精子 DNA 碎片与精液常规参数的相关性研究进展

男性不育诊断的第一步传统上采用精液常规检查,但是,该检查在判断引起该疾病的潜在机制方面存在明显的局限性。精子DNA碎片可能是生育障碍的致病因素,其评估已被建议作为男性不育实验室检查的辅助项目,尤其是在应用辅助生殖技术（ ART）之前。通过对近期文献进行回顾,旨在评估精液常规参数和精子DNA碎片检查作为诊断男性不育手段时,两者间可能相关性。     

精子DNA碎片率与男性不育的关系研究

目的分析研究精子DNA碎片率与男性不育的关系,探究不育患者年龄、精子碎片率和精液常规参数的相关性。方法选择我院收治的男性不育患者100例作为本次研究的对象,收治时间在2013年3月~2014年6月,按照年龄将这100例患者分成三组,25~29岁组(n=33),30~35岁组(n=33),36~50岁组(n=34),使用SCD检测其精子DNA碎片率,分析检测其精液常规参数。结果正常形态精子率和精子活力不存在相关性(r=0.65,P>0.05);精子活力和年龄存在负相关(r=-2.41,P<0.05);和精子DFI存在正相关关系(r=0.33,P<0.05)。结论随着年龄的增长精子活力会逐渐的下降,对男性的生育能力具有影响,且精液常规参数与精子DNA碎片率不存在密切的联系,故认为,精子DNA碎片检测可以在精液常规分析中应用,作为反映男性生育能力的重要指标。     

精子DNA损伤对辅助生殖技术后生育结局的影响

精子DNA质量对维持男性生殖潜能非常重要。众所周知,精子DNA的一半要传给子代。受精胚胎和胎儿发育以及出生后的孩子也都需要有好的遗传物质。不正常的DNA会扰乱这一系列过程中任何一个环节。从睾丸一直到卵子受精,精子DNA要耐受各种损伤。最近的很多报道都更加关注由遗传变化造成的男性生育力下降的问题。更多的是孩子先天异常和睾丸癌的报道[1]。这种遗传物质的缺陷可以导致核缩合或核成熟缺陷、DNA断裂或DNA完整性缺陷和精子染色体非整倍体增加[2]。在不孕男性中,具有正常精液参数而不育的男性,其原因应该与异常精子DNA有关[3]…     

严重生精障碍男性精子DNA碎片指数及Hcy水平的研究分析

目的探讨同型半胱酸、精子DNA碎片指数与严重生精障碍男性的精子计数之间的相关性研究。方法 2015年12月~2017年2月期间在医院就诊的严重生精障碍男性患者56例,按WHO标准分为严重无、少精子症组25例和弱精子症组31例,对照组为无生育障碍的男性27例。对所有纳入研究者进行精子参数、精子DNA碎片指数和血清Hcy水平的检测。结果严重生精障碍男性的精子DNA碎片指数和Hcy均高于正常对照组。精子DNA碎片指数与血清Hcy水平、精子浓度呈正相关,而Hcy水平和精子浓度呈负相关。结论 Hcy水平和精子DNA碎片指数的升高,可能是严重生精障碍男性的重要病因,但其具体机制有待进一步研究。     

咪喹莫特对精子浓度、活动率及DNA碎片指数的影响

目的 通过观察在培养液中加入咪喹莫特后精子浓度、活动率及DNA碎片指数(DFI)的变化,以明确免疫调节剂咪喹莫特是否会影响男性精子质量。方法 选取2021年9月至2022年1月河南省生殖妇产医院体检的健康男性志愿者新鲜液化的精液标本10份,每份分为不添加药物的空白对照组和咪喹莫特0.3、0.6、3.0μmol/L组。上游法培养60 min后分别检查四组上层精子浓度、活动率和精子DFI。结果 被测人员年龄(30.5±4.1)岁,精子浓度(48.82±24.43)×10⁹/L,总活动率(50.83±23.33)%。培养后空白对照组精子浓度(23.53±15.45)×10⁹/L,总活动率(16.54±16.04)%。培养后咪喹莫特组精子浓度(22.23±16.85)×10⁹/L,精子总活动率(16.79±13.89)%。培养后各组精子浓度及活动率与培养前比较,差异有统计学意义(P<0.05);培养后各组精子浓度和活动率比较,差异无统计学意义(P>0.05)。培养后及各咪喹莫特剂量组均处于正常范围,与空白对照组比较,...     

