Association between age and epididymal and accessory sex gland function and their relation to sperm motility

Increased male age has been associated with significant reduction in pregnancy rates. This study investigated the association between age, the function of epididymal and accessory sex glands, and their relation to sperm motility. Ejaculates from 498 men assessed for infertility were analysed according to WHO [1999] guidelines. Seminal markers of epididymal (neutral alpha-glucosidase (NAG)), prostatic (prostate-specific antigen (PSA) and zinc), and seminal vesicle function (fructose) were measured. Four groups according to age were defined: G(21-30) (21-30 years), G(31-40) (31-40 years), G(41-50) (41-50 years), and G(>50) (51-66 years). Percentage progressive motility was significantly lower in G(>50) compared with G(21-30). NAG, PSA, zinc, and fructose were significantly lower in G(>50) compared with G(21-30). In a multiple regression analysis model, NAG and PSA showed positive significant association with percentage progressive motility. The opposite trend was found regarding zinc. No association between fructose and percentage progressive motility was shown. In this cross-sectional study, declined sperm motility observed in men over 50 years of age might be due to age-dependent changes in epididymal and accessory sex gland function.     

The Evaluation of Free-L-Carnitine, Zinc and Fructose in the Seminal Plasma of Patients with Varicocele and Normozoospermia/Auswertung von freiem L-Carnitin, Zinc und Fructose im Spermaplasma von Männern mit einer Varikocele und Normozoospermie

The function of the epididymis and of the sex accessory glands have been investigated in a selected group of varicocele patients with normal sperm count. In the seminal plasma of these patients free-L-carnitine, fructose and zinc levels were determined as functional markers respectively of epididymis, seminal vesicles and prostate. Despite the unvaried free-L-carnitine and fructose levels, zinc levels were significantly lower (p less than 0.001) than in the control group. The Zn/F ratio, an index of the ratio between the prostatic and vesicular secretions, resulted also lower (p less than 0.01) with respect to the controls. The authors suggest that the impaired prostatic function could arise from the decreased venous drainage in the vesico-prostatic plexus. In the same patients sperm motility resulted significantly lower than in the controls, and was positively related to zinc levels (r = 0.44, p less than 0.01) and, to a higher degree, to the Zn/F ratio (r = 0.62, p less than 0.001). Our data show that in this selected group of varicocele patients with a not yet altered tubular epididymal unit, sex accessory gland secretions can influence, per se, the motility of the ejaculated spermatozoa.     

Effects of ejaculation-to-analysis delay on levels of markers of epididymal and accessory sex gland functions and sperm motility

This study aimed to examine the association between the interval from ejaculation to analysis and epididymal and accessory sex gland function in relation to sperm motility. Ejaculates from 1079 men assessed for infertility were analyzed according to World Health Organization guidelines. Biochemical markers were measured in semen to assess the function of the epididymis (neutral alpha-glucosidase [NAG]), prostate (prostate-specific antigen [PSA] and zinc), and seminal vesicles (fructose). Three groups were defined according to time from ejaculation to analysis: G(< or =30) (24-30 minutes), G(31-60) (31-60 minutes), and G(>60) (63-180 minutes). The proportion of progressively motile sperm was significantly lower in G(>60) than in G(< or =30) (mean difference, 8.0%; 95% confidence interval [CI], 2.0%-13%) or G(31-60) (mean difference, 6.0%; 95% CI, 1.0%-12%). The proportion of rapid progressive sperm motility was significantly higher in G(< or =30) compared with G(31-60) (mean difference, 3.0%; 95% CI, 1.0%-5.0%) and G(>60) (mean difference, 6.0%; 95% CI, 1.0%-10%). Sperm morphology and viability did not vary significantly between the groups. However, PSA levels in G(>60) were 29% and 31% significantly lower than in G(< or =30) (95% CI, 3.0%-54%) and G(31-60) (95% CI, 7.0%-58%), respectively. Moreover, men in G(>60) had 29% and 17% significantly lower zinc compared with those in G(< or =30) (95% CI, 4.0%-69%) and G(31-60) (95% CI, 4.0%-64%), respectively. Levels of NAG and fructose did not differ significantly between the groups. There were negative associations between the ejaculation-to-analysis interval and sperm motility and levels of PSA and zinc. In male infertility assessments, semen analysis should be performed within 60 minutes of ejaculation.     

