Leukocytes and oxidative stress： dilemma for sperm Function and male fertility

Spermatozoa are constantly exposed to the interphase between oxidation through high amounts of reactive oxygen species （ROS） and leukocytes, and reduction by means of scavengers and antioxidants. Considering the very special functions as being the only cells with such high polarization and exerting their functions outside the body, even in a different individual, the female genital tract, the membranes of these cells are chemically composed of an extraordinary high amount of polyunsaturated fatty acids. This in turn, renders them very susceptible to oxidative stress, which is defined as an imbalance between oxidation and reduction towards the oxidative status. As a result, ROS deriving from both leukocytes and the male germ cells themselves cause a process called ＇lipid peroxidation＇ and other damages to the sperm cell. On the other hand, a certain limited amount of ROS iS essential in order to trigger vital physiological reactions in cells, including capacitation or the acrosome reaction in sperm. The treatment of patients with antioxidants to compensate the oxidative status caused by oxidative stress is highly debated as uncontrolled antioxidative treatment might derail the system towards the reduced status, which is also unphysiological and can even induce cancer. This paradox is called the ＇antioxidant paradox＇. Therefore, a proper andrological diagnostic work-up, including the evaluation of ROS levels and the antioxidant capacity of the semen, has to he carried out beforehand, aimed at keeping the fine balance between oxidation and scavenging of vital amounts of ROS.

Semen analysis and sperm function testing

Despite controversy regarding the clinical value of semen analysis, male fertility investigation still relies on a standardized analysis of the semen parameters. This is especially true for infertility clinics in both developing and developed countries. Other optional tests or sophisticated technologies have not been widely applied. The current review addresses important changes in the analysis of semen as described in the new World Health Organization （WHO） manual for semen analysis. The most important change in the manual is the use of evidence-based publications as references to determine cutoff values for normality. Apart from the above mentioned changes, the initial evaluation and handling methods remain, in most instances, the same as in previous editions. Furthermore, the review evaluates the importance of quality control in andrology with emphasis on the evaluation of sperm morphology. WHO sperm morphology training programmes for Sub-Saharan countries were initiated at Tygerberg Hospital in 1995. The external qualitY control programme has ensured that the majority of participants have maintained their morphological reading skills acquired during initial training. This review reports on current sperm functional tests, such as the induced acrosome reaction, and sperm-zona pellucida binding assays, as well as the impact of sperm quality in terms of DNA integrity, and the relationship of sperm function tests to sperm morphology.

Ameliorative effect of Punica granatum on sperm parameters in rats exposed to mobile radioelectromagnetic radiation

Objective:To study the effect of mobile emitted radio frequency electromagnetic radiation(RF-EMR)on sperm parameters(sperm count,viability,motility,progressivity,and morphology)and ameliorative effect of pomegranate juice in rats.Methods:Thirty male Sprague Dawley rats were divided into five groups(n=6 in each group).GroupⅠwas neither exposed to RF-EMR nor given pomegranate juice,groupⅡ,ⅢandⅣwere exposed to mobile emitted RF-EMR for 60 min/day for 90 days.After 90-day exposure to RF-EMR,groupⅢwas supplemented with pomegranate juice for 90 days(1 mL/day)and groupⅣwas allowed to recover for 90 days without supplementation of pomegranate juice.GroupⅤwas supplemented with pomegranate juice for 90 days without exposure to RF-EMR.At the end of intervention,epididymal sperm parameters(sperm count,viability,motility,progressivity,and morphology)were measured.Results:The microscopic examination of sperm parameters such as sperm count,sperm viability,sperm motility,progressivity were significantly decreased in groupⅡ(the mobile RF-EMR group)compared to groupⅠ(the control group)(P<0.05).In addition,sperm morphology was also significantly altered(abnormal)in groupⅡcompared to groupⅠ(P<0.05).However,the sperm parameters including sperm morphology were significantly altered in groupⅢ(mobile RF-EMR+pomegranate juice)compared to groupⅡ(P<0.05).The sperm parameters including sperm morphology were not significantly altered in groupⅣ(the mobile RF-EMR recovery group)compared to groupⅡ(P>0.05).The sperm parameters were non-significantly increased in group V(the pomegranate juice group)compared to groupⅠ(P>0.05).Conclusions:Mobile RF-EMR exposure reduces the sperm parameters,which,however,can be reversed by treatment with pomegranate juice,indicating that pomegranate juice can be used as a nutritional supplement to improve sperm quality.

