血清抑制素B在非梗阻性无精子症中的应用

目的:探讨血清抑制素B(INHB)在非梗阻性无精子症中的应用及对睾丸精子抽吸结局的预测作用。方法:用回顾性分析方法对52例非梗阻性无精子症(NOA)、12例梗阻性无精子症(OA)及20例正常生育男性,采用双抗夹心ELISA法测定各组血清中INHB水平;采用化学发光法测定各组血清中卵泡刺激素(FSH)、黄体生成素(LH)和睾酮(T)水平。结果:NOA组血清INHB水平明显低于正常生育男性组和OA组,其差异均有统计学意义(P<0.01);血清FSH和LH水平明显高于OA组和正常生育男性组(P<0.01)。NOA组行睾丸抽吸(TESE)获得精子的患者,其血清INHB水平明显高于未获得精子者,其差异有统计学意义(P<0.01);而NOA组行TESE未获得精子的患者,其血清FSH水平明显高于获得精子者,其差异有统计学意义(P<0.01)。比较两组血清中LH和T水平,其差异均无统计学意义(P>0.05)。结论:血清INHB水平可反映睾丸精子发生的情况,能准确预测TESE获取精子的结局。     

吸烟、精浆锌与男性不育患者精子形态的关系

目的:探讨吸烟、精浆锌与不育男性患者精子形态的关系。方法:对115例男性不育患者的吸烟情况进行问卷调查,采用精子形态检测系统下人工修正方法分析共精子形态,以分光光度比色法测定精浆锌含量。结果:不育男性吸烟组精浆锌水平显著低于不吸烟组(P<0.05),且吸烟程度与精浆锌水平呈显著负相关性(r=-0.273,P<0.05);吸烟组正常形态精子百分率显著低于不吸烟组(P<0.05);吸烟精浆锌异常组正常形态精子百分率显著低于吸烟精浆锌正常组(P<0.05),且显著低于不吸烟精浆锌正常和异常组(P<0.01);不吸烟精浆锌异常组正常形态精子百分率与精浆锌正常组差异无统计学意义(P>0.05)。结论:吸烟能使精浆锌水平降低;吸烟对精子形态的影响可能通过降低精浆锌含量,增加氧化应激,使正常形态精子百分率下降。     

630例无精子症患者染色体畸变及性激素水平

目的:探讨无精子症患者遗传学因素与性激素变化的关系。方法:采用回顾性方法对630例无精子症患者进行染色体核型分析,并采用化学发光法测定各组血清中卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)和催乳素(PRL)水平。结果:630例无精子症患者中共检出染色体畸变110例,占17.46%,其中性染色体94例,占异常总数的85.45%,常染色体异常16例,占异常总数的14.55%,性染色体数目异常中Klinefelter综合征76例,占异常总数的69.09%;性激素检测中,无论核型正常与否,FSH、LH显著升高,T值降低,其差异有统计学意义(P<0.01),核型异常组FSH、LH升高更为明显。结论:无精子症与遗传因素及性激素改变密切相关,对无精子症患者进行遗传学检查、性激素检查是十分必要的。     

血清性激素指标、精浆锌与果糖检测诊断男性不育症的应用价值

目的分析血清性激素指标、精浆锌与果糖检测诊断男性不育症的应用价值。方法选取2016年1月-2017年11月收治的110例男性不育症患者为研究对象,按照精液常规检查结果分为少精子组(37例)、弱精子组(30例)和无精子组(43例)。选取同期同院体检中心70例健康成年男性为对照组。比较4组血清性激素指标、精浆锌与果糖水平。结果少精子组与其余3组精子浓度比较,差异均有统计学意义(均P0. 05);少精子组与弱精子组、无精子组精子活率比较,差异均有统计学意义(均P0. 05);少精子组与无精子组正常形态精子比例比较,差异有统计学意义(P0. 05)。弱精子组与无精子组精子浓度、精子活率、正常形态精子比例比较,差异均有统计学意义(均P0. 05);弱精子组与对照组精子活率比较,差异有统计学意义(P0. 05)。无精子组与对照组精子浓度、精子活率、正常形态精子比例比较,差异均有统计学意义(均P0. 05)。对照组与其余3组血清PRL、FSH、LH、T水平,精浆锌及果糖水平比较,差异均有统计学意义(均P0. 05)。少精子组、弱精子组与无精子组血清FSH及精浆果糖水平比较,差异均有统计学意义(均P0. 05)。少精子组与弱精子组血清FSH及精浆果糖水平比较,差异均有统计学意义(均P0. 05)。结论血清性激素及精浆锌、果糖水平与男性不育症均有紧密联系,联合检验可作为男性不育症临床诊治的指导。     

