精索静脉曲张程度对性激素和精液参数的影响

目的:探讨临床型、亚临床型精索静脉曲张不育症患者性激素水平的变化以及对精液参数的影响。方法:选择临床型精索静脉曲张不育症患者(A组)、亚临床型精索静脉曲张不育症患者(B组)、正常生育者(C组)各30例,采用酶联免疫定量测定法(ELISA)测定其外周血性激素水平,用计算机辅助精液分析仪测定精子密度、活动精子、前向运动精子、快速前向运动精子以及畸形精子百分率。结果:①A组与C组比较,FSH、LH明显升高,而T明显下降(P<0.05),B组与C组,以及A组与B组之间FSH、LH、T差异无统计学意义(P>0.05)。②A组与B组与C组比较,精子密度、活动精子、前向运动精子、快速前向运动精子百分率均有明显下降,畸形精子百分率升高(P<0.05),同时A组与B组比较,差异也有显著性(P<0.05)。结论:精索静脉曲张程度越重,其对外周血性激素水平及精液参数影响越大。早期发现亚临床型精索静脉曲张对治疗男性不育症有指导意义。     

有机磷农药接触对精液质量影响的研究

目的:探讨有机磷农药接触对精液质量的可能影响因素。 方法:对161例有机磷农药暴露组的对象和161例非暴露组对象进行流行病学问卷调查、外生殖器检查和精液质量测定。结果:多因素结果显示:受教育程度和饮酒对精液量有影响,受教育程度为初中的对象精液量正常率高(OR=1.961);随饮酒年数的增加,精液量正常率降低(OR=0.962)。有机磷农药接触使快速前向运动精子百分比(OR=0.528)、精子密度(OR=0.266)、精子存活率(OR=0.398)和正常精子形态率(OR=0.281)这4个指标的正常率下降。精液收集的季节对快速前向运动精子百分比、精子存活率和正常精子形态率均有影响,与夏季相比,冬季采集的精液这3个指标的正常率高(OR分别为2.272、4.060、5.249)。 结论:有机磷农药暴露可导致农民精液质量下降。     

不同病因无精子症的生殖激素水平

目的 :探讨不同病因无精子症患者生殖激素水平及病变部位和睾丸生精功能的关系。方法 :采用 RIA法检测 6 5 1例患者血清中的生殖激素 FSH、LH、T、PRL值。结果 :FSH值升高者 ,病变在睾丸 ,且生精功能受损 ;而在正常值上限 2倍以上 ,则生精功能丧失。病变不在睾丸和特发性无精子症者 ,FSH值水平正常或低下 ,LH、T、PRL值不一 ,部分患者生精障碍可随疾病的治愈而恢复。结论 :生殖激素水平可表示无精子症的不同病因 ,FSH值的升高是睾丸生精功能损伤的指标     

成年男性生育与不育血清中生殖内分泌激素含量的研究

<正> 促卵泡成熟激素(FSH)和促黄体生成激素(LH)是糖蛋白类。FSH 主要作用于睾丸曲细精管的生精作用与支持细胞,LH 主要通过刺激睾丸间质细胞(Leydig)分泌睾酮(T)促进精子形成。因而测定血清中 FSH、LH、T含量可以间接评估男性生育力。我们通过50例正常生育男性和68例男性不育患者血清中 FSH、LH、T 含量测定进一步探讨 FSH、LH、T 浓度与精子密度,睾丸功能,睾丸体积的关系及其测定的临床意义。     

人类精液的电子计算机自动化分析

<正> 精液分析是检验男性生育力的主要指标。常规的精液分析内容包括:精液量、液化程度、精子密度、精子活动度、精子生存能力、精子细胞形态等。精液的分析过程是较为复杂和费时的;而且常规分析方法对精子运动的定     

人精浆与血清中生殖激素及免疫球蛋白的相关性研究

对152例生育与不育男性,分组观察精浆和血清中五种生殖激素(ICSH、FSH、PRL、T、E_2)及三种免疫球蛋白(IgG、IgA、IgM)的变化,分析它们之间的相关性以及与精液质量的关系。结果表明:1.生殖激素在精浆与血清中含量变化不一致。精浆中ICSH与PRL呈正相关,精浆ICSH、PRL与精于活力、密度间亦呈正相关关系。2.精浆IgG与血清、精浆T呈负相关,不育者精浆IgG与精子活力亦为负相关关系。     

