人类精子库供精志愿者筛查结果分析

目的分析供精志愿者筛查结果及被淘汰原因。方法按2003年卫生部修订的《人类精子库基本标准和技术规范》对576例供精志愿者进行筛查。结果82例(14．2%)成为合格的供精者,淘汰494例(85．8%),其中：441例(89．3%)未达到人类精子库有关的精液质量要求,26例(5．3%)主要是体检中支原体阳性(11/108)、乙肝表面抗原阳性(6/108)和常规细菌培养异常(4/108)等,其他原因27例(5．4%)。结论供精志愿者筛查被淘汰的主要原因是精液质量未达到人类精子库标准,另外支原体、乙肝表面抗原阳性及精液常规细菌培养异常等也是淘汰的重要因素。     

四川地区2754名供精志愿者染色体筛选及结果分析

目的 分析四川地区供精志愿者染色体筛选结果,为精子库排除志愿者遗传缺陷提供依据。方法 选取2013年1月至2022年12月于四川大学华西第二医院生殖男科/人类精子库进行精液筛查的2 754例供精志愿者,分析其染色体核型结果。据染色体结果将供精志愿者分为染色体正常组(2 661例)、染色体核型异常组(7例)及染色体多态性组(86例),比较3组间的人群特征及精液参数。结果 2 754例供精志愿者中,有93例供精志愿者为染色体核型异常或染色体多态性,检出率为3.38%(93/2 754)。染色体正常组、染色体核型异常组及染色体多态性组3组间的年龄、身高、体重及体质量指数(BMI)均无显著差异(P>0.05);3组间冷冻前及复苏后的精液质量也均无显著差异(P>0.05)。93例染色体核型异常或染色体多态性的供精志愿者中,染色体核型异常的志愿者有7例,占比7.53%(7/93);染色体多态性86例,占比92.47%(86/93)。染色体多态性中以D组(13、14、15号)和G组(21、22及Y)染色体随体区变异最多,多态性占比34.88%(30/86);其次为25例1号、9号、16号...     

尿毒症患者精液质量的变化

目的 :分析肾移植术前尿毒症患者精液质量的变化。　方法 :对 2 4例尿毒症患者和 12例正常男性的精液进行常规分析。　结果 :尿毒症患者的精液体积、精子活动力、存活率、精子密度及精子正常形态百分率分别为 (2 .5± 0 .4 )ml、(13.4± 3.9) %、(2 5 .4± 5 .6 ) %、(2 0 .6± 4 .5 )× 10 6/ml和 (16 .8± 2 .1) % ,明显低于正常对照组 (P均 <0 .0 1)。　结论 :尿毒症患者精液质量显著降低 ,生精功能受到严重影响。     

男性肿瘤患者精液冷冻保存后常规参数分析

目的:了解男性肿瘤患者精液质量现状,探索保存男性肿瘤患者生育能力的方法。方法:对来源于2005~2013年浙江省人类精子库43例肿瘤自精保存患者的精液质量进行回顾性分析,检测项目包括精液体积、精子浓度、精子活力、精子冷冻复苏率等指标。比较肿瘤患者与供精志愿者(248例)之间精液质量的差异;并将肿瘤患者分为睾丸肿瘤组(22例)和非睾丸肿瘤组(21例),比较两组之间精液质量的差异。结果:43例肿瘤患者精液的平均精子浓度(60.90×106/ml)、前向运动精子百分率(41.07%)及精子冷冻复苏率(49.98%)均显著低于供精志愿者(分别为74.27×106/ml、51.79%和57.33%),P均<0.05;睾丸肿瘤组的冻后平均前向运动精子百分率(15.68%)与冷冻复苏率(42.81%)均显著低于非睾丸肿瘤组(分别为28.36%和57.53%),P均<0.05。结论:肿瘤患者精液质量普遍下降,进行自精保存的时机非常重要,应该加强自精保存的宣传力度。另外,睾丸肿瘤患者精液冷冻保存效果较差,精子库应对其冷冻复苏率低下的原因进行深入研究,优化冷冻保存技术,为患者提供更好的生育力保护。     