白细胞介素6与血清生殖激素及精子浓度的相关性分析

目的:探讨男性不育症患者血浆白细胞介素6(IL-6)与血清生殖激素水平及精子浓度的相关性及临床意义。方法:检测68例男性不育症患者精子浓度、血浆IL-6与血清睾酮(T)、黄体生成激素(LH)、卵泡刺激素(FSH)、催乳激素(PRL)水平,并与40例正常生育男性检测结果进行对照分析。结果:不育组血清T水平显著低于生育组(P<0.01),而血浆IL-6水平高于生育组(P<0.01)。不育组血浆IL-6水平与血清T水平呈负相关(P<0.05),而与血清FSH水平呈正相关(P<0.05)。不育患者中,精子浓度正常者较少精子症者血浆IL-6水平升高(P<0.01),T水平降低(P<0.01)。结论:血浆IL-6的水平与男性生殖密切相关,不仅对不育症的诊断、临床治疗及预后判断具有良好的参考价值,也可为不育症发病机制的研究提供新的思路。     

生殖道感染对少弱精子症患者精浆生化指标与精液参数的影响

目的探讨少弱精子症患者生殖道感染与精子质量及精浆中性α-葡萄糖苷酶的相关性。方法分析2011年1月-2015年12月检测的精液分析结果和精浆生化资料。结果少弱精子症的确诊感染者较精浆弹性硬蛋白酶正常者的精液量、精子总数、精浆中性α-葡萄糖苷酶降低,差异有统计学意义(P0.05)。少弱精子症患者精浆中性α-葡萄糖苷酶测定值随精液量的减少而降低,差异均有统计学意义(P0.05)。非严重少弱精子症确诊感染组患者的血清FSH测定值高于正常组,差异有统计学意义(P0.05)。结论生殖道感染可引起少弱精子症患者精浆中性α-葡萄糖苷酶异常。生殖道感染可能是导致少弱精子症患者精液量减少,精子总数下降的重要病因之一。生殖道感染严重可能会影响睾丸生精功能。     

男性不育患者血清及精浆维生素D、抗苗勒管激素与精液参数及性激素水平相关性

目的:探讨男性不育患者血清及精浆维生素D[25(OH)D]、抗苗勒管激素(AMH)水平与精液参数、性激素关系。方法:选取2017年1月—2019年12月本院收治的144例男性不育患者,按照精液参数分为少精子组(n=37)、弱精子组(n=39)、少弱精子组(n=32)和正常参数组(n=36),分析患者血清及精浆25(OH)D、AMH表达关系及与各精液参数间相关性。结果:少精子组、少弱精子组精子浓度、血清T、精浆AMH及25(OH)D水平均低于弱精子组和正常参数组,精液体积、血清卵泡刺激素高于弱精子组和正常参数组,弱精子组、少弱精子组精子向前运动比例低于少精子组和正常参数组(P0.05),各精液参数组血清促黄体生成素、雌二醇、泌乳素、25(OH)D、AMH水平均无差异(P0.05)。Spearman相关性分析显示,精浆25(OH)D、AMH水平与精液体积呈负相关(r=-0.352、-0.309,P0.05),与精子浓度、睾酮水平呈正相关(r=0.410、0.403、0.287、0.329,P0.05),而血清及精浆25(OH)D与AMH之间两两分析无相关性(P0.05)。结论:男性不育患者精浆中25(OH)D、AMH水平与患者精液参数及性激素有一定相关性,表达水平能反映患者的睾丸生精功能。     

