率检测。其中47例标本常规密度及活率检测正常后,分别在离心前后涂片,应用快速苏木精-伊红染色法进行染色,检测精子头、尾部畸形率。对比精子畸形指数(sperm deformity index,SDI)和畸形精子指数(teratozoo spermia index,TZI)是否受到离心洗涤的影响。结果:在619例精液标本中,异常438例,其中弱精子症287例,占65.53%,单纯少精子症21例,占4.79%,无精子47例,占10.73%;正常181例,占29.24%;少精合并弱精83例,占18.95%。离心洗涤后的精子头部畸形率和正常精子率较离心前直接涂片无显著差异,尾部畸形率、SDI、TZI各指数在离心前后的差异均有统计学意义。结论:在内蒙古地区男性不育病人中,精子活率低占精液检测异常大部分,远远高于其他各指标,少精症和精子畸形症所占比例也不容忽视。精液常规参数结合精子计算机辅助分析能够更加准确反映精子的授精能力,指导临床治疗。精子形态学分析中离心精液对SDI和TZI有影响,但是不影响形态正常精子的比率。精液不经离心洗涤直接涂片适用于非严重少精及黏稠度低的标本。

Objective:To investigate the semen quality of the male infertility in Inner Mongolia and evaluate the influence of sperm washing on accuracy of sperm morphometry.Methods:The semen parameters of 619 samples were analysed strictly following the World Health Organization(WHO) guide,and for 47 sub fertile samples,smear preparation before and after centrifuged washing,then use HE staining,and assess the deformity ratio of sperm head,tail and SDI,TZI.Results:In the 619 semen samples,438(70.76%) are abnormal quality,including 287(65.53%) asthenospermia,47(10.73%) azoospermia,and 21(4.79%) oligozoospermia.While only 181(29.24%)are normal,83(18.95%) oligozoospermia with asthenospermia.The diversity ratio of deformed head and normal sperm have no significant difference before and after the washing procedure,but the ratio of tail abnormity,SDI,TZI have disparity,and the difference have statistical significance.Conclusion:Asthenospermia take a great part of male infertility in Inner Mongolia.Analyzing the quality of semen accurately is important to evaluate male fertility,especially computer-aided sperm analysis coupled with spermatozoa morphology count can provide the powerful evidence for the male infertility's diagnosis and treatment.These results indicate that sperm washing by centrifugation in morphology analyses has influence on SDI and TZI,but no influence on the ratio of eumorphism sperm.The direct smear preparation is applicable for the non-severity oligospermatism and the specimen of low viscosity.