空调使用对精液质量的影响

目的:探讨空调使用对精液质量的影响。方法:1998年12月至2000年2月调查了空调拥有10%以上的四个省市(上海、河南、浙江、河北,共计304例),在妇幼保健中心婚前体检的正常男性志愿者(年龄在22～30岁)精液质量,并分析使用空调对精液质量的影响。结果:在304例对象中,家中有空调者为90例,没有空调者为214例,空调拥有率为29.6%。单因素与多因素Logistic回归分析结果均显示,精液量、精子密度、正常形态精子率在有空调组和无空调组间的差别有统计学意义,家中有空调者精液量、精子密度、正常形态精子率较低。结论:使用空调对精液质量可能有一定的影响。     

精子线粒体膜电位与男性精液参数和体质量指数的相关性研究

目的探讨精子线粒体膜电位(MMP)与精子常规参数及体质量指数(BMI)的相关性。方法在本院辅助生殖科行精液分析的男性患者,禁欲3~7 d后,以手淫方式获取精液样本。通过计算机辅助精液分析仪检测精液常规,改良巴氏染色检查精子形态,JC-1染色后经流式细胞仪评估MMP。结果与对照组(56.68%±11.13%)相比,弱精子组MMP(41.24%±9.71%)显著降低。MMP与BMI呈显著负相关(r=-0.25,P0.01),与精子总活力(r=0.63,P0.01)、前向运动力(r=0.64,P0.01)及正常精子形态率(r=0.37,P0.01)呈显著正相关,而与年龄、精液量、精子浓度和精子数量其余参数的相关性均无统计学意义。结论精液中精子MMP是评估精子功能的重要指标,对临床综合分析男性不育症因素具有一定的参考意义。     

近25年中国正常男性精液质量的变化趋势分析

目的:研究近25年来中国正常男性的精液质量变化趋势。方法:通过文献检索,收集1985～2009年间我国正常男性精液质量检测报告文献115篇,涉及69个县市的23 126人。用直线回归法和秩和检验分析精液参数的变化趋势。结果:精子密度、精子非前向运动率(c%)呈显著下降趋势。1985～1989年、1990～1999年、2000～2009年3组的精子密度、精子总数的秩和检验显示组间差异有统计学意义(P<0.05)。结论:近25年来我国正常男性的精子密度可能呈下降趋势。     

新型冠状病毒感染对生殖功能的影响

目的:探讨新型冠状病毒(SARS-CoV-2)感染对女性卵巢储备和卵巢反应,以及男性精液参数的影响。方法:回顾分析2020年5月至2021年2月于华中科技大学同济医学院附属同济医院生殖医学中心就诊的拟行辅助生殖技术(ART)助孕患者,根据采卵前1周内新型冠状病毒抗体检测结果,分为病例组(新型冠状病毒抗体阳性)和对照组(新型冠状病毒抗体阴性)。对于女性患者,通过倾向性评分匹配均衡两组基线后,比较两组抗穆勒激素(AMH),卵泡刺激素(FSH),窦卵泡数(AFC),促性腺激素剂量和应用时间,以及大卵泡数等。对于男性患者,通过单臂研究观察比较感染前后精液参数,包括精液量、总活力、前向运动力、精子浓度、精子总数以及正常形态精子率等。结果:新型冠状病毒抗体阳性患者共有120例,其中女性70例,男性50例。对于女性患者,匹配基线后,对照组260例,病例组65例,两组的卵巢储备(AMH、FSH、AFC)和卵巢反应(促性腺激素剂量、促性腺激素应用时间和大卵泡数)差异均无统计学意义(P>0.05);对于男性患者,共有26例患者在感染前后均进行精液检测,感染后正常形态精子率相较感染前降低(P=0.00...     

