石河子地区6178例男性精液质量评估及其与年龄的相关性探讨

目的了解本地区就诊男性患者的精液质量状况,初步探讨男性年龄对精液质量的影响,为临床诊治提供参考。方法对2012年1月至2016年8月来我院就诊男性患者的6178例精液标本进行回顾性分析和统计,并按照年龄分为30岁、30-39岁及≥40岁3个年龄组,分析比较各组精液参数,分析指标主要包括pH值、精液量、精子密度、精子活率及前向运动率等。结果 6178例精液标本中,正常精液占27.57%,异常精液占72.43%,其中无精症占3.19%。异常精液主要以精子活率低为主,其次是前向运动率低及液化时间异常等。pH值在30-39岁年龄组高于其余2个年龄组,组间差异有统计学意义(P0.05),精液量在≥40岁年龄组均显著低于30岁年龄组及30-39岁年龄组,差异有统计学意义(P0.01);另外随着年龄的增加,精子活率和前向运动率呈递减趋势而精子密度呈递增趋势,组间差异有统计学意义(P0.01)。不同年龄组男性异常精液发生率不同,精子活率异常发生率在30-39岁组最高,精液量、前向运动率及液化时间异常发生率在≥40岁年龄组最高,组间差异有统计学意义(P0.01)。结论?石河子地区男性精液质量异常主要表现为精子活率低,且随着年龄的增长男性精液质量除pH值及精子密度外呈逐渐下降趋势。通过对本地区男性精液质量分析可初步评估本地男性的生育能力,对临床的诊治也具有重要的意义。     

某医院男性精液检查结果分析

目的 通过对我院男性精液检查的分析,了解本地区男性精液质量情况,为男性不育的临床诊疗提供依据。方法 采用伟力WLJY-9000型精子分析仪对308例精液进行分析,对异常指标分类统计,并根据年龄进行分组,比较各组精液量,液化时间,pH值,精子存活率,活力,精子密度,形态和各年龄组间精液量,精子密度,存活率,活力。结果 308例检查结果中,精液完全正常者179例,占58.12%,无精子症者3例,占0.97%,至少一项低于参考值者126例,占40.91%,其中精子活力异常占比最高;精液量方面:≥40岁组的为（2.85±1.13）ml,低于≤29岁组的（3.36±1.17）ml和30~39岁组的（3.41±1.21）ml,差异有统计学意义（P＜0.05）;精子存活率和活力方面随年龄有下降趋势,差异有统计学意义（P＜0.05）;精子密度方面,各组间比较,差异无统计学意义（P＞0.05）。结论 本地区男性精子活力、存活率、精子密度、精液量等指标异常所占比例较高;年龄对精液质量有一定影响,40岁以上人群精液质量下降。     

福建地区计算机职业对男性不育患者精子质量的影响

目的探讨计算机职业对精子DNA完整性和精子参数的影响。方法将就诊的860例男性不育患者分为计算机组和非计算机组,将520例正常生育组做为健康对照组。采用SQA-V全自动精子分析仪进行精液常规分析,精子DNA完整性检测采用精子染色质扩散试验（SCD）,以DNA断裂指数（DFI）表示。结果计算机组和非计算机组的精子密度、活动率、前向运动率和DFI与对照组比较差异有统计学意义（P〈0.05）;计算机工作者组的精子活动率、前向运动率、精子密度及和DFI与非计算机组比较差异有统计学意义（P〈0.05）;3组的精液量、精液pH值差异无统计学意义（P〉0.05）。结论长期使用计算机可以影响精液质量,从而导致男性不育。     

厦门地区126例肥胖男性不育患者精液质量分析

目的探讨肥胖对男性不育患者精液质量的影响。方法将2016年8月至2017年12月期间来我院生殖中心就诊的肥胖男性不育患者126例设为观察组,选择同期在我院进行健康体检的已生育男性102例为对照组。对以上两组入选对象进行精液pH值、精液量、精子密度、活率及前向运动率分析。结果与正常对照组相比较,肥胖性男性不育患者的精子密度、活率及前向运动率明显下降,差异有统计学意义(P0.05),而两组间精液pH值与精液量无显著性差异(P0.05)。结论肥胖对男性生殖系统会产生一定的影响,可能是引起男性不育的一个重要因素。     

弓形虫感染对男性精液质量的影响

目的探讨弓形虫感染对男性精液质量的影响。方法应用伟力彩色精子质量分析系统对86例弓形虫感染的不育男性和64例正常生育男性精液的精液量、液化时间、精子总数、精子密度、精子活力、精子活率等参数进行分析。结果正常男性组与弓形虫感染男性组精液的精液量、液化时间、精子总数两组无明显差异（P〉0.05）;精子密度、a级精子百分率、a＋b级精子百分率、精子活率两组差异有显著性（P〈0.05-0.01）。结论弓形虫感染可引起男性精液质量异常,为阐明弓形虫感染引起男性不育的机制提供了科学依据。     