精浆催乳素浓度与精子计数、活动率的关系

对107例男性进行精液分析并测定其精浆催乳素(PRL)浓度,精子活动率和精子密度正常男性的精浆PRL为11.53±5.36ng/ml,与精子活动率正常而少精子的男性相比(13.06±4.62ng/ml),两组间无显著性差异(t=0.91,t>0.2);而精子密度正常、正常精子活率组和低活率组相比,低活率组的精浆PRL水平(17.24 ±5.86ng/ml)明显增高(t=4.15,P<0.001).相关分析表明精浆PRL与精子活动率呈负相关(r=-0.38,P<0.001);与精子密度亦呈负相关(r=-0.37,P<0.001).49例受试者取精液前抽血测定血清PRL水平,精浆PRL水平与血清PRL无关(r=0.204,P>0.1).     

Two-dimensional electrophoresis of proteins in various fractions of the human split ejaculate

Two-dimensional electrophoresis of six fractions of split ejaculates from normal men (median age 23 years, n = 6) revealed large differences in the pattern of proteins found between the prostate-enriched fractions and secretions associated with the seminal vesicles. The glandular contributions were assessed using the concentrations of spermine, zinc and prostatic acid phosphatase (PAP) for prostatic secretion, and fructose and prostaglandin E for seminal vesicle secretion in the various fractions. Aside from PAP, four additional proteins were apparently associated with the prostatic fraction, one of which shared the biochemical characteristics of the specific ventral lobe protein of the rat prostate, prostatein (molecular mass 16 000, pI 4.8). The presumptive vesicular fractions contained a large number of low molecular mass proteins (10-20 000), with widely varying pI-values. The concentration of albumin and transferrin appeared to be highest in the sperm cell enriched fractions, indicating a major contribution to the ejaculate of testicular/epididymal origin.     

Assessment of seminal plasma laminin in fertile and infertile men

Aim： To assess laminin levels in the seminal plasma of infertile and fertile men, and to analyze the correlation of laminin levels with sperm count, age, sperm motility and semen volume. Methods： One hundred and twenty-five recruited men were equally divided into five groups according to their sperm concentration and clinical examination： fertile normozoospermia, oligoasthenozoospermia, non-obstructive azoospermia （NOA）, obstructive azoospermia （OA） and congenital bilateral absent vas deferens （CBAVD）. The patients＇ medical history was investigated and patients underwent clinical examination, conventional semen analysis and estimation of seminal plasma laminin by radioimmunoassay. Results： Seminal plasma laminin levels of successive groups were： 2.82 ± 0.62, 2.49 ± 0.44, 1.77 ± 0.56, 1.72 ± 0.76, 1.35 ± 0.63 U/mL, respectively. The fertile normozoospermic group showed the highest concentration compared to all infertile groups with significant differences compared to azoospermic groups （P 〈 0.05）. Testicular contribution was estimated to be approximately one-third of the seminal laminin. Seminal plasma laminin demonstrated significant correlation with sperm concentration （r = 0.460, P 〈 0.001） and nonsignificant correlation with age （r = 0.021, P = 0.940）, sperm motility percentage （r = 0.142, P = 0.615） and semen volume （r = 0.035, P = 0.087）. Conelusion： Seminal plasma laminin is derived mostly from prostatic and testicular portions and minimally from the seminal vesicle and vas deferens. Estimating seminal laminin alone is not conclusive in diagnosing different cases of male infertility.     