Effects of Medicines and Supplements on Spontaneous Pregnancy and Semen Parameters in Male Infertility:A Systematic Review Update and Network Meta-Analysis

In this study,we used a network meta-analysis(NMA)to compare the effectiveness of medicines and supplements for idiopathic male infertility and to identify the best treatment.Medline,Excerpta Medica Database(EMBASE),Ovid,and China National Knowledge Infrastructure(CNKI),were searched for the period from January 1990 to June 2021 using the keywords"male infertility,""medical therapy,""supplement/nutrient therapy,"and related terms.Randomized controlled trials(RCTs)investigating medicines(mainly follicle-stimulating hormone(FSH),androgen,and clomiphene/tamoxifen)or supplements(mainly zinc,selenium,vitamin C or E,carnitine,coenzyme Q10(CoQ10),or combined treatment)for idiopathic infertile men were selected for meta-analysis.Preferred reporting items for systematic reviews and meta-analysis(PRISMA)was used for data extraction,and a risk-of-bias tool and grades of recommendation,assessment,development,and evaluation(GRADE)system adapted to the NMA were employed to assess the quality of the evidence.The primary outcomes were live birth and spontaneous pregnancy rate(SPR).The secondary outcomes were sperm parameters(including concentration,progressive motility,and morphology)and side effects.In total,65 RCTs involving 7541 men with sperm abnormalities but normal hormone levels were included.A total of 36 studies reported SPR but only three reported live birth rates.The quality of the included studies was found to be moderate to high.Compared with a placebo or being untreated,carnitine plus vitamins significantly improved SPR(relative risk(RR)=3.7,95%confidence interval(95%CI),1.6-8.5);fatty acids significantly increased sperm concentrations(mean difference(MD)=12.5×10^(6)mL-1,95%CI,3.1×10^(6)-22.0×10^(6));and selective estrogen receptor modulator(SERM)plus CoQ10 significantly improved sperm progressive motility(MD=11.0%,95%CI,0.1%-21.9%)and normal sperm morphology(MD=11.0%,95%CI,4.6%-17.4%).The most optimal intervention was carnitine plus vitamins and fatty acids for SPR and sperm concentrations,respectively,even after excluding trials at a high risk of bias.Compared with a placebo or being untreated,FSH(RR=4.9,95%CI,1.1-21.3)significantly increased SPR,whereas SERM plus kallikrein increased sperm concentration(MD=16.5×10^(6)mL^(-1),95%CI,1.6×10^(6)-31.4×10^(6)),and SERM plus CoQ10 significantly improved sperm progressive motility(MD=11.3%,95%CI,7.3%-15.4%)and normal morphology(MD=11.2%,95%CI,5.4%-16.9%)in men with oligoasthenozoospermia(OA).In terms of side effects,fatty acids and pentoxifylline were associated with foul breath and/or a bad taste(RR=8.1,95%CI,1.0-63.5)and vomiting(RR=8.0,95%CI,1.0-63.0),respectively.In conclusion,the optimal treatment for male infertility for live birth is still unknown.Carnitine plus vitamins and FSH are likely to be better than other therapies in achieving successful spontaneous pregnancy in couples overall and in cou ples with men with OA,respectively.The efficacy of other treatments on pregnancy outcomes warrants further verification.

