精液参数与射精频率的关系

通过对２０例性功能正常的男子（１０例精液正常，１０例少弱精症）连续１周，每天采集精液标本进行观察，探讨了他们的精液参数与射精频率之间的关系，结果表明，正常组的精液容积，１次射精的精子总数逐日下降，于第５天降至原水平５０％左右；以后维持在该水平上下波动，而精子密度并不下降，少弱精组精液容积，精子密度及１次射精的精子总数均显著下降，精子活力和形态在两组中都相对变化不大。     

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。     

少精,无精症者精浆表皮生长因子分析

按ＷＨＯ精液参数标准分析精液常规后,根据精子密度＞ ２０,１１ ～２０,１～１０（ ×１０６ 精子／ｍｌ） 和无精子将研究对象相应分为Ⅰ、Ⅱ、Ⅲ、Ⅳ组,每组２０ 例。用放射免疫法测精浆ＥＧＦ,并与有关参数进行相关分析。结果显示：Ⅰ、Ⅱ、Ⅲ、Ⅳ组精浆ＥＧＦ浓度分别是３ ．４４ ±１ ．０９ ,４．２２ ±１ ．１６,４．４１ ±１．７４ ,４ ．３３ ±１ ．４７（ｎｇ／ｍｌ） ,Ⅰ组显著低于Ⅱ、Ⅲ、Ⅳ组（Ｐ＜ ０．０５）;１ 次射精的ＥＧＦ水平分别是８．０１±３．３１,１０．４１±４．６１,９ ．７５ ±４ ．０７ ,９ ．６６±３ ．９５（ｎｇ／１次射精）,组间比较没有显著差异;相关分析表明,精浆ＥＧＦ浓度（ｎｇ／ｍｌ） 与１ 次射精精子数呈显著负相关关系（ｒ＝ － ０．２５４８,ｎ＝ ６０ ,Ｐ＜０ ．０５）,而在Ⅱ、Ⅲ组中,１ 次射精ＥＧＦ水平与精子计数呈显著正相关关系（ｒ＝ ０．３７１６ ,ｎ＝４０,Ｐ＜ ０．０２） ,精浆α糖苷酶、果糖、精子顶体酶无相关关系。     

先天性双侧输精管缺如2例报告

先天性双侧输精管缺如２例报告罗建良，陈欲昌例１２７岁。因结婚１．５年未育就诊。性生活正常，有射精，但每次射精后觉两侧阴囊胀痛不适，多次检查精液均未发现精子。否认有腮腺炎及结核病史，检查：男性第二性征正常，外生殖器成人型，两侧睾丸容积１３ｍｌ，附睾头增...     

连续射精对正常男性精液分析参数的影响

目的 :探讨连续射精对正常男性精液分析参数的影响。　方法 :8名正常男性逐日手淫取精 ,共 8d。采用世界卫生组织人类精液检验手册方法测定精液体积、pH值、精子密度、总精子数、存活率和活动率 ,进行统计学分析。　结果 :精液体积、总精子数逐日下降 ,从第 5d起至第 8d非常显著低于第 1d(P <0 .0 1)。精子密度亦呈逐渐下降趋势 ,但无显著性差异。精子存活率和精子活动率 (a +b级 )均呈逐渐上升趋势 ,但是仅第 7d显著高于第1d(P <0 .0 5 )。　结论 :人类精液体积、总精子数随射精频度增加而显著降低 ,精子存活率和活动率增加。频繁射精并不影响正常男性精液质量。     

PSA和PAP在不同状态精液中的变化

目的　探讨不同状态精液中PSA和PAP的变化水平及二者间的关系。方法　按WHO精液分析标准 ,112份精液样品分为精液正常组 ,少、弱精子症组 ,无精子症组 ,白细胞精子症组 ,液化不良精子症和高粘度精液组。分别测定精浆中PSA水平和PAP活性 ,并分别以每毫升 ,每克精浆蛋白和 1次射精表示PSA的量及PAP活性。结果　三种表示方法的PSA含量在各异常精液组均较正常组呈下降趋势 ,但只有以每克精浆蛋白表示PSA量时 ,除无精子症组外 ,其它各异常组才显著低于正常组 ;三种方法表示的PAP活性 ,在少、弱精子症组均显著低于正常组 ;以 1次射精表示PSA和PAP时 ,无精子症组均低于正常组 ;以同一种表示方法的结果进行PSA和PAP间相关分析时显示以每克精浆蛋白表示法相关性最好 (r =0 .689,P <0 .0 0 1,n =112 )。结论　以mg/ g精浆蛋白表示PSA含量能更准确反映精浆中PSA的实际状态     

