精液留取后不同时间分析对精子运动参数的影响

目的:探讨精液留取后不同时间进行计算机辅助精液分析系统(CASA)分析对精子运动参数的影响。方法:选择92例精液标本,精子密度均大于20×106/ml,液化时间均小于20min。精液留取后置37℃孵箱,在20、30、60、90min时,采用CASA进行精液参数分析。结果:30、60、90min时a级精子百分率、b级精子百分率分别显著低于20min时的a级精子百分率、b级精子百分率(P<0.05)。60min、90min时c级精子百分率分别显著低于20min、30min时的c级精子百分率(P<0.05)。c级精子百分率在20min和30min时无明显差异(P>0.05)。30、60、90min时(a+b)级精子百分率、(a+b+c)级精子百分率则均显著低于20min时(a+b)级精子百分率、(a+b+c)级精子百分率(P<0.05)。鞭打频率(BCF)在30min时则显著高于20min(P<0.05)。90min时侧摆幅度(ALH)与30min时相比显著降低(P<0.05)。90min时摆动性(WOB)与20、30min时比显著增高(P<0.05)。90min时曲线速度(VCL)显著低于20、30min时的曲线速度(P<0.05)。30、60、90min时的前向性(STR)与20min相比显著降低(P<0.05)。9min时的平均路径速度(VAP)、直线速度(VSL)分别均显著低于20min时的平均路径速度、直线速度(P<0.05)。精子密度、平均移动角度(MAD)、直线性(LIN)在4个不同时间点分析时均无显著性差异(P>0.05)。结论:精液常规分析中精液留取后至分析的时间需要标准化,对正常液化标本,精子留取后30～60min精子运动参数分析相对恒定。     

计算机辅助精液分析男性不育患者精子运动参数与精子活力的相关性

目的探讨计算机辅助精液分析精子运动参数在评价男性不育患者精子活力中的价值。方法按《WHO人类精液及精子-宫颈黏液相互作用实验检验手册》标准,采用国产WLJY-9000伟力彩色精子质量检测系统对276例男性不育患者的精液进行平均直线运动速度、平均曲线运动速度、运动的前向性、运动的直线性、运动的摆动性、平均路径速度、精子活力及分级等进行检测并分析其相关性。结果276名男性不育患者的平均精子活力为（48.93±19.10）%,分级为A级（32.11±17.25）%、B级（17.03±8.91）%、C级（10.14±5.99）%。平均直线运动速度、平均曲线运动速度、运动的前向性、运动的直线性、运动的摆动性、平均路径速度与精子活力的相关系数分别为0.60（P〈0.01）、0.59（P〈0.01）、0.51（P〈0.01）、0.55（P〈0.01）、0.52（P〈0.01）、0.67（P〈0.01）。结论计算机辅助精液分析精子运动参数平均直线运动速度、平均曲线运动速度、平均路径速度是反映精子活力的有效指标,精子运动参数对男性不育的诊断和生育能力的评估具有实用意义。     

精子DNA荧光分析与两种常规精液分析方法的比较

目的 :比较计算机辅助的DNA荧光染色精子分析系统 (简称荧光CASA)与两种常规精液分析方法。　方法 :随机选择 2 2例男性不育患者 ,采用荧光CASA、灰度CASA和人工技术分析精液 ,以荧光CASA检测的精子密度为基础 ,分别与常规精液分析及灰度CASA的结果进行比较。　结果 :荧光CASA检测可以区别非精子颗粒及死活精子。与荧光CASA分析方法获得的精子密度相比 ,常规精液分析和灰度CASA法获得的精子密度差值绝对值的平均值分别为 (9.2 3± 8.0 1)× 10 6/ml和 (10 .2 7± 6 .2 2 )× 10 6/ml,检测精子密度误差的百分率分别为 (4 9.0 6±4 9.87) %和 (4 3.39± 2 5 .5 6 ) %。　结论 :荧光CASA更符合最新WHO男性不育实验室诊断标准的要求 ,推荐在临床工作中使用DNA荧光染色精子分析系统来分析精子特性 ,尤其是精子密度分析。     