6例圆头精子症患者临床分析

目的:探讨圆头精子症患者病因和临床表型特征。方法:收集6例圆头精子症导致不育患者和8例正常生育男性基本信息,进行外周血染色体、AZF、性激素、精液质量检查。结果:6例患者不育年限平均为4年,其中4例从事电焊、汽车喷漆、高温作业、接触化学物品职业,2例从事网络和电子商务;6例患者临床特征、染色体和AZF基因、性激素未见异常,3例患者圆头精子率100.00%,3例圆头精子率95.00%～99.50%,圆头精子症患者精子活力明显低于正常生育组(P<0.05)。结论:圆头精子症发生可能与外界环境有关,除具有圆头精子和精子活力低下外,无其他异常表型,建议采用辅助生殖技术助孕。     

不同类型精子对ICSI助孕后妊娠结局的影响及相关因素分析

目的 探究男性不育患者不同类型精子行卵胞浆内单精子注射(intracytoplasmic sperm injection, ICSI)助孕后对ICSI助孕患者妊娠结局的影响及相关因素分析。方法 回顾性分析2013年1月至2021年12月在西南医科大学附属医院行ICSI助孕的患者共563个周期的临床资料,根据精子类型分为正常精子组(A组,47例)、轻中度少弱精子症组(B组,140例)、重度少弱精子症组(C组,167例)、极重度少弱精子症组(D组,61例)、无精子症组(E组,148例)。比较各组患者的基本临床特点、促排卵情况、获卵情况、受精率、2PN受精率、优质胚胎率、囊胚形成率,新鲜和累积胚胎种植率、临床妊娠率、流产率、活产率等。结果 hCG日雌二醇水平D组较A组、B组高,平均获卵数D组高于B组,E组高于B组及C组,MII卵数D组和E组高于其余三组,差异均有统计学意义(P<0.05);男女双方年龄、不孕年限、基础FSH、BMI、AMH、Gn量等差异无统计学意义(P>0.05);各组的受精率、2PN受精率、优质胚胎率、囊胚形成率差异均无统计学意义(P>0.05);鲜胚活产...     

酒精对雄性大鼠性激素、精浆果糖、精浆锌的影响

目的：研究酒精对雄性大鼠性激素（睾酮、卵泡刺激素、黄体生成素）、精浆生化（果糖、锌）的影响。方法：40只健康雄性成年SD大鼠随机分为四组,各组每日分别给予酒精0g/kg、2.7g/kg、4.5g/kg、7.5g/kg灌胃,连续13周。测定各组大鼠精浆果糖、精浆锌,血清T、LH、FSH含量。结果：各酒精组T、FSH、LH水平均低于正常对照组,差异均有统计学意义（P〈0.05或P〈0.01）;各酒精组精浆果糖、精浆锌水平均低于正常对照组,差异均有统计学意义（P〈0.05或P〈0.01）。结论：酒精可导致雄性大鼠生殖内分泌系统损害,抑制雄性大鼠附属性腺的分泌。     

ANALYSIS OF LIPID PEROXIDATIVE LEVELS IN SEMINAL PLASMA OF INFERTILE MEN BY HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY

For the purpose to evaluate the significance of lipid peroxidative products on male infertility, the levels of malondialdehyde (MDA), which is one of the final products of lipid peroxidation in seminal plasma, were determined. Ninety-three male infertile patients were divided into obstructive azoospermic group (12 cases), non-obstructive azoospermic group (15 cases), oligozoospermic group (21 cases), asthenozoospermic group (19 cases), oligoasthenozoospermic group (16 cases) and oligoasthenoteratozoospermic group (10 cases). Eighteen fertile males were included in the control group. MDA concentrations of seminal plasma in the fertile and infertile men were detected by high-performance liquid chromatography (HPLC). The results showed that the concentration of MDA in seminal plasma differed significantly between the control group and all the infertile groups (P?<?0.01) except the obstructive azoospermic group, between the oligoasthenozoospermic group and the oligozoospermic and asthenozoospermic groups (P?<?0.01), and between the oligoasthenoteratozoospermic group and the oligozoospermic and asthenozoospermic groups (P?<?0.01). MDA concentration of seminal plasma in the oligoasthenoteratozoospermic group differed significantly from that in the oligoasthenozoospermic group (P?<?0.05). The results suggested that detection of MDA concentrations in seminal plasma by HPLC has an indicative value on the diagnosis of male infertility induced by overproduction of reactive oxygen species in male reproductive system.     