1985～2008年间我国正常男性精液质量变化分析

目的:研究1985～2008年间国内正常男性精液质量变化趋势。方法:检索历年发表的精子质量方面的文献,系统收集相关资料和数据,利用散点图和直线回归法,分析近24年正常男性精液精子密度、精液量及精子总数的变化。结果:1985～2008年间国内正常男性精液质量参数中精液量没有明显变化(P>0.05)。1985～1994年精子密度和精子总数不存在与时间相关的变化(P>0.05),但自1995年后的14年以来,精子密度和精子总数呈现显著下降趋势(P<0.05),精子密度从1995年81.5×106/ml下降到2008年66.7×106/ml,每年降低1.40%;精子总数从1995年257.2×106下降到2008年的185.9×106,每年下降2.15%。结论:1985～1995年间国内正常男性精液质量未见明显变化,而1995～2008年14年间精子密度和精子总数明显降低,很可能与进入重化工时代引起的日益加重的环境污染有关。     

流式细胞计检测人精子顶体及其与精液其他参数的关系

运用流式细胞计及人精子顶体特异性标记物结合异硫氰酸荧光素的花生凝集素检测了３４例精液精子顶体结构的完整性。其中正常生育精液１２例，弱精症精液１２例，畸形弱精症精液１０例。并且进一步检测了２０例精液在体外诱导下精子发生顶体反应的能力，其中正常生育精液１０例，不育精液１０例。结果表明人精子顶体结构的完整性与精于正常形态百分率，存活率，前向运动百分率显著正相关（Ｐ＜０．００１）。不育组精子在体外诱导下发生顶体反应的能力明显低于生育组（Ｐ＜０．０１），说明流式细胞计能用于预测生育力。     

吸烟和不吸烟不育男子精液参数比较

为了探讨吸烟对精液各参数的影响及与不育的关系,本文选择了吸烟和不吸烟不育男子各50例,作精液各参数对比研究。结果表明:少、中量吸烟(1～20支/天)对精液各参数无明显影响,大量吸烟者(>20支/天),1次射精精子总数显著低于不吸烟组(P<0.01),精子密度、活动精子百分率及前向运动级别也明显低于不吸烟组(P<0.05)。提示大最吸烟可能对生育有不良影响。作者认为,对于不育男子,尤其是精子质量不良者,应避免大量吸烟。     

糖尿病患者与健康男性精液参数的比较性研究

目的通过分析男性糖尿病(DM)患者精液的主要参数,明确糖尿病导致男性生育能力损伤在精液方面的具体指标。方法采集2013年3月至2014年5月期间在本研究机构就诊的且已经在我院内分泌科确诊为糖尿病、并有生育需求的就诊患者与正常育龄男性对照研究。两组均按照25~35岁、36~45岁分为两个年龄段组。采集其精液观测精液量、酸碱度(pH)、液化时间、精子密度、精子总数、各级精子百分率。所得数据进行统计学分析比较。结果糖尿病患者精液量减少、精液液化时间延长、(a+b)级精子减少,这几项均与正常组人群存在显著性差异;精液的pH、精子密度、c级和d级精子均与正常组比较没有显著性差异。结论糖尿病患者精液质量下降主要引起了精液量、精液液化时间、精子活力的异常,从而导致男性生育能力降低。     

Study of a group of 484 fertile men Part I: Distribution of semen characteristics

The semen characteristics studied were the sperm count, semen volume, morphology and pre-freeze and post-thaw motility. Two categories of fertile men were investigated: semen donor candidates for artificial insemination and pre-vasectomy subjects. Since mean values for each variable in the two series were similar, they could be considered as a single group of 484 fertile men. Only those subjects whose ejaculates were obtained after an abstinence of 5 days or less were retained. The distribution, mean and percentiles were determined for each variable. The 10th and 90th percentiles for sperm count, percentage of motile forms and percentage of normal cells were respectively 25 and 180 million per ml, 60% and 80% and 50% and 75% The three variables, sperm count, semen volume and total number of spermatozoa which were dependent on abstinence were analysed in the same manner for 3 days of abstinence. The group studied seemed to be as representative and as well defined as possible.     