禁欲时间对精子DNA损伤、形态及精液常规分析参数的影响

目的 探讨不同禁欲时间对精子DNA损伤、形态及精液常规分析参数的影响。方法 收集从2018年9月至2021年2月到东南大学附属中大医院生殖医学中心就诊的男性患者精液样本1 128例。采用CFT-9201型计算机辅助精子分析系统进行精液常规分析,包括精子浓度、精子活动率、前向运动精子百分率(PR)等主要参数;采用Diff-Quik染色法进行精子形态分析;采用精子染色质结构分析法(SCSA)检测精子DNA碎片指数(DFI)。结果 1 128例患者的禁欲时间为0～30天,中位数为3.0[3.0, 5.0];仅精子活动率呈正态分布(P=0.117),其余参数均呈非正态分布(P<0.01)。患者禁欲时间与精液量(r=0.21,P<0.01)、精子浓度(r=0.098,P<0.01)和精子DFI(r=0.068,P<0.05)均呈显著正相关,而与PR、精子活动率和正常形态精子百分率均呈负相关,但均无显著相关性(P>0.05)。精子DFI与精子浓度没有显著相关性(P>0.05),但与PR、精子活动率和正常形态精子百分率均呈显著负相关(P<0.01)。结论 随...     

不同获能时间豚鼠精子运动参数分析

目的:评价精子运动参数在研究豚鼠精子超激活运动中的作用,进一步确定豚鼠精子超激活运动的指标。方法:采用计算机辅助精液分析(CASA)系统检测豚鼠精子不同孵育时间(0、1、3、5、7h)的运动参数。结果:豚鼠精子孵育过程中精子曲线运动速度(VCL)、平均路线速度(VAP)、头部侧摆幅度(ALH)随孵育时间的增加而提高,并在5h达到最大值,而直线运动速度(VSL)、直线性(LIN)、向前性(STR)、鞭打频率(BCF)随孵育时间的增加而降低,并在5h达到最低值。结论:豚鼠精子获能培养过程中在发生超激活运动前精子的运动方式可发生很大的变化。     

精子核DNA成熟度与精液参数与精子授精能力之间的关系

本文通过对１９对能育夫妇和７２对不育夫妇丈夫精液中绿色ＡＯ精子（成熟精子）比率２民政部的比较分析，探讨了绿色ＡＯ荧光精子百分率与精液参数及精子受精能力之间的关系。在１－３年随访中，通过ＡＩＨ，其它治疗或 非治疗期，５４对ＡＯ荧光精子≥５０％夫妇有１８对怀孕。而地８对绿色ＡＯ荧炮清子〈５０％的夫妇无１例怀孕，结果还显示了绿色ＡＯ荧光精子百分率与精液参数无关。     

精子DNA碎片指数与精液参数的相关性分析

目的:探讨精子DNA碎片指数(DFI)与精液参数的关系,并评价其在男性精子质量评估中的应用价值。方法:收集9 694例男性精液标本,采用流式细胞仪辅助的精子染色质结构分析法(SCSA)进行精子DFI和高DNA着色性(HDS)检测,根据WHO《人类精液检查与处理实验室手册》(第5版)精液参数参考值标准分为正常组和异常组,异常组再依据精子浓度、精子总活率和前向运动精子百分率异常程度分为A组:精子浓度(11.3～14.0)×10~6/ml,精子总活率30%～39%,前向运动精子百分率24%～31%;B组:精子浓度(7.5～11.2)×10~6/ml,精子总活率20%～29%,前向运动精子百分率16%～23%;C组:精子浓度(3.8～7.4)×10~6/ml,精子总活率10%～19%,前向运动精子百分率8%～15%;D组:精子浓度(0～3.7)×10~6/ml,精子总活率0～9%,前向运动精子百分率0～7%;按照不同DFI值分为15%、15%～30%和30%3组。分析DFI与精液参数的关系。结果:正常组DFI均显著低于异常组及其亚组(P均0.01);各异常亚组(A、B、C、D组)随着精子指标的降低DFI逐渐升高(P0.01)。根据DFI分组,发现DFI与年龄、禁欲时间、精液体积、精液pH、精子浓度、精子总活率、前向运动精子百分率、正常形态精子百分率以及HDS的差异均有统计学意义(P均0.01);相关性分析表明DFI与年龄、禁欲时间、精液体积和HDS存在正相关(r分别为0.15、0.10、0.05、0.15,P均0.01),而与精液pH、精子浓度、精子总活率、前向运动精子百分率和正常形态精子百分率存在负相关(r分别为-0.06、-0.27、-0.53、-0.52、-0.16,P均0.01)。多重线性回归分析表明精子总活率、精子浓度、年龄、禁欲时间和精液pH是与DFI相关的5个重要相关变量,标准化回归系数分别为-0.47、-0.19、0.12、0.07、-0.04,P均0.01。结论:DFI与精液参数存在中等相关性,二者可协同评估男性精子质量。     