Effect of smoking on seminal plasma ascorbic acid in infertile and fertile males

This work aimed to assess the relationship of seminal ascorbic acid levels with smoking in infertile males. One hundred and seventy men were divided into four groups: nonobstructive azoospermia [NOA: smokers (n = 20), nonsmokers (n = 20)]; oligoasthenozoospermia [smokers (n = 30), nonsmokers (n = 20)]; asthenozoospermia [smokers (n = 20), nonsmokers (n = 20)] and normozoospermic fertile men [smokers (n = 20), nonsmokers (n = 20)]. The patients underwent medical history, clinical examination, conventional semen analysis and estimation of ascorbic acid in the seminal plasma calorimetrically. There was a significant decrease in the mean seminal plasma ascorbic acid levels in smokers versus nonsmokers in all groups (mean +/- SD; 6.03 +/- 2.18 versus 6.62 +/- 1.29, 7.81 +/- 1.98 versus 9.44 +/- 2.15, 8.09 +/- 1.98 versus 9.95 +/- 2.03, 11.32 +/- 2.15 versus 12.98 +/- 12.19 mg dl(-1) respectively). Fertile subjects, smokers or not, demonstrated significant higher seminal ascorbic acid levels than any infertile group. Seminal plasma ascorbic acid in smokers and nonsmokers was correlated significantly with sperm concentration (r = 0.59, 0.60, P < 0.001), sperm motility (r = 0.65, 0.55, P < 0.001) and negatively with sperm abnormal forms per cent (r = -0.53, -0.50, P < 0.001). Nonsignificant correlations were elicited with semen volume (r = 0.2, 0.09) or liquefaction time (r = 0.03, 0.06). It is concluded that seminal plasma ascorbic acid decreased significantly in smokers and infertile men versus nonsmokers and fertile men, and is significantly correlated with the main sperm parameters: count, motility and normal morphology. Also, cigarette smoking is associated with reduced semen main parameters that could worsen the male fertilizing potential, especially in borderline cases.     

Comparison of urinary and seminal N-acetyl-beta-glucosaminidase isoenzymes

N-acetyl-beta-glucosaminidase (NAG) and its isoenzymes were measured in the urine and seminal plasma of healthy volunteers. Urinary NAG level was 2.62 +/- 1.30 U/L (mean +/- standard deviation), 1.99 +/- 0.77 U/g creatinine and seminal NAG level was 2370 +/- 1007 U/l. Urinary NAG level was 2.59 +/- 1.44 U/l, 1.93 +/- 0.80 U/g creatinine in males and 2.67 +/- 1.15 U/l, 2.08 +/- 0.78 U/g creatinine in females, and there was no significant sex difference. NAG isoenzymes in the urine and seminal plasma were divided into two major peaks, A and B. The A:B ratio was 78.0 +/- 6.5: 21.9 +/- 6.5 in the urine and 24.7 +/- 3.2: 75.2 +/- 3.2 in the seminal plasma, and was significantly different. Urinary NAG isoenzyme was 80.3 +/- 6.7: 19.6 +/- 6.7 in males and 74.1 +/- 4.3: 25.9 +/- 4.3 in females, and there was no significant difference between the sexes. These results indicated that urinary and seminal NAG can be differentiated by measuring the isoenzymes. Furthermore, the comparison of seminal NAG isoenzymes before and after vasectomy indicated that seminal NAG may be affected not only by the sperm but also by the prostatic fluid.     