Body mass index in relation to semen quality and reproductive hormones among 1,558 Danish men

OBJECTIVE: To examine the relationship between body mass index (BMI) and semen quality among young men from the general population. DESIGN: Cross-sectional study. SETTING: Danish young men were approached when they attended a compulsory physical examination to determine their fitness for military service. PATIENT(S): From 1996-1998, 1,558 (19%) young men (mean age 19 years) volunteered. MAIN OUTCOME MEASURE(S): Semen volume (in milliliters), sperm concentration (in million per milliliter), percentage of motile spermatozoa, percentage of spermatozoa with normal morphology, total sperm count (in million), and testis size (in milliliters). In addition, serum reproductive hormones were measured. RESULT(S): Serum T, sex hormone-binding globulin (SHBG), and inhibin B all decreased with increasing BMI, whereas free androgen index and E(2) increased with increasing BMI. Serum FSH was higher among slim men. After control for confounders, men with a BMI <20 kg/m(2) had a reduction in sperm concentration and total sperm count of 28.1% (95% confidence interval [CI] 8.3%-47.9%) and 36.4% (95% CI 14.6%-58.3%), respectively, and men with a BMI >25 kg/m(2) had a reduction in sperm concentration and total sperm count of 21.6% (95% CI 4.0%-39.4%) and 23.9% (95% CI 4.7%-43.2%), respectively, compared to men with BMI between 20-25 kg/m(2). Percentages of normal spermatozoa were reduced, although not significantly, among men with high or low BMI. Semen volume and percentage of motile spermatozoa were not affected by BMI. CONCLUSION(S): High or low BMI was associated with reduced semen quality. It remains to be seen whether the increasing occurrence of obesity in the Western world may contribute to an epidemic of poor semen quality registered in some of the same countries. If so, some cases of subfertility may be preventable.     

Annual variation in semen characteristics and plasma hormone levels in men undergoing vasectomy

Prevasectomy levels of plasma luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), estradiol (E2), and 20 alpha-dihydroprogesterone (20 alpha-DHP), as well as semen analyses including semen volume, sperm count, and sperm motility from 260 healthy men were evaluated for annual changes. A statistically significant (P less than or equal to 0.015) high-amplitude seasonal variation with the peak in April to May was detected in semen volume, sperm count, and sperm motility. A statistically significant (P less than or equal to 0.04) annual change of moderate T to large FSH amplitude was detected in each of the five plasma endocrine variables as well. Plasma LH, T, and E2 peaked in autumn, while FSH and 20 alpha-DHP peaked in summer. Analysis of postvasectomy LH, FSH, E2, 20 alpha-DHP, and T blood levels for the 3 years following vasectomy revealed loss of seasonal rhythmicity as a group phenomenon in LH, E2, and T. The amplitude of the seasonal variation in FSH was decreased and that in 20 alpha-DHP was unchanged compared with before-vasectomy baselines. For those annual rhythms which persisted following vasectomy, the peak time was unchanged. Compared with the prevasectomy group annual mean, that for each of the endocrine values was unchanged, except for that of LH and T, which was slightly, yet statistically significantly, elevated. The existence of prominent annual variation implicates their consideration in the design of research protocols involving investigation of reproductive phenomena in human beings.     

Male infertility associated with adult dominant polycystic kidney disease: a case series

Introduction  Although described earlier, the association of male infertility with adult dominant polycystic kidney disease (ADPKD) is quite rare and unfamiliar to some of the multidisciplinary team members caring for affected men. Materials and methods  Infertile men diagnosed to have ADPKD were evaluated by clinical characteristics including testis volume, as well as serum hormone levels, semen analysis, and transrectal ultrasonography (TRUS) because of low volume ejaculate. Results  Semen analysis revealed low-normal volume, normal pH, and azoospermia/virtual azoospermia. Serum hormones were within the normal range. Transrectal ultrasonography demonstrated cystic dilatation of the seminal vesicles in all three men. Conclusion  Patients should be referred for andrological evaluation of a presentation similar to obstructive azoospermia. Their potential to achieve paternity by surgical sperm retrieval combined with assisted reproductive technology is another example of cooperation between andrologists and gynecologists.     

Recombinant human follicle-stimulating hormone as a pretreatment for idiopathic oligoasthenoteratozoospermic patients undergoing intracytoplasmic sperm injection