Lycopene and male infertility

Excessive amounts of reactive oxygen species （ROS） cause a state of oxidative stress, which result in sperm membrane lipid peroxidation, DNA damage and apoptosis, leading to decreased sperm viability and motility. Elevated levels of ROS are a major cause of idiopathic male factor infertility, which is an increasingly common problem today. Lycopene, the most potent singlet oxygen quencher of all carotenoids, is a possible treatment option for male infertility because of its antioxidant properties. By reacting with and neutralizing free radicals, lycopene could reduce the incidence of oxidative stress and thus, lessen the damage that would otherwise be inflicted on spermatozoa. It is postulated that lycopene may have other beneficial effects via nonoxidative mechanisms in the testis, such as gap junction communication, modulation of gene expression, regulation of the cell cycle and immunoenhancement. Various lycopene supplementation studies conducted on both humans and animals have shown promising results in alleviating male infertility--lipid peroxidation and DNA damage were decreased, while sperm count and viability, and general immunity were increased. Improvement of these parameters indicates a reduction in oxidative stress, and thus the spermatozoa is less vulnerable to oxidative damage, which increases the chances of a normal sperm fertilizing the egg. Human trials have reported improvement in sperm parameters and pregnancy rates with supplementation of 4-8 mg of lycopene daily for 3-12 months. However, further detailed and extensive research is still required to determine the dosage and the usefulness of lycopene as a treatment for male infertility.

Does alcohol have any effect on male reproductive Function？ A review of literature

Although alcohol is widely used, its impact on the male reproductive function is still controversial. Over the years, many studies have investigated the effects of alcohol consumption on sperm parameters and male infertility. This article reviews the main preclinical and clinical evidences. Studies conducted on the experimental animal have shown that a diet enriched with ethanol causes sperm parameter abnormalities, a number of alterations involving the reproductive tract inhibition, and reduced mouse oocyte in vitro fertilization rate. These effects were partly reversible upon discontinuation of alcohol consumption. Most of the studies evaluating the effects of alcohol in men have shown a negative impact on the sperm parameters. This has been reported to be associated with hypotestosteronemia and low-normal or elevated gonadotropin levels suggesting a combined central and testicular detrimental effect of alcohol. Nevertheless, alcohol consumption does not seem to have much effect on fertility either in in vitro fertilization programs or population-based studies. Finally, the genetic background and other concomitant, alcohol consumption-related conditions influence the degree of the testicular damage. In conclusion, alcohol consumption is associated with a deterioration of sperm parameters which may be partially reversible upon alcohol consumption discontinuation.

Decline of semen quality among 10 932 males consulting for couple infertility over a 20-year period in Marseille, France

Semen from 10 932 male partners of infertile couples was analysed and sperm parameter trends were evaluated at the Reproduction Biology Laboratory of the University Hospital of Marseille （France） between 1988 and 2007. After 3-6 days of abstinence, semen samples were collected. Measurements of seminal fluid volume, pH, sperm concentration, total sperm count, motility and detailed morphology of spermatozoa were performed. Sperm parameters were analysed on the entire population and in men with normal total numeration （ 〉~ 40 million per ejaculate）. The whole population demonstrated declining trends in sperm concentration （1.5% per year）, total sperm count （1.6% per year）, total motility （0.4% per year）, rapid motility （5.5% per year） and normal morphology （2.2% per year）. In the group of selected samples with total normal sperm count, the same trends of sperm quality deterioration with time were observed. Our results clearly indicate that the auality of semen decreased in this population over the study period.