Seasonal changes of neutral alpha-glucosidase activity in human semen

Although there are contradictory reports, the biochemical evaluation of the seminal activity of neutral alpha-glucosidase (NAG) has repeatedly been described as an important parameter to test epididymal patency and is recommended by the WHO. Because, for a number of diagnostic parameters, seasonal variations have been described even in the human, it was the aim of this study to investigate possible circannual changes of NAG. This is an important aspect of andrological diagnosis, as seasonal changes of specific diagnostic parameters might have an impact on the accuracy and predictive power of these parameters, which in turn might have an effect on the therapeutic concept for the patients. In a total of 473 patients, sperm concentration, volume of the ejaculate, total motility, progressive motility, pH value, number of peroxidase-positive cells, concentration of fructose, and NAG as functional markers of the seminal vesicles and the epididymis, respectively, were analyzed according to standard procedures. Seminal activity of NAG was significantly correlated with the sperm concentration (P < .0001), ejaculate volume (P < .0001), and the pH (P = .0025). Moreover, significant (P = .0008) seasonal changes in the activity of seminal NAG with the maximum in spring (76.87 mU/ejaculate) and the minimum in autumn (58.55 mU/ejaculate) were found. The incidence of low-ranged activity of the enzyme was 9.2% in spring, while it was 20.3% in autumn. Thus, our data clearly demonstrate circannual changes of the seminal activity of neutral alpha-glucosidase. This in turn has clinical impact as the predictive power of the test system changes throughout the year.     

精子染色质结构分析与精液参数的相关性研究

目的 :研究精子染色质结构分析 (SCSA)与精液参数的相关性 ,探讨评估精液质量的可靠方法。　方法 :将5 11份精液标本流式细胞术SCSA结果与精液常规分析结果进行多参数的相关性分析。　结果 :与变性精子百分数(COMPαt)呈低度正相关 (r在 0 .10～ 0 .3 0 )的参数是粘度、本次射精间隔时间、精子畸形率、c级精子密度 ;呈低度负相关的参数 (r在 - 0 .3 0～ - 0 .10 )是曲线速度、直线速度、平均路径速度 ;呈中度正相关 (r在 0 .3 0～ 0 .70 )的参数是精子密度、d级精子率和d级精子密度 ;呈中度负相关 (r在 - 0 .70～ - 0 .3 0 )的参数是平均移动角度、a级精子密度和精子存活率。　结论 :流式细胞术能简单、快速、准确地评估损伤和变性精子的百分数 ,其结果 (COMPαt)与精液参数部分相关 ,并不是完全独立于精液常规检查的指标。SCSA对评估生育力具有重要意义     

N-acetyl-beta-D-glucosaminidase (NAG) activity in human semen: its relation to gamma-glutamyl transpeptidase (gamma-GTP) activity in seminal plasma and reproductive tissues, and relation between seminal mucoprotein concentration and seminal NAG, and gamma-GTP activities

N-Acetyl-beta-D-glucosaminidase (NAG) and gamma-glutamyl transpeptidase (gamma-GTP) activities in seminal plasma obtained from male infertile patients and these activities in reproductive tissues obtained from cryptorchids and patients with bladder tumors were studied. Seminal mucoprotein concentration was also measured. The mean NAG and gamma-GTP activity in seminal plasma was 2,092 +/- 794 mU/ml and 10,942 +/- 4,179 mIU/ml, respectively. The mean seminal mucoprotein concentration was 28.0 +/- 5.7 mg/ml. In seminal plasma, a significant correlation was obtained between NAG and gamma-GTP (p less than 0.001). and between gamma-GTP and mucoprotein concentration (p less than 0.05). However, there was no correlation between NAG and mucoprotein concentration. In the reproductive tissue high gamma-GTP activity was observed in the testicular tissue and in the external gland of the prostate. The activity in the epididymis was higher in the tail than in the head. High NAG activity was observed in the epididymal head and in the internal gland of the prostate. In the testicular tissue, NAG activity was low. These findings showed that in the seminal plasma NAG and gamma-GTP activities were closely related but in the reproductive tissue, these activities located in different areas.     

Testicular and glandular contributions to the prolactin pool in human semen

The immunoreactive prolactin in human seminal plasma originates predominantly from two sources, the seminal vesicles and the testicular-epididymal axis. The following evidence supported a testicular-epididymal origin: Vasectomy reduced the content of prolactin in the ejaculates by 50%; the concentration of seminal prolactin was highly correlated (r = 0.54, p less than 0.003) with the concentration of sperm in a normal population of young and middle-aged men; and prolactin concentrations in the split ejaculates of normospermic men revealed a profile that corresponded to the sperm distribution pattern. Evidence supporting an additional contribution from the seminal vesicles included the following. The split ejaculate of an azoospermic individual coincided more with the distribution of the vesicular parameter fructose; vasectomy did not cause the disappearance of prolactin from the ejaculate; and split-ejaculate analyses weakened the possibility of a major prostatic source.     