精子DNA碎片化率对男性不育影响的研究

目的探讨精子DFI对男性不育及精液参数的影响。方法运用流式细胞技术检测确切可育及不育男性的精液质量及精子DFI情况。结果 298名受试者中,DFI值与精液量、pH值、精子浓度无明显相关性(P0.05);与受试者年龄、前向运动率、精子活率及正常精子形态率之间具有负相关关系(P值分别为0.023、0.031、0.040和0.017)。正常精液参数人群中,不育组DFI(14.37±11.33)高于确切可育组(8.49±5.26),二者具有明显统计学意义(P0.001)。结论精子DFI与男性不育关系密切,是不同于常规精液参数的精子功能检测指标;同时与年龄和常规精液参数有一定关系,随着年龄的增长、精子活力及正常形态率较低的男性精子DFI较高。     

厦门地区不同职业对男性不育患者精子DNA完整性和精子参数的影响

目的探讨厦门地区不同职业对精子DNA完整性和精子参数的影响。方法将就诊的1509例男性不育患者按照职业分为司机组、计算机工作者组、工人组。将600例正常生育组做为健康对照组。采用SQA—V全自动精子分析仪进行精液常规分析,精子DNA完整性检测采用精子染色质扩散试验（SCD）,以DNA断裂指数（DFI）表示。结果司机组、计算机工作者,工人组的精子密度、活动率、前向运动率和DFI与对照组比较差异有统计学意义（P〈0．05）;司机组和计算机工作者组的精子活动率、前向运动率、精子密度及和DFI与工人组比较差异有统计学意义（P〈0．05）;4组的精液量、精液pH值差异无统计学意义（P〉0．05）。结论司机、计算机工作者和工人可以影响精液质量,从而导致男性不育。     

精浆锌与精液主要参数及体外受精率的关系

目的探讨不育夫妇中男性精浆的锌含量与精液主要参数及体外受精(IVF)受精率相关性。方法回顾性分析2014年1月~2014年10月在我院生殖中心行常规IVF助孕不育夫妇患者的相关资料,依据精浆锌含量分为异常组(n=57例)和正常组(n=498例),比较两组精液中精子前向运动百分率(PR,%)、前向运动精子总数、精子浓度、精子总数和IVF受精率的差异。结果精浆锌正常组中前向运动精子总数,精子总数和IVF受精率显著高于异常组,差异均有统计学意义(P0.05);前向运动百分率(PR,%),精子浓度无统计学意义(P0.05)。结论精浆锌含量与精子总数、前向运动精子总数和IVF受精率关系密切,精浆锌含量是评估男性生殖力的重要指标之一。     

计算机职业对男性精液质量影响研究

目的探讨计算机职业对男性精液质量的影响。方法对146例计算机职业男性,应用北京伟力公司WLJY-9000型彩色精子质量分析系统,从精液量、液化时间、精子总数、精子密度、a级精子百分率、b级精子百分率、a＋b级精子百分率、精子活率等方面进行分析。结果本研究发现：虽然,每周使用计算机时间〉30h,且工作年限〉3年的计算机职业男性的精液量、液化时间、精子总数和精子密度与正常对照组之间差异无显著性（P〉0.05）,但是,a级精子百分率、b级精子百分率、a＋b级精子百分率、精子活率显著降低（P〈0.05）。结论每周使用计算机时间〉30h,且工作年限〉3年的计算机职业男性,可引起精液质量异常。     

厨师职业与男性不育

目的探讨厨师职业对男性不育症患者精液质量的影响。方法对67例厨师不育者和364例不育对照组,采用计算机辅助分析系统对男性精液进行精子密度,精子活动率、精子活力等方面进行全面分析,同时采用伊红染色法检测精子存活率。结果厨师职业组与对照组比较,精液量、p H值差异无统计学意义(P0.05),而精子密度、存活率、精子活率差异具有统计学意义(P0.05),两组精子活力之间差异具有统计学意义(P0.01)。结论厨师可影响精液质量,主要表现在精子密度、活动率和活力降低,其原因可能与厨师所处的职业环境有关。     