重庆市人类精子库捐精志愿者精液质量分析

目的:了解重庆市人类精子库捐精志愿者精液质量,探讨年龄对精液质量的影响。方法:收集重庆市人类精子库899例捐精志愿者精液样本,根据年龄分为5组:22~25岁、26~30岁、31~35岁、36~40岁、40岁,使用Makler板人工计数,分别进行精液体积(ml)、前向运动(PR)精子百分率(PR%)、精子总活力[(PR+NP)%]、精子浓度、精子总数及正常形态精子百分率检测,并与世界卫生组织《人类精液检查与处理实验室手册》第5版(以下简称WHO第5版)的参考值进行比较;各年龄段的精液参数指标采用中位数表示,比较精液质量差异。结果:899例捐精志愿者精液参数第5百分位数精液体积(1.8 ml)、精子浓度(25.0×10~6/ml)、精子总数(100.7×106)和正常形态精子百分率(4.3%)均高于WHO第5版第5百分位数参考值,PR%(31.0%)、(PR+NP)%(38.0%)低于WHO第5版第5百分位数参考值;精液参数中位数精液体积(4.0 ml)、精子浓度(88.0×10~6/ml)、精子总数(333.7×106)高于WHO第5版中位数参考值,正常形态精子百分率(11.6%)低于WHO第5版中位数参考值,PR%(55.0%)和(PR+NP)%(61.0%)与WHO第5版中位数参考值一致。精子浓度在22~25岁、26~30岁、31~35岁、36~40岁、40岁年龄组分别为88.0(1.0~270.0)×10~6/ml、96.0(5.0~335.0)×10~6/ml、100.0(3.0~200.0)×10~6/ml、105.0(15.0~225.0)×10~6/ml、90.0(22.0~159.0)×10~6/ml,在各年龄组间有显著性差异(P0.05),精液体积、PR%、(PR+NP)%、精子总数和正常形态精子百分率在各年龄组间无显著性差异(P0.05)。结论:重庆市人类精子库捐精志愿者精液质量普遍较好。随着年龄的增长,精子浓度呈显著性升高,但40岁以后精子浓度呈显著性下降。     

供精者捐精的最佳时间研究

目的 了解禁欲时间对供精志愿者精液参数、精了形态及冷冻精液合格率的影响,为供精志愿者捐精最佳时间提供依据.方法 6414份精液样奉均来自2006年9月-2008年6月浙江省计划生育科学技术研究所人类精子库的1135例供精志愿者,年龄22至32周岁.对所有6414份精液标奉进行精液常规分析:其中的483例供精志愿者的精液标本进行精子形态学分析;5425份精液标木进行冷冻及冻后精液常规分析.结果 按禁欲时间分为3d、4d、5d及6～7d四组,各组之间精液量、精子密度及前向运动精子百分率有显著性差异(P＜0.05),精液量、精子密度随禁欲时间的延长而增加,前向运动精子白分率随禁欲时间的延长而下降,各组之间的精液pH值无显著性差异(P＞0.05);四组之间精子正常率、头部异常率、预及中段异常率、尾部异常率、胞质小滴发生率、畸形精子指数(TZI)及精子畸形指数(SDI)均无显著性差异(P＞0.05);各组之间前向运动精子冷冻复苏率无显著性差异(P＞0.05),但禁欲3d、4d、5d三组冷冻精液合格率均高于禁欲6～7d组,有显著性差异(P＜0.05);结论禁欲3～7d,精液量、精子密度随禁欲时间的延长而增加,前向运动精子百分率随禁欲时间的延长而下降;禁欲时间对精子形态参数、前向运动精子冷冻复苏率无影响;禁欲3～5d的冷冻精液合格率明显高于禁欲6～7d,供精者捐精的最佳禁欲时间为3～5d.     