精子线粒体膜电位作为综合评估男性生育能力指标的初探

目的本研究旨在探讨精子线粒体膜电位(MMP)与精液常规、精子形态学以及精子DNA碎片指数(DFI)之间的关联,以及MMP对于临床评估和预测男性生育能力的价值。方法选择2023年4—7月于江苏省中医院男科进行孕前优生检查、生育咨询以及不育症治疗的患者的精液标本为研究对象,按照世界卫生组织(WHO)第5版标准进行精液常规和精子形态学分析,并通过流式细胞术检测精子DFI和MMP。根据不同精液质量分为两组:精液质量各项指标均正常,即精液量>2 ml、pH值7.2~7.8、精子浓度≥15×106/ml,精子前向运动(PR)≥32%、精子形态正常率≥4%、DFI<30%为精液质量正常组(n=57);PR<32%、精子形态正常率<4%、DFI≥30%为精液质量异常组(n=67),比较两组精液质量各项参数;采用Spearman相关性分析,分析MMP与精子浓度、PR、精子形态正常率以及DFI之间的关系;绘制受试者工作特征曲线(ROC),分析MMP对于临床评估男性生育能力的价值。结果两组间平均年龄、精液量比较均无显著差异(P>0.05),精液质量正常组精子浓度、PR、精子形态正常率、MMP显著高于精液质量异常组(P<0.05),DFI显著低于精液质量异常组(P<0.05);Spearman相关性分析结果显示,MMP与精液量无明显相关性(r=-0.065,P=0.475),与精子浓度(r=0.396,P<0.001)、PR(r=0.471,P<0.001)、精子形态正常率(r=0.468,P<0.001)呈显著正相关,与DFI(r=-0.701,P<0.001)呈显著负相关;ROC分析结果显示,MMP对精液质量整体水平预测的ROC曲线下面积(AUC)为0.891,敏感度87.5%,特异性83.3%,截断值53.69%;MMP对精子浓度预测的AUC为0.787,敏感度82.0%,特异性69.2%,截断值43.97%;MMP对PR预测的AUC为0.741,敏感度65.7%,特异性84.2%,截断值56.33%;MMP对精子形态正常率预测的AUC为0.733,敏感度71.1%,特异性69.1%,截断值56.63%;MMP对DFI预测的AUC为0.809,敏感度89.5%,特异性72.1%,截断值54.78%。结论精子MMP与精子浓度、PR、精子形态正常率呈显著正相关,与DFI呈显著负相关。与各单项精液指标相比,MMP能更全面地反映精子能量代谢和凋亡,推荐将MMP 54%作为全面评估和预测男性生育能力的参考值下限。

《世界卫生组织人类精液检查与处理实验室手册》版本演变及临床意义

精液分析是男性生育力评估的基石,《世界卫生组织人类精液检查与处理实验室手册》是公认的精液分析指南,为全世界精液检查程序的标准化和参考值提供了基础。自第1版问世以来已经过去了40余年,期间用于评价精液质量的实验室方法发生了显著变化,检测的精确度和准确性得到了提高。随着男科学和生殖医学的不断进步及辅助生殖技术的出现和进展,该手册不断更新并引入新的、基于循证医学的检测方法,除了进行精液常规分析,还可以评估精子功能以满足临床需要。2021年第6版发布,提供了满足评估男性生殖功能、生育保健、不育症的诊断与治疗所需实验室程序的最新循证信息。本文对手册的演变进行了梳理和分析,并强调了更新之处及其临床应用价值,希望其能够获得广泛接受和应用。

Exploring the impact of pericentric inversion of chromosome 9 on fertility in sperm donors

Pericentric inversion of chromosome 9(inv[9])is a common chromosomal structural variant,but its impact on clinical outcomesremains debated.The screening criteria of sperm banks are rarely mentioned to individuals with inv(9).In this study,we evaluatedthe fertility of sperm donors with inv(9)who met eligibility criteria for sperm banks(inv[9]-eligible donors).From March 2004 toMay 2022,chromosomal analysis of 16124 sperm donors at CITIC-Xiangya Human Sperm Bank in Hunan Province(Changsha,China)found that 251(1.6%)had chromosome variations,with inv(9)being the most prevalent at 1.1%.All 169 inv(9)-eligibledonors were contacted to collect fertility outcome data,along with 206 eligible donors without inv(9)as controls.In addition,semen samples from inv(9)-eligible donors and eligible donors underwent assessments of sperm fluorescence in situ hybridization(FISH),mitochondrial membrane potential,DNA fragmentation index,acrosome integrity,reactive oxygen species(ROS),andsperm morphology.Results showed that inv(9)did not significantly increase reproductive risks overall.Despite detecting ROSlevel differences,the clinical impact may be insignificant.This study provides new data on the inv(9)population that can serveas a valuable reference for decision-making by sperm banks as well as for genetic counseling and clinical guidance for individualscarrying inv(9)variant.