人精子膜功能完整性与精液参数的关系

目的探讨精子膜功能完整性与精液参数的关系。方法收集503例精液样本,其中对照组149例,不育组354例。根据WHO标准分析精子密度、活率、活力、精液白细胞浓度、精子形态和精子尾部低渗膨胀(HOS)率。结果不育组精子尾部低渗膨胀率显著低于对照组(P<0.05)。与对照组相比,HOS正常不育组和HOS异常不育组形态正常精子率、密度、活力、活率均显著降低(P<0.05),头部异常精子率、精液白细胞浓度显著增高(P<0.05);此外,HOS正常不育组的尾部异常精子率显著高于对照组,其精子活力、活率均显著高于HOS异常不育组(P<0.05)。精子HOS与精子密度、活力、活率呈显著正相关,与精液白细胞浓度呈显著负相关(P<0.05)。结论精子膜功能可能与精液参数密切相关,精子膜功能是评价男性生育力的重要指标。     

Incidence and impact of hyperviscosity on sperm parameters of Malawian men seeking assisted reproduction

BackgroundSeminal hyperviscosity has been shown to be associated with male infertility. The aim of this study was to assess the prevalence of hyperviscosity in semen of Malawian males seeking infertility treatment.MethodsA total of 120 men visiting our laboratory for fertility assessment donated semen samples. The semen samples were assessed for hyperviscosity, volume, concentration, total motility, progressive motility, viability, and morphology.ResultsOut of the 120 samples analyzed, 34 samples were hyperviscous representing 28.3%. No significant statistical difference in semen volume between samples with normal viscosity compared to those with hyperviscosity (p>0.05). Sperm concentration, progressive motility, total motility, viability, and normal morphology were significantly higher in the normal viscosity group when compared to the abnormal viscocity group (p<0.05).ConclusionHyperviscosity affects a significant number of men in Malawi and may be the cause of decreased fertility as it was associated with poor sperm concentration, total motility, progressive motility, viability, and morphology.     

Sperm aneuploidies and low progressive motility

BACKGROUND: Patients with poor semen quality show increased sperm disomy and diploidy rates. Oligozoospermia and teratozoospermia are known to influence sperm aneuploidy, but there is still a debate about whether aneuploidies are associated with reduced motility. METHODS: Ejaculates from a large group of patients were examined by light microscopy to evaluate sperm concentration, motility and morphology, and by fluorescence in-situ hybridization (FISH) to analyse the presence of aneuploidies. Statistical analysis was performed to compare differences and to evaluate the relationship between sperm aneuploidy rate and semen quality. RESULTS: Five groups were established following the motility parameter, and total aneuploidy rates were statistically significantly higher in the groups where motility was <30% compared to the controls. A homogeneous group of men with asthenozoospermia showed higher FISH values compared to control data, although the difference was not statistically significant. Motility and sperm morphology were each found to be statistically related to aneuploidy using a multiple linear regression analysis, whereas sperm concentration was only related to aneuploidy by the equation of a hyperbolic curve. CONCLUSIONS: In conclusion, biological and statistical data from the present research support the idea that the presence of aneuploidies could also be associated with reduced sperm motility.     

What constitutes a normal seminal analysis? Semen parameters of 243 fertile men

A cross-sectional study was conducted to determine the semen parameters (i.e. volume, concentration, motility, viability and normal morphology) of proven fertile males in Singapore and compare it with the World Health Organization (WHO) recommended normal values and to examine some factors that may affect spermatogenesis. A total of 243 men, whose wives were pregnant at the time of collection of semen, provided a semen sample each after sexual abstinence for 3 days. A questionnaire was used to elicit occupational exposure, alcoholic consumption, smoking history and past significant medical history. Most subjects had normal sperm volume (56.4%), concentration (79.8%), motility (69.5%) and viability (53.5%) based on WHO criteria. However, fertile men had a low mean percentage of normal sperm morphology (20.0%), although they were normally distributed. Cigarette smoking was associated with significantly lower semen volumes even after adjusting for alcohol consumption. The sperm parameters (i.e. volume, density, motility, viability and normal morphology) were not significantly associated with ethnic differences. The WHO criterion for normal sperm morphology is too stringent, and should be adopted with caution. Normal sperm morphology is but one of many parameters for assessment of fertility. Social alcohol consumption, cigarette smoking, and 'recent fever' did not appear to affect sperm quality in this group of fertile men.      