2008～2018年捐精志愿者精液细菌培养结果分析

目的:分析捐精志愿者精液中病原菌分布情况及细菌感染对精液质量的影响。方法:对2008～2018年4 897例捐精志愿者精液样本进行细菌培养,按菌落数不同分为<10~4cfu/ml组(n=4 229)和≥10~4cfu/ml组(n=150),并选择同期未检出细菌的捐精志愿者518例(即菌落数=0 cfu/ml)作为对照组,采用生物梅里埃公司的微量生化反应系统对菌落数≥10~4cfu/ml的样本进行菌种鉴定,使用SCA计算机辅助精液分析仪对所有精液样本进行分析,并与对照组的精液质量进行比较。结果:4 897例捐精志愿者精液样本细菌培养中,杂菌生长的精液样本6例(0.12%),细菌纯生长的精液样本4379例(89.42%),其中菌落数≥10~4cfu/ml的精液样本150例(3.43%)。菌落数≥10~4cfu/ml的精液样本中培养出革兰阴性菌(G~-菌)104例(69.33%),以大肠埃希菌为主,普通变形杆菌和肠杆菌次之;革兰阳性球菌39例(26.00%),革兰阳性性杆菌4例(2.67%),淋病奈瑟氏菌3例(2.00%)。菌落数≥10~4cfu/ml和菌落数<10~4cfu/ml的精子总数和前向运动精子百分率明显低于对照组精子总数(P<0.05),精液液化时间、精液pH值、精子总活力和正常形态精子百分率与对照组比较无明显差异(P>0.05)。结论:捐精志愿者精液细菌培养阳性率占89.42%,细菌种类较多,以G~-菌为主。同时,精液质量随着菌落数的增多呈降低趋势。     

重庆市人类精子库440例合格志愿者捐精有效率分析

目的:分析合格志愿者捐精有效性,为提高精子库效益提供依据。方法:对重庆市人类精子库2015年4月至2019年6月440例合格志愿者捐精情况进行分析,统计其捐精情况、捐精不合格原因及精液细菌培养结果。结果:440例合格志愿者中,合格后未进行捐精11例(2.50%),合格后多次捐精不成功而淘汰28例(6.36%),完成捐精流程397例(90.2%),最后1次捐精结束后6个月未进行HIV复查4例(0.91%);完成捐精流程的397例志愿者共捐精2 965例次,合格2 159例次(72.8%),不合格806例次(27.2%),其中精子浓度、活力不达标684例次(23.1%),精液体积小于2 ml 33例次(1.11%),精液液化异常14例次(0.47%),精液细菌培养不合格75例次(2.53%)。结论:精液质量不达标是影响捐精效果的主要因素,人类精子库工作人员应重视首次接待,过程中加强沟通,消除顾虑,同时加强保健指导,预防污染,提高捐精成功率。     