精子形态学分析在男性不育诊治中的应用

近年来,男性不育的发病率呈逐渐上升的趋势,男性生殖学科也随之不断发展起来,精子形态学的相关研究已成为男性不育和辅助生殖临床评估的一项重要内容。回顾近年来精子形态方面的相关文献,精子形态分析在男性生育     

精索静脉曲张患者精浆丙二醛水平与精子DNA碎片率的相关性分析

目的:检测精索静脉曲张所致的不育患者精子DNA碎片率和精浆氧化水平并分析其相关性.方法:采用染色质扩散实验(SCD)对52例精索静脉曲张所致男性不育患者(精曲组)和24例健康生育男性(对照组)进行精子DNA碎片率(DFI)检测;采用硫代巴比妥酸法(TBA)测定精浆丙二醛(MDA)的含量,计算机辅助精液分析仪按照WHO标准进行精液常规分析;采用苏木素-伊红染色,Kruger评分标准进行精子形态学分析.结果:与对照组相比,精曲组的精液量、精子浓度、前向精子活力和正常精子形态百分率下降,而精子DNA碎片率和精浆MDA水平显著升高,差异有统计学意义(P＜0.05);精曲组的精浆MDA水平与精子DNA碎片率呈正相关(P＜0.05).结论:精浆活性氧水平升高和精子DNA碎片率的增加可能与精索静脉曲张患者的不育相关,且精浆活性氧水平升高可能是导致精子DNA碎片率增加的重要因素之一.     

精子染色质扩散实验检测精子DNA碎片与宫腔内人工授精妊娠率的关系

目的:探讨精液DNA碎片与宫腔内人工授精妊娠率的关系。方法:收集分析70例不育不孕患者共88个IUI治疗周期,精子染色质扩散(SCD)实验分析精子DNA碎片,苯胺蓝染色法评价精子核成熟度,并按妊娠结局分成妊娠组与非妊娠组,比较各组间精子DNA碎片比值、精子核成熟度和IUI妊娠率的关系。结果:非妊娠组SCD小光晕和无光晕精子(精子DNA碎片)比值平均为(28.3±10.6)%,非妊娠组明显高于对照组(12.0±5.9)%(P<0.05);而大光晕和中光晕精子比值非妊娠组明显低于对照组(P<0.05);非妊娠组组苯胺蓝染色阳性率明显高于对照组。结论:非妊娠组患者核成熟度异常的精子、精子DNA碎片比例增高。     

精子DNA完整性对辅助生殖技术结局的影响

目的 探讨精子DNA完整性与辅助生殖技术结局的相关性.方法 采用改良SCD法对精子DNA完整性进行测定.同时运用统计学方法对测定结果进行分析.结果 在行辅助生殖治疗的患者中,精子DNA完整性正常组与异常组比较,受精率(IVF:77.4％与84.8％,P=0.366; ICSI:90.1％与92.1％,P==0.899)、卵裂率(IVF:97.1％与96.4％,p=0.958;ICSI:96.0％与99.0％,P=0.845)、优质胚胎形成率(IVF:42.8％与38.6％,P =0.485;ICSI:25.8％与46.2％,P=0.002)及临床妊娠结局(IUI:13.8％与16.6％,P=1.000;IVF:35.3％与73.7,P=0.150;ICSI:49.5％与42.8,P=0.832)等指标,除ICSI治疗的优质胚胎率之外,差异无统计学意义.结论 精子DNA完整性尚且不能作为独立的指标对辅助生殖技术结局进行预测.     

精子形态学分析与动态分析中各参数间相关性研究

为了考察同一标本在全自动精子分析中精子形态与动态分析中各参数间的相关性 ,对 16 8份健康受试者的精液进行了测定 ,并对各参数进行了相关性分析。结果显示 ,含有原生质滴 (胞浆小滴 )的异常精子率与所有运动性参数间无相关性 ,其它形态学参数与运动性参数间具有低度相关或不相关     

复发性流产与男性精液常规及动态的相关性研究

目的探讨复发性流产与男性精液常规及动态的相关性。方法严格按照WHO技术规范,对我中心56例复发性流产患者丈夫精液做常规检查及动态分析,并设立正常对照组。结果精液检查统计分析结果表明复发性流产患者丈夫精液畸形精子指数明显高于正常对照组。精子的运动速度及前向性低于正常对照组。结论复发性流产者,其中一部分可能由于畸形精子指数高及精子运动参数异常导致。     

正常精子形态率对常规体外受精-胚胎移植临床结局的影响

目的:探讨NSMR对常规体外受精-胚胎移植(IVF-ET)临床治疗结局的影响.方法:回顾性分析在本中心行IVF治疗的565个取卵周期,根据WHO 5版推荐的Diff-Quick染色方法及评价标准对男方精液进行形态学分析,研究分为3组:A组:中度畸形组,1％≤NSMR<2.5％;B组:轻度畸形组,2.5％≤NSMR<4％...     