男性不育患者精子线粒体膜电位及顶体酶活性检测研究

目的:探讨男性不育患者精子线粒体膜电位(MMP)及顶体酶活性检测研究。方法:选取2022年7月—2023年7月赤峰学院附属医院收治的102例男性不育患者为研究组,并依据实际情况分为弱畸精子症组、弱精子症组、畸精子症组,各34例;同时选取102例健康男性作为对照组。各组均进行顶体酶活性检测以及精子线粒体膜电位检测,对比检测结果。结果:相较于对照组,研究组的顶体酶活性、MMP更低,差异有统计学意义(P<0.05)。与弱精子症组相比,畸精子症组的MMP明显降低,弱畸精子症组的MMP、顶体酶活性显著降低,差异有统计学意义(P<0.05);与畸精子症组相比,弱畸精子症组顶体酶活性明显降低,差异有统计学意义(P<0.05)。相较于对照组,研究组的正常形态精子百分率(PNM)、精子向前运动率(PFM)更低,差异有统计学意义(P<0.05)。与弱精子症组相比,畸精子症组、弱畸精子症组的PNM显著降低,差异有统计学意义(P<0.05);与畸精子症组相比,弱畸精子症组PFM、PNM明显降低,差异有统计学意义(P<0.05)。研究组的MMP、顶体酶活性与PFM、PNM之间呈正相关性(P<0.05)。结论:在男性生育能力诊断中,顶体酶活性以及MMP检测的价值较高,检测结果和精子形态、活动力密切相关,是评定男性不育患者精子质量的重要检测指标。

不育患者精浆弹性蛋白酶、精子DNA碎片指数与精液常规参数的相关性研究

目的研究探讨不育患者精浆弹性蛋白酶(SPE)、精子DNA碎片指数(DFI)与精液常规参数的相关性。方法选取2020年06月~2022年06月就诊的155例男性不育患者为研究对象纳入观察组,另选同期进行健康体检的有正常生育史男性50例为对照组。采集观察组患者和对照组受试者精液样本,以酶联免疫吸附试验法检测SPE,以吖啶橙染色配合流式细胞仪技术检测DFI,按照《WHO人类精液检查与处理实验室手册》检测精液常规参数。对观察组、对照组SPE、DFI、精液常规参数进行统计比较,并采用Pearson检验对SPE、DFI与精液常规参数的相关性进行分析探讨。结果观察组患者的SPE、DFI高于对照组受试者(P<0.05)。观察组患者的精液常规参数包括精子活力、向前运动精子率、正常形态率均低于对照组受试者(P<0.05),两组精液量、精子浓度、精液pH值比较无差异性(P>0.05)。经Pearson检验分析,不育患者SPE、DFI与精子活力、向前运动精子率、正常形态率呈负相关性,与精液量、精子浓度、精液pH值无相关性。结论在不育男性患者中SPE、DFI呈现高表达,并且与精液常规参数精子活力、向前运动精子率、正常形态率呈负相关性。因此,通过对SPE、DFI的检测,可作为精液常规分析的补充指标,对于男性不育症的诊断及病情评估有重要意义。

Specialized sperm function tests in varicocele ant Ihe future of andrology laboratory

Varicocele is a common medical condition entangled with many controversies. Though it is highly prevalent in men with infertility, still it marks its presence in males who do have normal fertility. Determining which patients are negatively affected by varicocele would enable clinicians to better select those men who benefitted the most from surgery. Since conventional semen analysis has been limited in its ability to evaluate the negative effects of varicocele on fertility, a multitude of specialized laboratory tests have emerged. In this review, we examine the role and significance of specialized sperm function tests with regards to varicocele. Among the various tests, analysis of sperm DNA fragmentation and measurements of oxidative stress markers provide an independent measure of fertility in men with varicocele. These diagnostic modalities have both diagnostic and prognostic information complementary to, but distinct from conventional sperm parameters. Test results can guide management and aid in monitoring intervention outcomes. Proteomics, metabolomics, and genomics are areas; though still developing, holding promise to revolutionize our understanding of reproductive physiology, including varicocele.