计算机辅助精子运动参数分析在男性不育症诊断中的价值

精液分析在男性不育症诊断中占有重要的地位,是确定男性生育能力的重要检查方法。近年来,随着计算机辅助精子分析(CASA)系统的应用,精子的运动参数在男性不育症诊断中的价值受到普遍关注。为了探讨精子运动参数的变化对男性生育能力诊断的临床价值,我们应用CASA对307例男性的精液进行了相关参数的分析,报告如下。     

334例男性不育症患者精子DNA完整性与精液常规参数间的相关性分析

目的探讨男性不育症患者精子DNA完整性与精液常规参数的相关性,研究精子DNA完整性在评估男性生育力方面的应用价值。方法回顾性分析2015年1月至2016年12月于西北妇女儿童医院生殖中心男性不育门诊就诊的334例患者的临床资料,按照精子DNA碎片指数(DFI)不同进行分组,Ⅰ组(192例):DFI≤15%;Ⅱ组(98例):15%DFI30%;Ⅲ组(44例):DFI≥30%。比较各组患者的精液常规参数(精子浓度、前向运动精子率、正常形态率、年龄和禁欲时间),分析DFI与精液常规参数的相关性。结果不同DFI组间比较,年龄、精子浓度及正常形态率无统计学差异(P0.05),但禁欲时间和前向运动精子率组间差异有统计学意义(P0.05)。DFI与前向运动精子率和正常形态率呈显著负相关(r分别为-0.457、-0.147,P0.05),与禁欲时间呈显著正相关(r=0.222,P0.05),与年龄及精子浓度无明显相关性(P0.05)。结论精子DNA完整性与精液常规参数(前向运动精子率、正常精子形态率、禁欲时间)具有一定的相关性,精子DNA完整性检测可作为精液常规分析的补充。     

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     

Comparative study of the effects of three semen preparation media on semen analysis,DNA damage and protamine deficiency,and the correlation between DNA integrity and sperm parameters

Semen samples collected from 28 male partners of infertile couples were divided into three equal aliquots and prepared with three selected media,such as PureSperm （Nidacon,Gothenburg,Sweden）,Sil-Select Plus^TM （Fertipro,Beemem,Belgium） and SpermGrad^TM（Vitrolife,Gothenburg,Sweden）. The differences in mean percentages of semen parameters were assessed by repeated measures analysis. Correlations of sperm DNA damage,as measured by terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） assay,and of protamine deficiency,as measured by chromomycin A3 （CMA3） staining with sperm parameters,were determined by Pearson＇s correlation. After preparation with all three media,sperm concentrations decreased （P〈0.05） while percentages of sperm with normal morphology increased （P〈0.05）. Percentages of sperm motility,rapid motility and progressive motile concentration （PMC） increased （P〈0.05） for each ofthese parameters,PureSperm preparation gave the best results （P〈0.05）. The percentage of DNA damage decreased in the PureSperm and Sil-Select Plus preparations （17.9% and 31.3%,respectively,P〈0.05） and increased in the SpermGrad preparation （56.3%,P〈0.05）. Protamine deficiency also decreased in all three kinds of media,59.3%,47.7% and 40.3% for PureSperm,Sil-Select Plus and SpermGrad preparations,respectively （P〈0.05）. The percentage of DNA-damaged sperm was negatively correlated with the percentages of sperm motility,rapid motility and PMC,but was positively correlated with static motility （P〈0.05）. This comparative study and correlation analysis revealed that PureSperm preparation yielded sperm with the best motility and the lowest percentage of protamine deficiency. The Sil-Select Plus preparation yielded sperm with the lowest amount of DNA damage. The SpermGrad preparation had a high percentage of sperm with normal morphology,but also had the highest percentage of sperm with DNA damage. Sperm DNA damage was correlated with percentages of sperm motility,rapid motility,static motility and PMC.     