原发性高血压与低钾血症的相关性分析

目的研究分析原发性高血压(EH)患者的血压变化与低钾血症的相关性。方法对100例各级EH患者和30例健康者进行血压测量和血清钾的检查,比较各级血压与血清钾之间的相关性。结果 100例各级EH患者的血压变化与血清钾浓度呈负相关(P<0.05)。结论低钾血症程度与原发性高血压的血压变化密切相关,可能是EH的重要发病机制之一。     

Sperm DNA damage and its relation with leukocyte DNA damage

DNA fragmentation in human sperm has been related to endogenous and exogenous factors. Exogenous factors can also affect leukocyte DNA integrity. This study evaluated the relation between sperm DNA damage and leukocyte DNA integrity, as a predictor of exogenous factors. DNA damage in the sperm and leukocytes of 41 individuals undergoing ICSI were measured by Comet assay. In addition, sperm chromatin dispersion (SCD) was carried out on semen samples. A positive correlation was observed between the DNA integrity of sperm with leukocytes. When patients were divided into low and high DNA exposure groups, sperm DNA fragmentation was significantly different between the two groups. Cleavage rate and embryo quality showed significant correlation with leukocyte DNA integrity. The results showed that leukocyte DNA integrity could be used to identify individuals at high risk in order to reduce the extent of DNA damage in patients before ICSI in order to improve the subsequent outcome of this procedure.     

Developmental and Reproductive Outcomes in Humans and Animals After Glyphosate Exposure: A Critical Analysis

In the risk assessment process, the reference dose, tolerable intake, or acceptable daily intake (RfD, TDI, ADI) is apportioned to specific exposure sources on the basis of a source allocation factor (AF) or relative source contribution (RSC). The U.S. Environmental Protection Agency (EPA) published an exposure decision tree framework in 2000 to guide the determination of AF (or RSC) of drinking-water contaminants (DWC). Besides that, there has not been any systematic analysis of the basis of the use of AF in DWC risk assessments. This article therefore critically reviews and integrates current knowledge and approaches for the development of AF, while focusing on its consistent use in DWC risk assessments based on consideration of (i) risk assessment endpoint, (ii) existing guidelines, (iii) exposure estimates, (iv) usage pattern and environmental fate information, (v) physicochemical properties, (vi) bounds of AF, (vii) multiroute exposures, and (viii) target population characteristics. Accordingly, for a DWC for which drinking water is not a major source of exposure and for which there is documented evidence of widespread presence in one or more of the other media (i.e., air, food, soil, or consumer products), the use of an AF value of 0.2 is suggested. For DWC for which drinking water represents nearly the single major source of exposure, a ceiling AF value of 0.8 is suggested. For other situations, chemical- and context-specific AF values can be developed based on exposure data or models, which should in turn be bounded by the floor and ceiling AF values as originally described by the U.S. EPA (i.e., 0.2–0.8). Future studies need to focus on improvements in methods for deriving AF, by basing it on the consideration of bioavailability, target tissue dose, and extent of route-specific absorption, as well as improvement in the modeling of dose received via direct/voluntary exposure through consumer products and at workplaces.     

Dibromoacetic Acid Affects Reproductive Competence and Sperm Quality in the Male Rat