Decline of semen quality among 10 932 males consulting for couple infertility over a 20-year period in Marseille,France

Semen from 10 932 male partners of infertile couples was analysed and sperm parameter trends were evaluated at the Reproduction Biology Laboratory of the University Hospital of Marseille (France) between 1988 and 2007. After 3–6 days of abstinence, semen samples were collected. Measurements of seminal fluid volume, pH, sperm concentration, total sperm count, motility and detailed morphology of spermatozoa were performed. Sperm parameters were analysed on the entire population and in men with normal total numeration (≥40 million per ejaculate). The whole population demonstrated declining trends in sperm concentration (1.5% per year), total sperm count (1.6% per year), total motility (0.4% per year), rapid motility (5.5% per year) and normal morphology (2.2% per year). In the group of selected samples with total normal sperm count, the same trends of sperm quality deterioration with time were observed. Our results clearly indicate that the quality of semen decreased in this population over the study period.     

Semen quality changes among 2343 healthy Slovenian men included in an IVF-ET programme from 1983 to 1996

To determine whether semen quality in Slovenians has changed over 14 years (1983-96), we analysed retrospectively the semen of 2343 healthy men with a normal spermiogram, who were partners of women with tubal infertility included in the IVF-ET programme. Age at semen collection, duration of sexual abstinence, semen volume, sperm concentration, total sperm count, percentage of spermatozoa with progressive motility, and normal morphology were determined. Multiple regression analysis was used to assess the changes in sperm characteristics according to the year of semen collection, year of the man's birth and the duration of sexual abstinence. Semen volume, sperm concentration, sperm count and total sperm motility did not change between 1983 and 1996, whereas between 1988 and 1996 rapid progressive sperm motility decreased by 0.95% per year (p < 0.0001). Semen volume, sperm concentration, and sperm count increased with duration of sexual abstinence. After adjustment for the year of semen collection and duration of sexual abstinence, multiple regression analysis showed that sperm concentration decreased by 0.67% per each successive year of birth (p = 0.03). Thus the sperm concentration decreased from 87.6 x 10(6)/mL in men born in the 1940s to 77.3 x 10(6)/mL in those born between 1956 and 1960. After 1960, sperm concentration was found to increase. In 2343 healthy men, no decline in semen quality, except in rapid progressive motility, was observed in the study period. Lower sperm concentration was found among men born between 1950 and 1960. This could be related to worse socio-economic status, stress or negative environmental factors in this time period.     

复方玄驹胶囊治疗少弱精子症患者的多中心临床研究

目的:观察复方玄驹胶囊治疗少弱精子症患者的疗效。方法:采用多中心、开放性、自身前后对照的临床研究方法,对120例少弱精子症患者采用口服复方玄驹胶囊(3粒,3次/d)治疗12周。以精子密度和(a+b)级精子为主要疗效指标,以a级精子、精子活动率及精液量为次要疗效指标,评价复方玄驹胶囊治疗效果。结果:有107例患者完成了临床研究,与治疗前相比,除精液量仅在治疗12周后明显增加(P<0.01)外,精子密度、a级精子和(a+b)级精子及精子活动率等精液参数在治疗4、8和12周后具有显著改善(P均<0.01)。此外,与治疗4周后相比,精子密度、a级精子和(a+b)级精子及精子活动率等精液参数在治疗8周和12周后也有显著改善(P<0.05或0.01);同样,与治疗8周后相比,精液参数在治疗12周后也有显著改善(P均<0.01)。治疗12周后,精子密度增加了63.28%,达到正常标准的病例数为73例(68.22%);(a+b)级精子提高了63.17%,达到正常标准的病例数为39例(36.45%);a级精子提高了78.56%,达到正常标准的病例数为34例(31.78%);精子活动率提高了44.36%,达到正常标准的病例人数为77例(71.96%);精液量增加了18.13%。结论:复方玄驹胶囊可明显提高少弱精子症患者精液质量,未见明显不良反应。     