Human sperm DNA integrity in normal and abnormal semen samples and its correlation with sperm characteristics

Reports indicate an increase in the incidence of DNA fragmentation in male factor infertility and its role in the outcome of assisted reproductive techniques (ART). However, reports are conflicting between the relationships of sperm DNA integrity with conventional semen parameters. We examined the relationship between conventional sperm parameters and DNA integrity using acridine orange (AO) test. The study included 373 patients and 28 fertile volunteers. DNA normality was compared with semen parameters between the patient and donor populations. Significant correlations were noted between DNA normality and sperm concentration ( r  = 0.18, P  = 0.000), motility ( r =  0.21, P  = 0.0001), rapid motility (0.19, P  = 0.000), normal morphology by World Health Organization ( r =  0.15, P  = 0.019) and head defects ( r =  −0.15, P  = 0.023). A significant difference was noted in AO levels between donors and patients with asthenozoospermia ( P  = 0.002) and oligoasthenozoospermia ( P  = 0.001). A significant difference in DNA integrity was noted in samples having <30% and >30% normal morphology. A wide range of % DNA normality was observed in the patient group. Sperm assessment for DNA status using AO is reliable and shows good correlation with sperm count, motility and morphology. Assessment of sperm DNA status with AO staining may be helpful prior to ART.     

A randomised trial comparing conventional semen parameters,sperm DNA fragmentation levels and satisfaction levels between semen collection at home and at the clinic

The aim of the randomised trial was to compare conventional semen parameters, sperm DNA fragmentation levels and satisfaction levels between semen samples collected at home and at the clinic. We recruited 110 men with a history of infertility for at least 1 year from the outpatient andrology clinic. Each man collected two semen samples, one at home and one at the clinic. Men were randomly assigned into the home first (n = 55) or clinic first (n = 55) groups. The primary outcome was sperm concentration. There was no significant difference in sperm concentration, sperm DNA fragmentation levels or other conventional semen parameters between home first and clinic first samples (p > .05), while satisfaction levels were significantly higher for home first samples (p < .01). Consistent results were obtained when comparing home-collected and clinic-collected samples within individuals. Men can be offered the option to collect semen samples at home for examination or assisted reproduction without compromising semen quality, especially for those with difficulty in producing semen samples at the clinic.     

Relationship between age and semen parameters in men with normal sperm concentration: analysis of 6022 semen samples

This study evaluates retrospectively the relationship between age and semen parameters among men with normal sperm concentration. It was based on computerized data and performed in an Academic Fertility and IVF Unit. Six thousand and twenty-two semen samples with sperm concentrations of >or=20 x 10(6) ml(-1) were examined according to WHO criteria and analysed in relation to patients' age. For each age group, mean values +/- SD of semen volume, sperm concentration, percentage of motile spermatozoa, normal morphology, acrosome index, total sperm count/ejaculate, total motile sperm count/ejaculate and sexual abstinence duration were examined. A peak semen volume of 3.51 +/- 1.76 ml(-1) was observed at age >or=30 to <35 years and a lowest volume of 2.21 +/- 1.23 ml(-1) was observed at age >or=55 years (P<0.05). Sperm motility was found to be inversely related to age with peak motility of 44.39 +/- 20.69% at age <25 years and lowest motility of 24.76 +/- 18.27% at age >or=55 years (P<0.05). A reduction of 54% was observed for total motile sperm, between values of 103.34 +/- 107 x 10(6) at age >or=30 to <35 years and 46.68 +/- 53.73 x 10(6) (P<0.05) at age >55 years. A statistically significant and inverse relationship was observed between semen volume, sperm quality and patient age, in spite of prolonged sexual abstinence duration. Top sperm parameters were observed at age >or=30 to <35 years, while the most significant reduction in sperm parameters occurred after the age of 55 years.     