睾丸精曲小管精子发生功能量化评价法分析无精子症患者睾丸生精功能

目的 :分析无精子症患者临床和病理资料 ,研究病理学量化评价睾丸精曲小管精子发生功能的方法的临床意义。　方法 :无精子症患者 112例 ,年龄 2 2～ 4 6 (2 9.0± 4 .4 )岁 ,婚龄 2～ 12 (4 .0± 2 .8)年、病程 2～ 6 (2 .70±1.0 2 )年 ,其中原发性无精子症 96例 ,继发性无精子症 16例 ;梗阻性无精子症 7例。不育症患者精液常规检查 3次确认无精子症 ,检测性激素水平 ,常规消毒下睾丸活检病理检查 ,在高倍镜下计数每个精曲小管中各类生精细胞数 ,测定小管直径、生精上皮高度和固有层厚度 ,按制定的精曲小管精子发生功能 10分 5级分度法加以评分 ,进行统计学分析。　结果 :精曲小管生精上皮 10分分度法评分结果 ,1分 5例 (4 .5 % ) ,2分 38例 (33.9% ) ,3分 2例(1.8% ) ,4分 6例 (5 .4 % ) ,5分 2例 (1.8% ) ,6分 17例 (15 .2 % ) ,7分 6例 (5 .4 % ) ,8分 19例 (17% ) ,9分 10例(8.9% ) ,10分 7例 (6 .3% )。精曲小管精子发生功能 5级分度法结果 ,1级 5例 (4 .5 % ) ,2级 38例 (33.9% ) ,3级 33例 (2 9.5 % ) ,4级 2 9例 (2 5 .9% ) ,5级 7例 (6 .3% )。多元回归分析结果 ,精曲小管精子发生功能分级与生精上皮高度、固有层厚度、精曲小管直径和血清卵泡刺激素 (FSH)具有极显著相关性 (P <0 .0 1)。组合     

冷冻精液行供精人工授精685例临床观察

目的比较ICI和IUI的成功率,评价人类精子库的冻精质量。方法对用我库的冷冻精液行供精人工授精(AID)治疗有适应证妇女685例的临床资料进行回顾性分析。精液冻后平均活率为(62.23±26.78)%,平均密度为(38.17±13.62)×106/ml。结果供精人工授精685例,共有1385个周期中214例获临床妊娠,周期妊娠率15.5%,受孕率31.2%,二种AID方法的成功率无显著性差异(P>0.05)。结论我院人类精子库的冷冻精液各项指标均达到并超过部颁标准,可用作供精人工授精。     

上海地区正常生育力男性精液参考值初探

目的:回顾分析上海地区志愿捐精者与正常生育力男性精液分析各项主要参数的分布特征,比较两组男性精液质量的差别,探讨上海地区男性精液参数的正常参考值下限。方法:2010年10月至2011年7月上海市人类精子库招募正常生育力男性41例,健康捐精者100例,按《世界卫生组织人类精液检查与处理实验室手册》(第5版)进行精液常规检测,评估精液体积、精子浓度、前向运动(PR)精子百分率、精子总数和PR精子总数的均值,标准差,并进行t检验。同时统计正常生育力组上述各参数的分布,得出精液特征参数的正常参考值下限。结果:健康捐精组与正常生育力组精液常规各项主要参数(精液体积、精子浓度、PR精子百分率、精子总数、PR精子总数)间差异无统计学意义(P<0.05)。上海地区正常生育力男性精液参考值下限(P<0.05)为:浓度≥27.3×106/ml、PR≥8.1%、体积≥0.82 ml、精子总数≥44.73×106/1次射精、PR精子总数≥24.68×106/1次射精。结论:在评估男性生育力时,精子总数和PR精子总数可能是比精子浓度、精液体积和PR精子百分数更具参考价值的评价指标。     

Single semen analysis as a predictor of semen quality： clinical and epidemiological implications

It is generally thought that a single ejaculate is a bad predictor of semen quality of a subject, because of significant intra-individual variation. Therefore, we investigated the degree to which the results of a first semen analysis differ from that of a second analysis among men from a how the two different semen results mirrored the overall general population in Norway. In addition, we analysed semen quality assessment. A total of 199 volunteers participated in the study and delivered two semen samples with an interval of 6 months. The semen parameters were determined according to the World Health Organization （WHO） 1999 guidelines, which were also used to determine whether semen quality was normal or abnormal. In addition, the DNA fragmentation index （DFI） was determined using the Sperm Chromatin Structure Assay. The two samples from each individual were very similar with regard to standard semen parameters and DFI （rs： 0.67-0.72）, and there were no significant systematic differences between the two samples. The result of the first sample （normal/abnormal） was highly predictive of the overall conclusion based on the two samples （sperm concentration： in 93% of the cases （95% confidence interval [CI]： 89%-96%）; sperm motility： in 85% of the cases （95% CI： 79%-89%）; overall semen quality： in 85% of the cases （95% CI： 80%-90%）. In epidemiological studies, one ejaculate is a sufficient indicator of semen quality in a group of subjects. In a clinical situation, when the question is whether the semen quality is normal or not, the first ejaculate will, in at least 85% of cases, give a correct overall conclusion.     

