少弱精子症与精浆附性腺标志物的相关性分析

目的分析少弱精子症患者精液参数与精浆附性腺标志物的相关性,探讨附性腺功能对男性生育力的影响。方法采用精液常规、精子形态、精浆附性腺标志物分析方法,检测正常供精者和门诊就诊的少弱精子症患者的精液相关指标。结果少弱精子症组正常形态精子百分数、精子穿透功能、精浆中性α-糖苷酶显著低于正常对照组。相关分析结果显示,少弱精子症患者组,精液量与精子活动率呈负相关(r=-0.415,P<0.05),精子数与形态呈正相关(r=0.393,P<0.05)。结论少弱精子症患者同时存在不同程度的附睾功能障碍,精子功能下降,精子畸形率显著升高,睾丸生精功能越低下,精子畸形发生率越高。     

Effect of treatment with myo-inositol on semen parameters of patients undergoing an IVF cycle: in vivo study

Introduction: Myo-inositol (MI) is a precursor for the synthesis of phosphatidylinositol polyphosphates (PIPs). The aim of the study is to evaluate the effect of its administration on semen parameters of male patients undergoing an in vitro fertilization cycles.

Methods: In vivo study. Samples were semen of 62 patients divided into three different groups: healthy fertile patients (Group A); patients with oligoasthenospermia (OA) (Group B); control group (CTR). The collected samples were analyzed by optic microscopy in order to evaluate semen’s volume, spermatozoa’s number and motility before and after density-gradient separation method. These parameters were evaluated before and after administration of 4000?mg/die of MI and 400?µg of folic acid for 2 months. The results were analyzed statistically with Student's t-test.

Results: After treatment there was a significant increase of basal and after density-gradient separation method spermatozoa concentration in Group B, and a significant increase of spermatozoa count after density-gradient separation method in Group A. The motility values were higher in healthy men than patients with OA before treatment, but there was no improvement in both groups after treatment.

Conclusions: Exogenous administration of MI significantly improves semen’s parameters both in patients with OA and in normal fertile men.     

右归胶囊治疗弱精子症的临床疗效观察研究

目的:探讨右归胶囊对弱精子症患者精子存活率及活力的影响。方法:2009年4月至2010年5月就诊的不育患者中,将弱精子症患者80例随机分为治疗组和对照组,分别服用右归胶囊和五子衍宗丸,治疗周期为3个月。治疗前后,检测患者精子存活率及其活力。结果:右归胶囊组治疗前精子存活率、a级、a+b级精子百分率分别为31.9%±16.9%,8.2%±3.7%,15.7%±13.9%;治疗后分别为65.7%±13.1%,22.5%±9.1%,47.6%±15.8%,五子衍宗丸组治疗前精子存活率、a级、a+b级精子百分率分别为31.7%±17.0%,7.9%±4.5%,16.9%±13.6%;治疗后分别为38.1%±11.1%,13.2%±6.8%,24.1%±10.9%。两组治疗前与治疗后比较均有显著性差异(P<0.05),治疗后两组间比较有显著性差异(P<0.05)。结论:右归胶囊可提高弱精子症患者的精子存活率及活力,疗效优于五子衍宗丸。     

16 835例中国不育男性的精液质量分析

目的：通过精液常规检查评价大样本量的不育男性的生育能力,为男性不育症的临床治疗和疗效观察提供
科学依据。方法：收集16 835例不育男性的精液标本,以1 567例精子库候选供精者精液标本作为普通人群对照组,采
用计算机辅助精液分析技术(computer assisted sperm analysis,CASA )进行精液常规检测并对结果进行统计学分析。结
果：不育患者精液异常主要表现为弱精症。不育组无精症、弱精症、少弱精症患者比例高于对照组,不育组少精症
患者比例低于对照组(P<0.001)。结论：弱精症、无精症、少弱精症与不育相关,而单纯少精症不一定与不育相关。     

碱性成纤维细胞生长因子用于治疗特发性少弱精子症的临床意义(附57例疗效观察)

为了探讨碱性成纤维细胞生长因子（ｂＦＧＦ）对特发性少弱精子症患者的作用,本研究对５７例确诊为将发性少弱精子症的患者用ｂＦＧＦ治疗,分别在治疗前后进行血生殖激素测定和精液质量分析。结果发现治疗后血生殖激素（ＰＲＬ、ＦＳＨ、ＬＨ、Ｔ）水平升高,精子密度及顶体酶活性显著提高（Ｐ〈０．０１）,精子活动力和成活率上升、畸形率下降（Ｐ〈０．０５）,生育能力提高。因此认为ｂＦＧＦ是治疗特发性少弱精子症的有效药物。     

中药复方调节模型大鼠精子尾部特异性钙通道

目的:研究中药复方"促育生精方"对环磷酰胺诱导的少弱精模型大鼠精子Catsper1、Catsper2基因及蛋白表达的影响,并探讨其调节机制。方法:采用实时荧光PCR法检测Catsper1 mRNA、Catsper2 mRNA在各组大鼠(随机分为模型组、低剂量组、中剂量组、高剂量组、空白对照组)精子中的表达;用蛋白印迹法检测各组Catsper1,Catsper2蛋白的表达。结果:Catsper1 mRNA、Catsper2 mRNA表达量为:中、高剂量组显著高于模型组(P<0.05)。Catsper1、Catsper2蛋白表达量:中、高剂量组显著高于模型组(P<0.05)。结论:促育生精方能有效提高少弱精症模型大鼠精子特异性钙通道Catsper1、Catsper2基因及其蛋白的表达。     