Seminal plasma neutral alpha‐glucosidase activity as an early predictor of patency and natural pregnancy after microsurgical vasoepididymostomy

Microsurgical vasoepididymostomy (MVE) is recommended as a first‐line option for treatment of epididymal obstructive azoospermia (EOA). However, early indicators for predicting patency and natural pregnancy are unclear. Our aim was to explore the early predictive value of seminal plasma neutral alpha‐glucosidase (NAG) activity for patency and natural pregnancy after MVE. Eighty‐four patients with EOA who underwent MVE were enrolled in this study. The post‐operative patency and natural pregnancy rates were 60.71% and 33.33% respectively. The presence of motile epididymal spermatozoa at the anastomosis site and NAG activity measured at the first month after MVE were early and independent predictors of patency and natural pregnancy. The areas under the receiver operating characteristic curves (AUCs) of NAG activity for prediction of patency and natural pregnancy were 0.78 (95% confidence interval [CI]: 0.68–0.88) and 0.82 (95% CI: 0.73–0.92). The best cut‐off values of NAG activity for predicting patency and pregnancy were 15.9 and 17.0 m IU/ejaculate respectively. In conclusion, NAG activity measured at the first month after MVE is an early and independent predictor of patency and natural pregnancy.     

Plasma homocysteine levels and cardiovascular mortality in patients with end-stage renal disease

Hyperhomocysteinemia is considered an independent risk factor for atherosclerosis in patients with normal renal function. Plasma homocysteine (Hcy) is increased in patients with chronic renal failure (CRF) and could be linked to their high cardiovascular (CV) morbidity and mortality. We prospectively studied 77 patients (47 males and 30 females aged 62.85 +/- 1.53 yrs) who had been on maintenance hemodialysis (HD) (4 hr/x3/week) for 65.5 +/- 7.23 months. Patients were followed-up for 44 months. At baseline, blood samples were taken for hemoglobin (Hb), total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, serum calcium, serum phosphates, parathyroid hormone (PTH), Hcy, vitamin B12, serum and erythrocyte folate and methylentetrahydrofolate-reductase (t-MTH-FR) genotype determination. Plasma Hcy levels of patients were divided into four quartiles. The univariate analysis demonstrated a significant relationship between Hcy and diastolic blood pressure (BP) (r=0.45; p=0.003), and both plasma (r=-0.30; p=0.03) and erythrocyte (r=-0.48; p=0.01) folate levels and CV score (r=0.39; p=0.007). Kaplan-Meier analysis showed that the mortality rate due to CV events was statistically significantly higher in the 4th Hcy quartile (68%; 12 patients) vs. the 3rd quartile (12%; two patients), the 2nd quartile (28%; four patients) and the 1st quartile (14%; two patients) (log-rank test p=0.02). Cox's regression analysis for CV survival showed that Hcy was a positive CV mortality predictor (beta=0.02; hazard ratio=1.031; 95% confidence interval (95% CI): 1.013-1.050; p=0.001), while LDL cholesterol and albumin related negatively to CV mortality (LDL cholesterol: beta=-0.02; hazard ratio=0.095; 95% CI: 0.0957-0.0997; p=0.035; albumin: beta=-2.35; hazard ratio=0.097; 95% CI: 0.011-0.847; p=0.026). Our results show that Hcy is a strong independent mortality predictor in HD patients with a 3% increase in mortality for each 1 micromol/L increase in plasma Hcy concentration. This agrees with previous findings confirming the role of Hcy in predicting CV risk factors in uremic patients.     