精索静脉曲张不育患者的精液质量和精子形态学观察

目的:观察不育伴精索静脉曲张(VC)患者的精液质量和精子形态学变化。方法:98例不育伴VC患者精液按WHO标准常规分析并对精子形态学进行评价。130例正常供精者精液检测结果作为对照。结果:VC患者正常形态精子和前向运动精子明显低于对照组(P<0.001),精子畸形的类型以梨形、锥形和不定型头部畸形为主。结论:VC可导致精子畸形率升高,后者可能是男性生育力受损的重要标志之一,经染色后的精子形态学分析是判定VC患者精子受损的一个敏感指标。     

Semen quality evaluation in a cohort of 28213 adult males from Sichuan area of south‐west China

The trends in semen quality are conflicting. Although many previous surveys on semen quality indicated a decline, the trends in semen quality in Sichuan area of south‐west China are not clear. We analysed the semen parameters in a cohort of 28 213 adult males close to general population in Sichuan between July 2007 and June 2012, and investigated the changes on semen quality. The semen parameters including pH, volume, concentration, motility, morphology were measured according to the World Health Organization (WHO) criteria. Kruskal–Wallis analysis of variance was used to examine the statistical differences of semen quality between groups. We found that the medians (5th and 95th percentiles) were 2.4 ml (1.0–5.0) for semen volume, 62.0 × 10⁶ ml^?1 (15.0–142.0) for semen concentration, 39% (18–60%) for sperm progressive motility and 10.5% (1.0–34.5%) for normal morphology. In these 5 years, sperm concentration and the percentage of sperm normal morphology were decreased from 66.0 × 10⁶ ml^?1 to 49.0 × 10⁶ ml^?1 and from 13.5% to 4.5%, respectively; among different reproductive history groups, sperm concentration and the percentage of sperm normal morphology were also decreased in these 5 years. And the incidence of azoospermia was increasing. These may imply that there is a decline in semen quality of adult males in Sichuan area.     

Evaluation of semen quality in 1808 university students,from Wuhan,Central China

The aim of this study was to evaluate the semen quality of university students in Wuhan, the largest city in the world in terms of the number of university students. All student sperm donors recorded in the Hubei Province Human Sperm Bank from 1 March 2010 to 31 December 2013 were screened. At last, a total of 3616 semen samples from 1808 university student sperm donors were eligible and retrospectively analyzed. Each donor''s semen parameters were averaged over two samples and compared with the World Health Organization criteria, and a generalized linear regression model was used to examine several determinants of semen quality. We found that the mean and median values were 3.0 ml and 2.8 ml for semen volume, 50.2 × 10⁶ ml⁻¹ and 50.0 × 10⁶ ml⁻¹ for sperm concentration, 148.1 × 10⁶ and 142.1 × 10⁶ for total sperm count, and 58.6% and 60.0% for total sperm motility. About 85.0% of donors had parameters that were all normal. Season and duration of abstinence were critical factors affecting semen quality. We also found a decrease in sperm concentration during the 4 years observation; however, this may not be a strong evidence to confirm the declining trend of semen quality. In conclusion, semen quality of university students in Wuhan was not optimal and should be paid high attention, long-term observation and further study should be carried out to confirm the present situation.     