Relationship of Sperm Acrosin Activity to Semen and Clinical Parameters in Infertile Patients/Die Beziehung der Akrosinaktivität zu verschiedenen Sperma- und klinischen Parametern bei infertilen Patienten

Acrosin activity (aa) was routinely measured in 189 infertile men who attended the hospital between March 1984 and January 1985. The evaluation of the male included semen analysis, microbial screening, postcoital testing (PCT), in vitro sperm penetration test (SPMT), and screening for anti-sperm antibodies in serum. The strongest positive correlations of aa were found for sperm motility, count, morphology, vitality and volume. In presence of a poor PCT result, aa was significantly reduced, even in patients with good motility in native semen. A similar result was obtained with the SPMT: reduced sperm density and poor sperm motility in the capillary after 2 hours were significantly correlated to reduced aa. Smokers exhibited lower aa in presence of normal sperm count and motility. In the infertile group aa was significantly lower than in the group of men whose spouses conceived. On the basis of our results, the routine determination of aa is not necessary, but it provides additional prognostic information in couples with unexplained infertility.     

Evaluation of sperm parameters in clinical trial with clomiphene citrate of oligospermic men

A randomized group of 101 oligospermic men, with low or normal serum follicle-stimulating hormone levels and infertile marriages of more than 2 years were studied with and without clomiphene citrate. For 6 to 9 months 56 patients were treated with 50 mg. clomiphene citrate daily and 45 men were given no treatment. Significant improvement in volume, sperm density and sperm motility was observed in the treated group but not in the control group. Sperm density greater than 20 times 10(6) per ml. was obtained in 18 men and there were 7 pregnancies in the treated group. In the control group 3 men had a sperm count greater than 20 times 10(6) per ml. and there was no pregnancy. This study showed statistically significant improvement in sperm parameters in the treated group but not in the untreated patients.     

Circannual variation in human semen parameters

The aim of the present study was to determine whether there were significant monthly variations in the semen parameters (i.e. volume, sperm count, total sperm count, motile and normal sperm count) of men living in a Mediterranean climate area. A total of 10 877 semen analysis results were included. Semen samples were obtained as a part of an initial screening of male partners from couples with infertility problems who were attending our laboratory from 1970 to 2000. Log transformation and cubic root transformation were used to test the sample distribution. Statistical significance was adjusted by year of examination, patient's age and sexual abstinence period by performing covariance analyses. Differences between months were assessed with the Bonferroni post-hoc test. There was an increase in March and a decrease in September in the adjusted mean sperm count (p < 0.0005), total sperm count (p < 0.0005), motile sperm count (p=0.01) and normal sperm count (p=0.002). There were no variations in semen volume in the study period. Monthly changes in semen quality are confirmed in this population.     

Within-subject variation of seminal parameters in men with infertile marriages

As little information exists on the semen variability in infertile men, this study aimed at analysing the within-subject variability of semen from men with infertile marriages included in an intrauterine insemination (IUI) programme. Five ejaculates from each of 436 men (2180 specimens) were analysed. The within-subject coefficients of variation (CV(w)) were high for all parameters (semen volume, sperm concentration, forward motility and combined parameters), ranging from 0.73 for the total motile sperm count to 0.27 for the semen volume. Nevertheless, within-subject fluctuations were smaller than the between-subject variability, as indicated by high Intraclass Correlation Coefficient (ICC) values, which, however, significantly lowered when 相似文献   

Effects of varying the abstinence period in the same individuals on sperm quality

Fourteen men each provided semen samples after 3, 6, and 10 days abstinence in a sequence decided by the individual and over a period of approximately 6 weeks. The proportion of sperm displaying progressive motility remained relatively constant up to 6 days but declined after a further 4 days of abstinence. This decrease was not associated with any major changes in sperm morphology or vitality. The total number of sperm with progressive movement in the ejaculate increased after 6 days and remained high after 10 days of abstinence. In subjects with asthenozoospermia, the greatest increase in the total number of sperm in the ejaculate occurred between 6 and 10 days. For men with reduced sperm quality participating in assisted fertilization programs, it may be advantageous to advise longer periods of abstinence, up to 10 days, prior to semen collection.