不孕症夫妇弓形虫感染检测

目的:检测弓形虫在不孕不育夫妇的感染情况。方法:采用ELISA方法检测患者血清弓形虫CAg、IgMI、gG。结果:CAgI、gMI、gG阳性率分别为9.09%、16.67%、25.00%;弓形虫抗体阳性率为37.12%;弓形虫感染率为37.88%;男、女性弓形虫感染率分别为22.73%、53.03%,男女弓形虫感染率有显著性差异。夫妻双方同时感染的阳性率为15.15%;习惯性流产患者弓形虫感染率为60%。结论:弓形虫感染在不孕不育夫妇中较常见,女性感染率高于男性;习惯性流产患者感染率最高;因此要高度重视并及时治疗弓形虫感染。     

Interpretation of semen analysis among infertile couples.

Among the male partners of 1074 infertile couples the mean results of semen analysis were sperm count 78 X 10(6)/ml, seminal volume 4.0 ml, proportion of progressively motile sperm 54%, proportion of sperm with normal morphologic features 81.4% and total motile sperm count 152.3 X 10(6) per ejaculate. After excluding 65 couples who chose donor insemination and 300 with known female causes of infertility, the cumulative pregnancy rates in the remaining 709 couples were higher with increasing sperm density and motility and seminal volume, but the higher rates were significant only when these variables were combined into total motile sperm count per ejaculate. The cumulative pregnancy rates were 20% with a total motile sperm count of 9 X 10(6) or less, 37% with a count of 10 to 19 X 10(6) and 52% with a count of 20 X 10(6) or more (p = 0.001). Counts higher than 20 X 10(6) were not associated with a further improvement in pregnancy rates, but variability in the results was high, which suggests that the test should be repeated as necessary to determine the true range. Although standards for these and other seminal variables are ill defined, the total motile sperm count incorporates the most useful prognostic information from semen analysis, and the associated pregnancy rates can help guide clinical decisions.     

Clinical factors affecting pregnancy rates among infertile couples.

In a follow-up study of 1297 couples registered at a Nova Scotia infertility clinic with a complaint of infertility of at least 12 months' duration, the cumulative pregnancy rate at 36 months, with 95% confidence limits, was found to be 49 +/- 4%. The predictors of pregnancy by univariate analysis were a favourable primary clinical diagnosis (p less than 0.001), a duration of infertility of less than 3 years (p less than 0.001), a single diagnosis for the infertility (p less than 0.001), a previous pregnancy in the partnership (p = 0.001) and a length of marriage of less than 4 years (p = 0.002). Proportional hazards analysis confirmed these variables as predictors of pregnancy. The highest cumulative pregnancy rates after 12 and 36 months of follow-up were observed in cases of ovulation deficiency, and the lowest were seen in cases of tubal defects. However, before the process of diagnosing infertility begins, useful prognostic information can be determined from the length of marriage, the duration of infertility and the partnership's history of previous pregnancy.     

Semen parameters at different age groups of male partners of infertile couples

As a good number of couples are coming to infertility clinics to have children at advanced ages, it is essential to know whether advanced paternal age is associated with diminished semen quality and a higher risk of infertility. This retrospective study was done to see the effects of age on semen quality, a well-known indicator of fertility status. Semen parameters of smokers and non-smokers in the study population were also analyzed. A sample of 1121 male partners of infertile couples (aged 25-55 years) who came to an infertility clinic for treatment were included into the study. In addition to clinical history including lifestyle, medical and occupational details and physical examination, their semen samples were examined. Semen volume (ml), sperm concentration (x 10(6)/ml), motility (%), rapidly progressing (%), slowly progressing (%), non-progressive (%) motility and morphology (%) were measured. Semen volume showed IQR 1.5-3.0 ml, and significant decreasing trend with increasing age (r = -0.070, p<0.05). Sperm motility and rapidly progressing motility showed significant decrease (IQR 40.0-70.0, r = -0.115, p<0.01 and IQR 20.0-50.0, r = -0.107, p<0.01 respectively) with increasing age. There was no significant difference between semen parameters of smokers and non-smokers in the study population. This study shown that semen volume, sperm motility and rapidly progressing motility were significantly decreased with increasing age.     