精浆弹性蛋白酶水平与精液主要参数和精子功能的相关性分析

目的探讨精浆弹性蛋白酶与精液主要参数和指标的关系。方法用酶联免疫吸附法（ELISA）检测精浆中的弹性蛋白酶,按照WHO人类精液实验室手册要求进行精液常规分析、精子形态分析,检测精子顶体酶活性、精浆抗体（AsAb）、解脲支原体等,分析弹性蛋白酶与男性不育相关因素的关系。结果209例男性不育患者中有43例精浆弹性蛋白酶≥290ng/ml,设为炎症组;166例患者的精浆弹性蛋白酶〈290ng/ml,设为非炎症组。炎症组的精子密度、精子活动率、a＋b级活力精子率、精子顶体酶阳性率均低于非炎症组（P〈0.05）;而精子畸形率、精浆抗体（AsAb）、解脲支原体阳性率均高于非炎症组（P〈0.05）。两组的精液量、Ph值和液化时间差异无显著性。结论精浆弹性蛋白酶水平与精液质量有密切的关系,生殖道感染是导致男性不育的重要原因。     

精液白细胞对精液主要参数及精子功能的影响分析

目的探讨精液白细胞含量与精液主要参数和指标的关系。方法按照WHO人类精液实验室手册要求检测精液中的白细胞、主要参数、精子形态分析、精子顶体酶活性、精浆抗体（AsAb）、解脲支原体等，分析精液白细胞与男性不育相关因素的关系。结果238例男性不育患者中有75例（31．5％）精液中白细胞〉1×10^6个／ml，设为白细胞精子组；163例（68．5％）患者精液中白细胞≤1×10^6个／ml，设为非白细胞精子组。白细胞精子组的精子密度、精子活动率、a＋b级活力精子率、精子顶体酶阳性率均低于非白细胞精子组（P〈0．05）；而精子畸形率、精浆抗体（AsAb）、解脲支原体阳性率均高于非白细胞精子组（P〈0．05）。两组的精液量、pH值和液化时间差异无显著性。结论精液中白细胞含量与精液质量有密切的关系，是导致男性不育的重要原因。     

不良生活习惯对男性精液质量的影响分析

目的探讨不良生活习惯对男性精液质量的影响。方法将258例男性不育患者按照不良生活习惯分为A组（长期吸烟饮酒）、B组（长时间接触电脑）及C组（长时间开车）,正常对照组为98例无不良生活习惯已生育健康男性,对以上各组精液标本的各项主要参数进行对比分析。结果与正常对照组比较,A组、B组及C组的精子密度及活率降低,精子畸形率升高,差异有统计学意义（P〈0.05）。结论不良的生活习惯会对男性精液质量产生一定的影响,可能是导致男性不育的重要因素之一。     

前列腺液白细胞含量与男性不育的相关性分析

目的探讨前列腺液白细胞含量与精液主要参数和指标的关系。方法对入选的260例男性不育患者进行前列腺液（EPS）常规检查计数白细胞和解脲支原体培养,按照WHO人类精液实验室手册要求检测精液主要参数、精子形态分析、精子顶体酶活性、精浆抗体（AsAb）等,分析前列腺白细胞与男性不育相关因素的关系。结果260例中炎症组93例（EPS中WBC≥10个/HP）：非炎症组（EPS中WBC〈10个/HP）167例。炎症组精液的精子密度、精子活动率、a＋b级活力精子率、精子顶体酶阳性率均低于非炎症组（P〈0.05）;而精液液化时间、精子畸形率、精浆抗体（AsAb）、前列腺液解脲支原体阳性率高于非炎症组（P〈0.05）。两组的精液量及pH值差异无显著性。结论前列腺液中白细胞含量对精液质量有一定的影响,慢性前列腺炎是导致男性不育的原因之一。     

The association of age and semen quality in healthy men

BACKGROUND: Although the effect of maternal age on fertility is well known, it is unclear whether paternal age also affects fertility. This cross-sectional study sought to characterize the association between age and semen quality, a well-known proxy of fertility status. METHODS: A convenience sample of 97 non-smoking men (aged 22-80 years) without known fertility problems was recruited from a national government laboratory. The men provided semen samples and information relating to lifestyle, diet, medical and occupational details. Semen volume (ml), sperm concentration (x10(6)/ml), total sperm count (x10(6)), motility (%), progressive motility (%) and total progressively motile sperm count (x10(6)) were measured. RESULTS: After adjusting for covariates, semen volume decreased by 0.03 ml per year of age (95% CI: -0.05, -0.01); motility decreased by 0.7% per year (95% CI: -0.92, -0.43); progressive motility decreased by 3.1% per year (95% CI: -4.5, -1.6); and total progressively motile sperm count decreased by 4.7% per year (95% CI: -7.2, -2.2). There was a suggested decrease in sperm concentration and count. The proportion of men with abnormal volume, concentration and motility was significantly increased across the age decades. CONCLUSIONS: In a convenience sample of healthy men from a non-clinical setting, semen volume and sperm motility decreased continuously between 22-80 years of age, with no evidence of a threshold.