Chlamydia trachomatis infection in the genital tractis associated with inflammation and hypospermia inthe infertile male of China

Chlamydia trachomatis (CT) infection is the most prevalent sexually transmitted bacterial disease worldwide. However, unlikethat in female infertility, the role of CT infection in male infertility remains controversial. The objective of this retrospective studywas to explore the impacts of CT infection in the genital tract on sperm quality, sperm acrosin activity, antisperm antibody levels,and inflammation in a large cohort of infertile males in China. A total of 7154 semen samples were collected from infertile malesubjects, 416 of whom were CT positive (CT+ group) and 6738 of whom were CT negative (CT− group), in our hospital betweenJanuary 2016 and December 2018. Routine semen parameters (semen volume, pH, sperm concentration, viability, motility,morphology, etc.), granulocyte elastase levels, antisperm antibody levels, and sperm acrosin activity were compared between theCT+ and CT− groups. Our results showed that CT infection was significantly correlated with an abnormally low semen volume, aswell as an increased white blood cell count and granulocyte elastase level (all P < 0.05) in the semen of infertile males;otherroutine semen parameters were not negatively impacted. The antisperm antibody level and sperm acrosin activity were not affectedby CT infection. These findings suggested that CT infection might contribute to inflammation and hypospermia but does not impairsperm viability, motility morphology, and acrosin activity or generate antisperm antibodies in the infertile males of China.

精子形态与精子运动参数关系研究

目的:探讨精子形态与精子运动参数关系。方法:783例不育患者,采用精子自动分析系统分析精子运动参数,采用精子形态检测系统下人工修正方法进行精子形态分析。精子形态正常组241例,异常组542例。结果:精子形态异常组精子曲线速度(VCL)、摆动性(WOB)、平均路径速度(VAP)均显著高于精子形态正常组(P<0.05,P<0.001),而精子形态异常组精子平均移动角度(MAD)、直线性(LIN)、前向性(STR)均显著低于精子形态正常组(P<0.05,P<0.001);形态正常精子百分率与MAD、LIN、WOB、STR有显著正相关性,而与侧摆幅度(ALH)有显著负相关。结论:精子形态异常和运动能力弱相伴产生,形态异常对精子运动的影响可能只是这一现象产生的次要原因,而一些共同作用于精子形态和运动能力的因素也许是导致这一现象产生的主要原因。

精浆抗精子抗体对精子形态及运动特征的影响

目的:探讨精浆抗精子抗体(AsAb)对精子形态和运动特征的影响。方法:检测251例男性不育患者精液样本,采用酶联免疫法进行AsAb检测,计算机自动分析精子运动特征,采用精子形态检测系统下人工修正方法进行精子形态分析。结果:251例男性不育患者中,AsAb阳性率为17·13%。AsAb阳性组正常形态精子百分率与阴性组无显著性差异(P>0·05),大头精子和锥形头精子百分率显著高于AsAb阴性组(P<0·05,P<0·005)。精浆AsAb阳性组a+b级精子百分率,精子运动参数MAD、LIN、WOB均明显低于阴性组,两组比较差异有显著性(P<0·05,P<0·01)。结论:精浆AsAb不影响正常形态精子百分率,但能使锥形头精子百分率显著升高;使a+b级精子百分率、精子运动参数MAD、LIN、WOB明显降低。

男性不育伴睾丸微石症患者精液质量及睾丸血流分析

目的：探讨男性不育伴睾丸微石症患者的睾丸血流状况及其与精液质量相关参数之间的关系。方法：自2007年1月-2007年5月，对在我院就诊符合入选标准的男性不育症患者进行彩色多普勒检查及精液常规检查。结果：符合标准的患者共有88例，伴睾丸微石症17例（19.3%），其中符合经典型睾丸微石症（classic testicular microlithiasis，CTM）诊断标准者7例（8.0%），符合局限型睾丸微石症（limited testicular microlithiasis，LTM）者10例（11.3%）。CTM、LTM及阴性组3组间的发病年龄、双侧睾丸体积、双侧睾丸动脉阻力指数（RI）、精液量及其精子畸形率均无明显差异（P〉0.05）。CTM组的双侧睾丸动脉峰值流速（PSV）及精子密度、精子活力均明显低于LTM组及阴性组（P〈0.05），但在LTM组及阴性组间并无明显差异（P〉0.05）。结论：睾丸微石症可能是造成不育患者精液质量下降的原因之一。