益气助精颗粒治疗特发性少弱精子症的临床研究

目的:观察益气助精颗粒治疗特发性少弱精子症的疗效。方法:从2012年3月至2013年3月间,对78例男性不育患者中的特发性少弱精子症患者,随机分2组治疗,对照组(n=39)采用葡萄糖酸锌口服液,1支/次,2次/d,维生素E胶丸,100 mg/次,2次/d;治疗组(n=39)在对照组治疗药物的基础上加用益气助精颗粒,2次/d;疗程3个月。结果:经过治疗,对照组前向运动精子百分率和精子存活率较治疗前提高,差异具有统计学意义(P均<0.05);治疗组精子总数、精子浓度、前向运动精子百分率和精子存活率较治疗前提高,差异具有统计学意义(P均<0.05)。精子总数、精子浓度、前向运动精子百分率和精子存活率治疗前后的差值,治疗组较对照组改善明显,差异具有统计学意义(P均<0.05)。经过治疗,对照组和治疗组在精浆生化各指标上均有不同程度的改善,其中治疗组较对照组精浆锌、α-葡糖苷酶、酸性磷酸酶改善更为显著,差异具有统计学意义(P均<0.05);治疗组在精浆锌、精浆果糖和α-葡糖苷酶的改善上,与对照组提高的差值相比较,差异具有统计学意义(P<0.05)。治疗组治疗后精浆锌变化水平与精子浓度改善水平成正相关(r=0.201,P<0.05);精浆果糖变化水平与精子浓度改善水平呈负相关(r=-0.136,P<0.05);α-葡糖苷酶变化水平与精子存活率呈正相关(r=0.314,P<0.05)。结论:益气助精颗粒在提高精子总数、精子浓度、前向运动精子百分率、精子存活率,改善精浆锌、精浆果糖、α-葡糖苷酶、酸性磷酸酶上面有显著效果。     

生育及不育男性血清及精浆抑制素-B水平分析

目的 :探讨生育及不育男性血清及精浆抑制素 B(inhibinB ,INHB)水平是否存在差异 ,了解血清及精浆INHB水平与精子发生的关系。　方法 :生育组 (n =2 0 )、少精子症组 (n =2 0 )、弱精子症组 (n =2 2 )和非阻塞性无精子症 (NOA)组 (n =2 0 )男性于上午 8∶0 0～ 10∶0 0留取精液和血液标本 ,进行精液常规分析 ,血清INHB、FSH、LH、T含量 ,精浆INHB、酸性磷酸酶、果糖、α 葡糖苷酶含量和活性测定。　结果 :血清、精浆INHB水平与血FSH均呈显著负相关 (r =- 0 .5 36 ,P <0 .0 0 1vsr =- 0 .2 88,P =0 .0 1) ,血清、精浆INHB水平与精子密度均呈显著正相关 (r=0 .49,P <0 .0 0 1vsr =0 .48,P <0 .0 0 1) ,血清INHB水平在生育组男性与少精子症组、NOA组男性间(分别为P <0 .0 5和P <0 .0 1)、弱精子症组与NOA组男性间 (P <0 .0 1)及少精子症组与NOA组男性间 (P <0 .0 5 )差异均有显著性 ,而精浆INHB变动范围较大 ,其水平仅在生育组男性与NOA组男性间及弱精子症组与NOA组男性间差异有显著性 (分别为P <0 .0 1和P <0 .0 5 )。精浆INHB水平与精浆α 葡糖苷酶活性呈正相关 (r=0 .377,P =0 .0 0 1)。血清INHB水平与精浆INHB水平间无相关性。　结论 :血清、精浆INHB水平均可反映睾丸的精子发生情况 ,精浆INHB水平还与     

Comparison of Biochemical Parameters of Human Blood Serum and Seminal Plasma

Blood and semen samples obtained from 24 "normal" volunteers were analyzed for 16 different biochemical parameters. These included: Ca, Mg, K, Na, Zn, Cl, P, glycerolphosphorylcholine (GPC), carnitine, fructose, uric acid, prostatic acid phosphatase, alkaline phosphatase, glutamic oxaloacetic transaminase (SGOT), lactic dehydrogenase (LDH), and glutamic pyruvate transaminase (SGPT). With the exception of uric acid, all the biochemical constituents in seminal plasma were either significantly higher (p less than 0.001, except alkaline phosphatase which was significant at p less than 0.05) or significantly lower (p less than 0.001) than in blood serum. Further, potassium (r = 0.51); carnitine (r = 0.54); and SGOT (r = 0.70) showed a significant direct relationship in blood and seminal plasma.     