Relationship of seminal plasma antioxidants and serum male hormones with sperm chromatin status in male factor infertility

We explored the relationship between sperm chromatin integrity, hormone levels, seminal plasma total antioxidant capacity (TAC), and routine sperm parameters in men with male factor (MF, n?=?81) and non-male factor (NMF, n?=?52) infertility. Semen and blood were collected and examined from men undergoing evaluation for infertility in the Avicenna Infertility Clinic. We have examined each patient for serum hormones (LH, FSH, E2, DHEA), sperm chromatin damage, level of protamination and seminal plasma TAC. Levels of FSH, LH, sperm chromatin damage, and abnormal protamination were significantly higher in MF vs. NMF groups (p?相似文献   

六价铬男性生殖毒性的初步探讨

目的 探讨六价铬的男性生殖毒性,方法 采用职业流行病学调查与相关实验室检查相结合的方法观察铬作业男工精液,精子形态,测定精浆锌,血铬,精浆铬,黄体生成激素（ＬＨ）和促卵泡成熟激素（ＦＳＨ）的改变。结果 铬作业（ＣｒＯ３Ｘ＝０．０１９５ｍｇ／ｍ＾３）男工组精子数（５２．２１±４５．５１）×１０＾９／Ｌ,显低于对照组（８８．９６±７４．８２）×１０＾９／Ｌ,精浆锌（４８１１．８５±１４０１．８８）μ     

Relationship of seminal plasma antioxidants and serum male hormones with sperm chromatin status in male factor infertility

We explored the relationship between sperm chromatin integrity, hormone levels, seminal plasma total antioxidant capacity (TAC), and routine sperm parameters in men with male factor (MF, n?=?81) and non-male factor (NMF, n?=?52) infertility. Semen and blood were collected and examined from men undergoing evaluation for infertility in the Avicenna Infertility Clinic. We have examined each patient for serum hormones (LH, FSH, E2, DHEA), sperm chromatin damage, level of protamination and seminal plasma TAC. Levels of FSH, LH, sperm chromatin damage, and abnormal protamination were significantly higher in MF vs. NMF groups (p?<?0.001). Sperm chromatin damage was correlated with percentage of CMA₃- positive sperm (r?=?0.64, p?<?0.001) and with sperm concentration (r?=??0.36, p?<?0.001), motility (r?=??0.21, p?<?0.05), and morphologically normal spermatozoa (r?=??0.29, p?<?0.001). Linear regression showed sperm chromatin damage was related to percentage of CMA₃- positive sperm (p?<?0.001) in ungrouped patients. It was related to both percentage of CMA₃- positive sperm and serum DHEA in the MF group (p?<?0.001 and p?<?0.05, respectively). Sperm chromatin maturity assessed by CMA₃ test was inversely related to sperm chromatin damage assessed by the toludine blue assay. Male factor infertility associated with sperm chromatin damage may be related to sperm protamination and to serum DHEA.     

男性不育患者精浆锌含量与精液主要参数相关性研究

目的:探讨不育男性精浆的锌含量与精液质量的关系。方法:回顾性分析2011年8月～2012年1月在广西壮族自治区妇幼保健院生殖中心就诊的343例男性不育患者的相关资料,依据精浆锌含量分为正常A组(n=274例)和异常B组(n=69例),比较两组间精液参数的差异;同时根据精液黏稠度分为黏稠C组(n=54例)与非黏稠D组(n=289例),比较两组间精浆锌含量及其他精液参数的差异。结果:A组与B组患者年龄比较差异无统计学意义(P>0.05)。A组的精液量、每次射精精子总数、前向运动精子总数显著高于B组,而黏稠精液的比例明显低于B组,差异均有统计学意义(P<0.05)。其他精液各指标比较差异无统计学意义(P>0.05);C组与D组精液圆细胞浓度、精液量、精子浓度、精子总数比较差异无统计学意义(P>0.05);D组的前向运动精子百分率、前向运动精子总数、活动率、精浆锌明显高于C组,差异有统计学意义(P<0.05)。精浆锌含量与精液量、每次射精精子总数、前向运动精子总数显著正相关,与其他参数无显著相关性。结论:精浆锌含量直接影响精液量、精子总数、前向运动精子总数和精液黏稠度,精浆锌含量是男性生殖力的重要评估指标。     