Effects of leucocytospermia on semen parameters and outcomes of intracytoplasmic sperm injection

Leucocytes are present throughout the male reproductive tract but the clinical significance of leucocytic infiltration in the human ejaculate is controversial. The World Health Organization (WHO) defines leucocytospermia as the presence of peroxidase-positive leucocytes in concentrations of > or =1 x 10(6)/mL of semen. The goals of this study were to clarify the relationship between leucocytospermia and semen parameters including sperm concentration, progressive and total motility before and after semen preparation, and intracytoplasmic sperm injection (ICSI) outcomes, including fertilization, embryo development, embryo morphology, cleavage and pregnancy rates. We compared the semen parameters and ICSI outcome of 34 leucocytospermic and 36 non-leucocytospermic control couples who were undergoing ICSI because of male factor infertility including oligo and/or astheno and/or teratozoospermia. Semen parameters including progressive motility rate (1.5% vs. 3%) and sperm concentrations (12 vs. 29 million/mL) were significantly lower in the leucocytospermic group compared with the control group. Other semen parameters were not affected by the presence of leucocytes. ICSI outcome, including fertilization (82% vs. 87%) and embryo development rates (79% vs. 86%) were significantly lower in the leucocytospermic group compared with the control group although there were no statistical difference for embryo quality, embryo cleavage and pregnancy rates. These results indicate that some semen parameters and the outcome of ICSI were negatively affected by the presence of leucocytospermia.     

18～35岁男性军人精液质量调查

目的:了解部队男性官兵精液质量现况。方法:采用手工方法与计算机辅助精液分析对某部1054例基层官兵进行了精液参数10项分析,并根据年龄分为18～20岁,21～25岁,26～30岁和31～35岁4组,分析并比较各组精液参数。结果:1054例青壮年男性精液量为(2.6±1.4)ml、精子密度为(55.9±46.5)×106/ml、a+b级精子(47.1±19.0)%、精子存活率为(70.6±22.1)%、正常形态精子率为(84.7±10.2)%、顶体完整率为(86.1±7.2)%。18～20岁组精液量少、粘度大、pH值偏碱性,与其他3组相比,差异有显著性(P<0.05)。精液质量指标符合WHO标准的百分率为精液量73.5%、液化时间91.1%、pH值93.0%、a+b级精子45.5%、精子存活率86.7%、精子密度80.4%、正常形态精子率为98.2%、精子总数为78.0%,上述各项指标都符合WHO标准的对象仅占40.2%。结论:18～35岁部队基层官兵男性精液质量现况好于国内同类文献报道。在不同年龄分组研究中26～30岁年龄组人员精液质量好于其他年龄组。     

The reference values for semen parameters of 1213 fertile men in Guangdong Province in China

Semen samples were collected from 1213 fertile men whose partners had a time-to-pregnancy (TTP) ≤12 months in Guangdong Province in Southern China, and semen parameters including semen volume, sperm concentration, total counts, motility, and morphology were evaluated according to the World Health Organization (WHO) 2010 guideline. All semen parameters analyzed were normal in ~62.2% of the total samples, whereas ~37.8% showed at least one of the semen parameters below normal threshold values. The fifth centiles (with 95% confidence intervals) were 1.3 (1.2–1.5) ml for semen volume, 20 × 10⁶ (18×10⁶–20×10⁶) ml⁻¹ for sperm concentration, 40 × 10⁶ (38×10⁶–44×10⁶) per ejaculate for total sperm counts, 48% (47%–53%) for vitality, 39% (36%–43%) for total motility, 25% (23%–27%) for sperm progressive motility, 5.0% (4%–5%) for normal morphology. The pH values ranged from 7.2 to 8.0 with the mean ± standard deviation at 7.32 ± 0.17. No effects of age and body mass index were found on semen parameters. Occupation, smoking and alcohol abuse, varicocele appeared to decrease semen quality. Sperm concentration, but not sperm morphology, is positively correlated with TTP, whereas vitality is negatively correlated with TTP. Our study provides the latest reference values for the semen parameters of Chinese fertile men in Guangdong Province, which are close to those described in the new WHO guidelines (5^th Edition).