不育男性精子DNA碎片指数与年龄和精液参数相关性分析

目的:通过对男性不育患者进行精子染色质结构分析(SCSA),探讨精子DNA碎片指数(DFI)与不育患者年龄、精子浓度及精子活率之间的关系。方法:531份精液样本来自2016年1月至2017年6月在武汉同济生殖医学专科医院就诊的男性不育患者。用计算机辅助精液分析系统(CASA)对精子浓度、活率和精液体积等参数进行常规分析,同时利用流式细胞术检测精子DFI,并分析精子DFI与受检者的年龄、精子浓度及精子活率的相关性。结果:随着患者年龄的增加,患者中精子DFI≤15%的比例明显减少,精子DFI≥25%的比例明显增加,21~30岁、31~40岁、41~52岁年龄组患者精子DFI≤15%分别为83.8%、47.8%、20.3%,精子DFI≥25%分别为8.8%、14.5%、72.9%,相关性分析表明患者年龄与精子DFI成正相关关系(r=0.653,P<0.01)。而随着患者精子浓度和精子活率的增加,患者中精子DFI≤15%的比例明显增加,15%<精子DFI<25%和精子DFI≥25%的比例明显减少,相关性分析表明精子浓度、精子活率分别与精子DFI成负相关(r=-0.246,P<0.01;r=-0.406,P<0.01)。结论:精液中精子DFI与患者年龄、精子浓度及精子活率均显著相关,精子DFI可以作为评估精液质量的一个重要指标。综合分析精子DFI及精液常规参数能够对男性生育力进行更全面的评估。

淮安地区4598例不育男性精液质量分析

目的对就诊的不孕不育男性的精液做常规检测分析,了解近年来男性不育的原因。方法用计算机辅助精子分析(CASA)技术,按照《WHO人类精液及精子-宫颈黏液相互作用实验室检验手册》,使用北京伟力公司WLJY9000仪器,对2007年12月至2011年3月就诊的4 598例不育男性精液进行分析。结果 4 598例不育男性中精液正常2 725例(54.96%),精液异常者1 873例(45.04%),精子活力异常1 110例(24.14%),活率异常1 648例(33.24%),密度异常745例(16.20%),精液量异常742例(16.14%),液化异常423例(9.21%),pH值异常271例(5.91%),无精子症136例(2.96%)。结论淮安地区不育男性精液质量与同期育龄男性精液质量相比,精液质量有所下降,约45.04%的不育男性患者精液质量异常,精子活率和精子活力异常所占比例较高,提示精液质量下降是导致男性不育的主要因素。

吸烟对男性不育患者精子活力和动态参数的影响及相关性研究

目的探讨吸烟对男性精液质量的影响并分析不育患者精子活力和动态参数的相关性。方法应用伟力彩色精子质量分析系统对255例男性不育患者(吸烟组96例、非吸烟组84例和烟酒组75例)和112名正常生育男性的精子活力、直线运动速度(VSL)、曲线运动速度(VCL)、平均路径速度(VAP)、平均移动角度(MAD)、侧摆幅度(ALH)、鞭打频率(BCF)、前向性(STR)、直线性(LIN)和摆动性(WOB)等参数进行检测并分析其相关性。结果与正常对照组相比,吸烟组、非吸烟组和烟酒组的精子活力、VSL、VCL、VAP、ALH、LIN和STR显著降低(P<0.05、P<0.01),而BCF显著升高(P<0.05、P<0.01)。吸烟组的精子活力显著低于非吸烟组(P<0.05、P<0.01);烟酒组精子活力、VSL、VCL、VAP、MAD和ALH显著低于吸烟组(P<0.05、P<0.01),而BCF显著升高(P<0.01)。大烟量组精子活力、VSL、VCL和ALH显著低于小烟量组(P<0.05、P<0.01),而BCF显著升高(P<0.01)。长烟龄组精子活力、VSL、VCL、VAP、ALH和LIN显著低于短烟龄组(P<0.05、P<0.01)。吸烟男性不育患者精子活力与VSL、VCL、VAP、LIN和STR呈明显正相关(P均<0.05),与BCF呈明显负相关(P<0.001)。结论吸烟可引起男性精子活力和精子动态参数异常,可能是导致男性不育的独立因素。烟量和烟龄对男性精子活力和动态参数的不良影响存在量效和时效关系,大量吸烟和烟龄长者可能对男性不育有不良影响。平均VSL、平均VCL、VAP、LIN、STR和BCF是反映吸烟男性不育患者精子活力的有效指标。