ANTIOXIDANT ACTIVITY OF SEMINAL PLASMA IN FERTILE AND INFERTILE MEN

This study was conducted to evaluate and compare the total antioxidant capacity among fertile and infertile men. Thirty infertile patients and 20 fertility-proven healthy donors with normal sperm analysis were included in the study. Total antioxidant capacity, zinc and fructose levels of seminal plasma, and various sperm parameters were compared among fertile controls and idiopathic infertility patients prospectively. The mean antioxidant capacity of fertile controls (2.02 &#45 0.16 mmol/L) was significantly higher than that of the infertile patients group (1.78 &#45 0.23 mmol/L) ( p <.01). Furthermore, asthenozoospermic and asthenoteratozoospermic groups had significantly lower mean antioxidant values (1.73 &#45 0.11 and 1.64 &#45 0.13, respectively) when compared to fertile control group ( p <.01). The mean fructose level was significantly lower in the fertile control group and mean zinc level was significantly lower in the entire infertile group. On the other hand, antioxidant capacity is positively correlated to sperm motility ( p =.001). Decreased antioxidant capacity was associated with impaired sperm function as a result of either increased ROS production or insufficient antioxidant capacity.     

Endocrine profile and seminal plasma composition in Hansen's disease

Endocrine profile and seminal plasma composition in 45 patients with tuberculoid-type Hansen's disease are reported. There was marked reduction in sperm count and motility (p less than 0.01, p less than 0.01, respectively) with an increase in abnormal forms of spermatozoa (p less than 0.05). The levels of serum prolactin and oestradiol-17B were increased significantly (p less than 0.05, p less than 0.05, respectively) with a marked reduction in serum FSH, LH and testosterone (p less than 0.05, p less than 0.05, p less than 0.05, respectively). The possible significance of these findings may help further to understand male reproductive function in Hansen's disease.     

Leptin and leptin-receptor polymorphisms in fertile and infertile men

The association of leptin (LEP) -2548G/A and/or leptin receptor (LEPR) Gln223Arg polymorphisms with male infertility and plasma FSH, LH, and testosterone (T) levels was examined. The genotypes and allele frequency distributions of LEP -2548G/A and LEPR Gln223Arg polymorphisms were investigated in 150 fertile and 150 infertile men by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Also, plasma levels of FSH, LH, and T were measured using commercial ELISA kits. Frequencies of AA, AG and GG genotypes of LEP-2548G/A polymorphism were statistically different in fertile and infertile men (p=0.012). The AG genotype showed a protective effect which could decrease risk of male infertility about 3 fold (p = 0.004). We did not observe any differences in frequencies of LEPR Gln223Arg alleles and genotypes between groups (p > 0.05). Sperm counts from infertile men with the AG and GG genotypes of the LEP polymorphism were significantly higher than AA genotype (p<0.05). Moreover, infertile men who carried the RR genotype of LEPR showed a statistically higher percentage of sperm with progressive motility than individuals with other genotypes (p = 0.004). There was no correlation between different combinations of LEP and LEPR genotypes and LH, FSH, and T levels (p > 0.05). Our study suggests that the LEP -2548G/A polymorphism may play a role in male fertility and the AG genotype may have a protective effect through increasing sperm counts. The distribution of genotypes of LEP -2548G/A polymorphism are different in fertile and infertile males and may be a useful tool in evaluation of male infertility.

Abbreviations: LEP: leptin; LEPR: leptin receptor; T: testosterone; FSH: follicle-stimulating hormone; LH: luteinizing hormone