精浆中游离L-肉碱水平与附属性腺生化指标的相关性研究

目的:研究精浆中游离L-肉碱水平与α-葡糖苷酶、果糖、酸性磷酸酶3项附属性腺生化指标之间的相关性,探讨L-肉碱作为一项生化指标在男性生殖功能评价中的作用。方法:采集30例正常生育男性和222例不育患者精液样品,分别以计算机辅助精液分析系统进行精液常规分析,同时测定精浆中游离L-肉碱、果糖水平以及α-葡糖苷酶和酸性磷酸酶活性。用SPSS 12.0统计软件包分析两组间各项生化指标之间的差异,以及精浆中游离L-肉碱与果糖水平、α-葡糖苷酶和酸性磷酸酶活性之间的相关性。结果:正常生育组精浆游离L-肉碱水平明显高于不育组(P<0.01)。两组间α-葡糖苷酶活性差异有统计学意义(P<0.05),而果糖水平和酸性磷酸酶活性差异无统计学意义。相关性分析结果显示,精浆游离L-肉碱水平与精浆中α-葡糖苷酶活性具有较强的正相关关系(r=0.504,P<0.001);而与精浆中果糖水平以及酸性磷酸酶活性之间无相关关系。结论:精浆中游离L-肉碱水平测定可作为评估附睾功能的一项生化指标,其在正常生育组与不育组间的水平差异较两组精浆中α-葡糖苷酶活性差异更为显著,可为男性不育检查及临床诊治和进行有关男性生殖功能机制研究提供参考。     

True corrected seminal fructose level: a better marker of the function of seminal vesicles in infertile men

This study was designed to determine if the value obtained after multiplying motile sperm concentration by seminal fructose concentration, named "true corrected fructose", correlates with sperm motility in asthenozoospermic men. Forty-two male partners in infertile couples were studied. Men were treated with 100 mg daily of clomiphene citrate for 5 days. Blood and semen samples were collected before treatment and 24 h after the end of treatment. Serum testosterone, seminal fructose and sperm motility were measured in each subject. Corrected fructose (log. sperm concentration multiplied by seminal fructose), and true corrected fructose (log. motile sperm concentration multiplied by seminal fructose) values were calculated. Prevalence of asthenozoospermia was 42.85% (18 of 42). Prevalence of hypofunction of the seminal vesicles was 9.5% using seminal fructose as a marker; 40.5% using seminal corrected fructose as a marker and 47.6% using true corrected fructose as a marker of seminal vesicle function. Regression analysis showed a better coefficient of determination between true corrected fructose and motile sperm concentration (R2=0.20, p < 0.001) than with corrected fructose (R(2)=0.05, p < 0.1) or fructose concentration (R(2)=0.006, p < 0.5). Asthenozoospermia was observed in 22.7% of subjects with normal function of the seminal vesicles, and in 65% of men with low values of true corrected fructose (z=6.02, p < 0.0001). Multivariate analysis showed that sperm motility grade 3 improved after treatment with clomiphene if true corrected fructose increased (p < 0.002). In those men whose seminal vesicle function improved after clomiphene treatment, a reduction in the prevalence of asthenozoospermia from 50 to 28.6% (z=3.10, p < 0.002) was observed whereas in those whose seminal vesicles did not respond to clomiphene the prevalence of asthenozoospermia was not reduced (z=1.05; p: NS). In conclusion, true corrected fructose measurement relates with sperm motility in cases of asthenozoospermia. Asthenozoospermia improves with clomiphene treatment if seminal vesicle function improves after treatment.