不孕症夫妇解脲支原体沙眼衣原体感染率分析

目的探讨不孕症夫妇解脲支原体（uu）和沙眼衣原体（CT）感染率及其与不孕症的关系。方法分别采用培养法和免疫学方法检测148对不孕症夫妇（不孕组）uu、CT感染率,与53对健康生育夫妇（对照组）uu、CT感染率比较,并作相关性分析。结果不孕组中妻子uu阳性率为39．19％,CT阳性率为20．95％,UU、CT混合感染（UU＋CT）阳性率为10．81％;对照组中妻子uu阳性率为13．21％,CT阳性率为7．55％,UU＋CT阳性率为1．89％,2组间差异有统计学意义（P〈0．05）。不孕组中丈夫uu阳性率为35．14％,CT阳性率为18．24％,UU＋CT阳性率为8．11％;对照组中丈夫UU阳性率为9．43％,CT阳性率为5．66％,UU＋CT阳性率为0％,2组间差异有统计学意义（P〈0．05）。不孕夫妇间uu和CT感染与不孕症均存在相关性（P〈0．001）。结论uu、CT感染与不孕症密切相关,uu、CT检测应成为不孕症检查的常规项目。     

斑点金免疫渗滤法检测不孕症患者血清抗子宫内膜抗体

目的：建立一种快速测定抗子宫内膜抗体（antiendometrial antibody,EMAb）的新方法。方法：采用经抗人血清抗体－Sepharose4B免疫吸附柱亲和层析纯化的人子宫内膜抗原（endometrium antigen ,EMAg)，以胶体金颗粒结合的羊抗人IgG为标记抗体，根据免疫渗滤原理，建立斑点金免疫渗滤法（Dot-immunogold filtration assay,DIGFA）检测人血清 EMAb。共检测586份不孕者血清并与酶联免疫吸附试验（ELISA）作对比研究。结果：纯化的人子宫内膜抗原与患者血清中特异性EMAb通过渗滤在硝酸纤维素膜上反应，8min内即可直接观察结果。在586份血清的检测中，阳性率为36．8％，与ELISA的结果基本一致（x^2＝3．45，P＞0．05），符合率95．0％。特异性为94．7％，敏感性为95．6％。交叉试验与重复试验结果显示DIGFA具有较好的特异性及稳定性。结论：DIGFA可测定EMAb，具有推广使用的价值。     

快速酶标记检测不育夫妇血清和精浆溶菌酶

用辣根过氧化物酶标记 M·lysodeikticus,以检测不育夫妇血清、精浆溶菌酶含量.37对生育组男性精浆溶酶菌含量为27.0±22.6mg/L.以+2s.即72.2mg/L 为升高,不育组、流产组男性精浆溶菌酶升高率分别为20.0%和33.3%。各组及男女之间血清溶菌酶含量无统计学差异.经与琼脂平板法对照.两法高度相关(r=0.92,P<0.01),但操作简便、快速.提示精浆溶菌酶含量可能反映了男性生殖道感染的程度,且可能与男性不育有关.     

男性不育患者的遗传学病因研究

目的 研究染色体异常、SRY基因突变及Y染色体AZF基因微缺失等遗传学病因与男性不育的关系.检测少精子症不育患者血液和精子基因组AZF微缺失情况.方法 采用染色体G显带对87例男性不育患者进行核型分析,采用PCR技术对患者SRY基因突变及Y染色体AZF基因微缺失进行检测.结果 87例男性不育患者中发现染色体异常25例(...     

不孕症子宫输卵管造影X线分析

目的探讨子宫输卵管造影对不孕症的诊断意义。方法回顾性分析180例子宫输卵管造影的影像资料及影像学表现特点。结果对180例患者根据有无妊娠史分为原发性不孕62例,继发性不孕118例。结论子宫输卵管造影检查对不孕妇女的子宫输卵管病变的原因确定有重要价值。     

女性不孕症子宫内膜的病理分析

目的:为探讨女性不孕症病因,了解子宫内膜形态变化及功能紊乱之间关系.方法:取125例不孕症妇女子宫内膜经固定、包埋、切片、染色后光镜观察.结果:女性不孕症患者属分泌反应类101例(占80.8%),属增生性反应类24例(占19.2%),两类反应中宫内膜间质均有出血现象.结论:引起女性不孕症多数为分泌反应类,少数为增生反应类.     

Chlamydial infection in asymptomatic infertile women

Thirty-six asymptomatic infertile women undergoing laparoscopic examination as part of their infertility investigations, were included in this study on chlamydial infection. Patients were tested for chlamydial antigen in the cervix and peritoneal fluid. The serum of twenty-five of these patients was titrated for evidence of chlamydial antibodies. Fifty women attending a family planning clinic were used as a control group. The study showed a strong relationship between chlamydial infection and infertility due to tubal pathology. The incidence of chlamydial infection in asymptomatic infertile women was 33.3%. The results indicate that Chlamydia trachomatis should be sought in patients presenting with infertility and, if detected, appropriate medical treatment be given.