Poor sperm quality and advancing age are associated with increased sperm DNA damage in infertile men

With increasing evidence for faulty paternal contribution to reproduction, there has been a steady increase in studies highlighting an association between sperm DNA damage, failed/delayed fertilisation and aberrant embryo development. Owing to prevailing ambiguity, the aims of the study were to analyse the genetic integrity of the male gamete and then to understand its association with age, standard semen parameters, lifestyle and occupational factors. The study included 504 subjects, attending university infertility clinic for fertility evaluation and treatment. Semen characteristics were analysed by standard criteria; terminal deoxynucelotidyl transferase-mediated nick end-labelling assay was employed for DNA damage assessment. The average incidence of sperm DNA damage in patients with normozoospermic semen parameters was <10%. Patients with oligozoospermia, severe oligozoospermia, oligoasthenoteratospermia, asthenoteratozoospermia and necrozoospermia had significantly higher level of sperm DNA damage (P < 0.001). Patients above 40 years of age had significantly high levels of DNA damage (P < 0.001) compared with their counterparts. Patients with varicocele and a history of alcohol consumption had higher incidence of spermatozoa with DNA damage (P < 0.01). Poor sperm characteristics in the ejaculate are associated with increased sperm DNA damage. Age-related increase in sperm DNA damage and association of the same with varicocele and alcohol consumption are also demonstrated.     

Detection of DNA fragmentation in human spermatozoa: correlation with semen parameters

To determine the prevalence of high levels of sperm DNA damage among infertile men with normal and abnormal semen parameters, 90 patients were subdivided into the following three groups. Group A ( n  = 30): men with normal semen parameters who acted as the controls. Group B ( n  = 30): asthenozoospermic men and group C ( n  = 30): teratozoospermic men, suffering from male infertility. DNA damage was evaluated by the rate of DNA fragmentation index (DFI) as assessed by the terminal desoxynucleotidyl transferase-mediated dUTP nick-end labelling assay. It was found that the difference was not significant between the percentage of DFI in patients with asthenozoospermia and the normospermic men (9.46% ± 8.68 and 8.19 ± 6.84 respectively, P- value not significant). The patients with teratozoospermia showed a significantly higher percentage of DNA fragmentation compared with the controls (respectively 21.37 ± 17.26% and 8.19 ± 6.84%, P  < 0.001). There was a positive correlation between abnormal sperm morphology and the DFI ( r  = 0.44, P  < 0.01) in group C. It is concluded that the impairments of sperm parameters were associated with an increase of DNA fragmentation; this association was strictly related to atypical forms.     

用传统方法与计算机辅助精液分析软件CRISMAS分析166名丹麦青年男性精液样本的结果比较

本研究以166名丹麦青年男性精液为样本,通过评估精于浓度和活力来比较传统精液分析与计算机辅助精液分析方法（CASA）（哥本哈根Rigshospitalet图像屋精子运动分析系统,CRISMAS软件4．6版本）。CRISMAS软件测定精子的浓度把精子活力分为三类。传统分析方法将精子活力分为四种状态。为了便于二者的比较,本文将传统的四种状态根据精子速度等级重新分为三个状态：rapidly progressive（A）,slowly progressive（B）和non-progressive（C＋D）。两种方法所研究的参数之间都有显著差异（P〈0．001）。与传统方法相比,CRISMAS高估了精子浓度以及快速运动精子的比例,因而低估了慢速运动和非运动精子。为分析研究结果是否会随精液分析时间而起伏变动,将精液分析结果按分析同期分为四个层次。结果表明CRISMAS对活力的分析结果比传统分析方法稳定,但两种方法都未表现出任何趋势。显然,无法比较CRISMAS CASA和传统分析方法在精子浓度和精子活力方面的分析结果。在临床上使用该软件时以及用其研究这些精子特性时需要说明这一点。     

全自动精子分析中各运动性参数间相关性研究

目的　考察全自动精子分析中各运动性参数间的相关性。方法　进行了 190份健康受试者精液全自动分析 ,并对其各运动性参数 :直线速度 (vsl)、曲线速度 (vcl)、平均路径速度 (vap)、直线性 (lin)、前向性 (str)、摆动性 (wob)、侧摆幅度 (alh)、平均移动角度 (mad)、鞭打频率 (bcf)、精子密度、精子活动率间进行相关性分析。结果　从相关性分析中可确定运动性参数具有代表意义的是vsl、str、mad。结论　全自动精子分析的众多参数中 ,可通过vsl、str、mad三参数了解精子活动性 ,从而达到简便、快速、准确诊断的目的