Recently, we demonstrated with short-duration tests that dibromoaceticacid (DBAA), a commonly occurring by-product of water disinfection,alters sperm morphology and motility in the male rat. Theseresults suggested that the effects of DBAA on sperm qualitywere likely to compromise reproductive competence of the malerat early in subchronic exposure. The present studies were undertakento investigate the dose response and time course of alterationsin fertility and sperm quality. Proven breeder male rats weregavaged daily with 0, 2, 10, 50, or 250 mg DBAA/kg for up to79 days; interim and terminal measurements of sperm qualityand reproductive outcome were made. Because of the known neurotoxicityof the analogue, dichloroacetic acid, both natural breedingand artificial inseminations were evaluated in untreated femalesto distinguish between possible behavioral and spermatogeniceffects. DBAA compromised male fertility during the second treatmentweek in naturally bred rats dosed with 250 mg/kg. The earlyantifertility effect appeared to be the result of behavioralchanges since females artificially inseminated with sperm collectedon Day 9 successfully produced offspring. However, sperm morphologyand motility also were rapidly affected by DBAA treatment sothat no offspring via natural insemination and only one littervia artificial insemination were produced subsequent to Day15. Through 31 days, substantial effects on sperm motility,sperm morphology, and epididymal sperm numbers were observed,but there was no demonstrable effect on serum testosterone orsperm production. Because severe toxicity developed in the groupgiven 250 mg/kg, exposure of these animals was prematurely terminatedafter 42 doses and their recovery was monitored through a 6-monthposttreatment period; decreased testis weights and only limitedrecovery of reproductive performance were observed. Ex posureto 50 mg/kg resulted in moderate changes in sperm morphologyand motility and moderate decreases in epididymal sperm countsin rats dosed for 31 or 79 days. However, these males remainedfertile, litter size was unaffected, and no paternally mediateddevelopmental defects were noted in their offspring. No effectson sperm quality were detected at dosages of 2 or 10 mg/kg.However, compared to controls, naturally bred DBAA-treated ratstended to have fewer inseminations, fewer copulatory plugs,and fewer multiple litters, suggesting that DBAA may have alteredmating behavior at dosages as low as 10 mg/kg.     

辅助生殖技术后致异位妊娠的临床特点及处理

目的：探讨辅助生殖技术后致异位妊娠的临床特点及处理对策,加深临床医师对辅助生殖技术并发症的认识,减少移植后异位妊娠的误诊或漏诊。方法：回顾性总结我院近12年间助孕中心辅助生殖技术后致异位妊娠并行手术治疗的49例患者的异位妊娠类型、高危因素及手术治疗方案。结果：输卵管妊娠是辅助生殖后致异位妊娠最为常见的类型,单纯输卵管妊娠和复合妊娠中输卵管妊娠者占85.71%。其它类型包括宫角妊娠、卵巢妊娠及腹腔妊娠。辅助生殖技术后致异位妊娠的高危因素包括输卵管因素、子宫内膜异位症、异位妊娠及其他妇科手术史、人流史、子宫因素等。各高危因素间差异有统计学意义（X2=34.8,P＜0.001）,其中输卵管因素占42.86%,为辅助生殖后致异位妊娠的最主要因素。输卵管妊娠者多行腹腔镜下患侧或双侧输卵管切除术,宫角妊娠依据胎囊部位,可行腹腔镜联合腹部超声下吸宫术,或腹腔镜下宫角部分切除术。49例患者术后均无持续性宫外孕,均临床治愈（治愈率100%）。结论：ART后致EP的高危因素中输卵管因素为最主要的因素。对于输卵管因素导致不孕的患者,建议ART前行输卵切除术,以降低异位妊娠发生的概率。在移植前需与患者沟通,做好心理准备和疏导。异位妊娠提倡及早发现,及时治疗。复合妊娠不提倡期待疗法,应立即手术治疗。既要去除异位妊娠灶,又要力争宫内活胎继续妊娠。     

血清硫酸粘多糖片断与非小细胞肺癌的关系探讨及应用价值

目的 探讨血清硫酸粘多糖片断与非小细胞肺癌(NSCLC)的关系及血清硫酸粘多糖片断检测的应用价值。方法 采用美国Polylabs的LTA乳胶凝集法试剂检测NSCLC26例、非NSCLC恶性肿瘤50例、非肿瘤80例患者和正常人对照108例血清硫酸粘多糖片断;观察12例LTA阳性NSCLC病例治疗前后血清硫酸粘多糖片断变化情况。结果NSCLC组、非NSCLC恶性肿瘤组、非肿瘤组、正常人对照组阳性率分别为88.46%、14.00%、10.00%、7.41%;LTA乳胶凝集试剂检测硫酸粘多糖片断对NSCLC的灵敏度为88.46 %,特异性为90.33%;各对照组之间对LTA乳胶凝集试剂检测结果的特异性差别无显著性意义(x2=0.035,P>0.05);NSCLC组与各对照组之间对LTA乳胶凝集试剂检测差别均有显著性意义(P<0.01)。12例LTA阳性NSCLC患者治疗前后血清硫酸粘多糖片断的变化与对NSCLC的治疗疗效有关(x2=0.89,P>0.05)。 结论 LTA法检测血清硫酸粘多糖片断用于筛查高危人群中NSCLC患者,对NSCLC临床诊断及观察疗效有较大的应用价值。