国医大师王琦治疗少弱精子症病例系列分析

目的:对国医大师王琦治疗少弱精子症的病例系列进行分析,初步探讨"肾虚夹湿、热、瘀、毒、虫"病机理论的临床应用,为少弱精子症的中医诊疗提供参考.方法:选取国医大师王琦治疗少弱精子症有代表性的病例13则,进行患者基本情况分析、病情变化分析、处方用药分析,结合王琦教授的中医男科理论,探讨少弱精子症的证治.结果:13份病例中,...     

“益精方”对小鼠精子尾部特异性钙通道CatSper1的影响

目的:观察"益精方"对环磷酰胺所致少弱精子症模型小鼠精子尾部特异性钙通道CatSper1的影响。方法:将40只雄性昆明小鼠随机分为对照组(CG)、模型组(MG)、小剂量中药治疗组(SG)和大剂量中药治疗组(LG),按60mg/kg体重给CG小鼠腹腔注射生理盐水(NS),给MG、SG、LG小鼠腹腔注射环磷酰胺,每天1次,连续5d,第6d开始按体重分别给SG和LG小鼠灌服"益精方",剂量分别为人类常规用量(以60kg为标准)的1倍和5倍,MG小鼠给予等体积的NS灌胃,每天1次,连续34d,CG常规饲养,然后对小鼠进行精液常规分析,并用RT-PCR法检测小鼠精子CatSper1的表达。结果:CG、MG、SG和LG组小鼠附睾精子密度分别为(5.20±1.34)、(1.73±0.03)、(2.08±0.01)、(3.31±0.56)×106/ml,a+b级精子百分率分别为(14.49±0.30)%、(6.64±1.88)%、(11.99±1.01)%、(19.40±3.13)%,a+b+c级精子百分率分别为(68.39±15.13)%、(39.96±4.89)%、(62.28±4.43)%、(73.61±5.05)%,MG组精子密度、a+b级精子百分率、a+b+c级精子百分率显著低于CG组(P<0.05),经治疗后LG组精子密度、a+b级精子百分率、a+b+c级精子百分率明显增加,与MG组比较有显著性差异(P<0.05),而与CG组在a+b级精子百分率和a+b+c级精子百分率上没有明显区别。CatSper1的表达量在CG、MG、SG和LG组分别为0.76±0.05、0.73±0.03、0.75±0.12、0.85±0.04,LG组显著高于MG组(P<0.05),而与CG组比较没有明显区别。结论:腹腔注射环磷酰胺可使小鼠精子密度、a+b级精子百分率、a+b+c级精子百分率降低,CatSper1表达量下降,大剂量"益精方"可以通过提高CatSper1的表达量,增加小鼠精子密度、a+b级和a+b+c级精子百分率,从而达到治疗少弱精子症的目的。     

Change of Accessory Genital Glands Markers in the Patients with Oligoasthenospermia

Objective To evaluate the effect of the accessory gential gland on the male fertility.
Methods The relevant seminal parameters of 32 normal donors and 35 patients with olioasthenospermia were measured by seminal routine analysis, sperm morphology and accessory, gentital glands markers.
Results The percentage of normal spermatozoa, the function of sperm penetration through cervical mucus and the enzyme activity of neutral α-1,4-glucosidase significantly declined as compared with the control. There was a significant negative relationship between the semen volume and the sperm motility for the oligoasthenospermia （r= -0.415, P〈0.05）, and a significant positive relationship between the sperm count and the percentage of normal sperm （r=0.393, P〈0.05）.
Conclusion The abnormal function of epididymis exists in patients with oligoasthenospermia. Sperm function,for the oligoasthenospermia declines with an increase of the percentage of the abnormal sperm. The poorer the spermatogenises function of the testis is, the higher the percentage of the abnormal sperm appears.     

Clinical and pathological correlation of the microdeletion of Y chromosome for the 30 patients with azoospermia and severe oligoasthenospermia

Aim: To review the accumulated 30 patients with different area of Y chromosome microdeletions, focus-ing on their correlation with the clinical and pathological findings. Methods: A total of 334 consecutive infertile men with azoospermia (218 patients) and severe oligoasthenospermia (116 patients) were screened. Complete physical and endocrinological examinations, general chromosome study and multiplex polymerase chain reaction assay to evaluate the Y chromosome microdeletion were performed. Ten patients received testicular biopsy. Then the clinical and pathological findings were analyzed with reference to the areas of Y chromosome microdeletion. Results: There is a decline of the percentage of sperm appearing in semen in the group that the gene deletion region from AZFc to AZFb. The clinical evidence of the impairment (decreased testicular size and elevated serum FSH) is also relevantly aggravated in this group. However, the pathology of testicular biopsy specimen was poorly correlated with the different deletion areas of the Y chromosome, which may be due to the limited number of specimens. Conclusion:The clinical correlation of spermatogenic impairment to the different AZF deletion regions may provide the information for the infertile couples in pre-treatment counseling. (Asian JAndrol 2004 Dec; 6:369-375)