OBJECTIVE: To evaluate the efficacy of recombinant human FSH pretreatment in improving fertilization and pregnancy rates in oligozoospermic patients who are undergoing ICSI. DESIGN: Prospective, controlled, clinical study. SETTING: A research institute's reproductive unit. PATIENT(S): Thirty-three subjects with idiopathic oligoasthenoteratozoospermia who failed to conceive after previous ICSI attempts. INTERVENTION(S): Treatment with recombinant human FSH 150 IU for 3 months (23 patients) or no treatment (10 patients); clinical, hormonal, and seminal evaluation before and after treatment. MAIN OUTCOME MEASURE(S): Testicular volume, sperm parameters, FSH, LH, T, E(2), and inhibin B plasma levels, E/T ratio, and fertilization and pregnancy rates. RESULT(S): Treatment with 150 IU of FSH induced a significant increase in testicular volume and sperm parameters. The mean fertilization rate (FR) after ICSI cycles was higher, although not significantly, in treated patients when compared with controls (62.3 +/- 22.4 vs. 47.2 +/- 20.4). A strong negative correlation was observed between FR and serum FSH, inhibin B and E/T ratio in controls, whereas in treated patients, FR correlated with posttreatment inhibin B levels. The pregnancy rate in the entire treated group was 30.4%. No pregnancies were recorded in the control group. CONCLUSION(S): Recombinant human FSH may be a valuable pretreatment for oligozoospermic patients undergoing ICSI and may influence testicular paracrine activity.     

Spermatid count as a predictor of response to FSH therapy

This study evaluated the predictive power of spermatid count and cytology for assisted reproduction outcome after FSH therapy. A total of 174 men with severe oligozoospermia and normal plasma FSH concentration underwent semen analysis including spermatid count, TUNEL test, FISH analysis for sperm aneuploidies and testicular fine-needle aspiration cytology. Ninety-two men with hypospermatogenesis received FSH therapy for 3 months and 82 patients with maturative disturbance or partial obstruction served as controls. Semen was analysed at baseline, after FSH therapy and after 3- and 9-month follow up, and pregnancies were recorded. Subjects not reaching pregnancy at 3-month follow up were recommended assisted reproduction treatment. Spermatid count was related to testicular cytology: spermatid concentrations <0.01, 0.01–0.3 and >0.3 × 10⁶/ml were predictive of partial obstruction, hypospermatogenesis and maturative disturbance. FSH therapy patients showed increases in sperm number and motility (both P < 0.001), allowing some couples to undergo intrauterine insemination instead of IVF. Cumulative pregnancy rate after 12 months was higher with FSH therapy (44.6%) than without (22.0%; P = 0.002). FSH therapy improved pregnancy rate and sometimes allowed less invasive assisted reproduction treatment in well-selected patients. Spermatid count could represent a new parameter to predict response to FSH therapy.One-hundred seventy-four patients with severe reduction of sperm count and normal sex hormones plasma levels underwent semen analysis with spermatid count, and testicular fine needle aspiration cytologiy (FNAC). Ninety-two men infertile men with reduced sperm production (hypospermatogenesis) were treated with highly purified urofollitropin and 82 patients with sperm maturative defects or partial obstruction of the seminal tract served as controls. After treatment and after the following 3 and 9 months all subjects performed a new semen analysis and pregnancies were recorded. Subjects who had not reached spontaneous pregnancy were suggested to undergo assisted reproductive techniques (ARTs). Spermatid count was strongly related to testicular cytology: spermatid concentrations were predictive of partial obstruction, hypospermatogenesis and maturative disturbance respectively. Treated patients showed significant increase in sperm number and motility allowing some couples to undergo easier and less invasive assisted reproductive techniques. The number of pregnancies was significantly higher among treated (44.6%) than untreated couples (22.0%). Our data confirmed that FSH treatment can induce a significant improvemet of pergnancy rate and sometimes allows less invasive ARTs use in well selected severe oligozoospermic patients. Moreover, we suggest that spermatid count can be useful to define tubular status and could represent a new parameter to predict response to FSH therapy.     

The effect of aromatase inhibitor letrozole on body mass index, serum hormones, and sperm parameters in infertile men

We investigated the effect of letrozole, an aromatase inhibitor, on body mass index, serum hormones, and sperm parameters in infertile men with decreased T:E(2) ratios. All sperm parameters increased after letrozole treatment. Letrozole may be effectively used to improve sperm parameters in infertile men with a low serum T:E(2) ratio.     

Relationship between male reproductive hormones, sperm DNA damage and markers of oxidative stress in infertility

This study investigated the relationship between male reproductive hormones and sperm DNA damage and markers of oxidative stress in men undergoing infertility evaluation for male factor (n = 66) and non-male factor (n = 63) infertility. Semen samples were analysed for DNA fragmentation index (DFI). Serum samples were analysed for FSH, inhibin B, anti-Müllerian hormone (AMH), testosterone and total antioxidant capacity (TAC). Serum inhibin B was significantly lower in the male factor group compared with the non-male factor group. Inhibin B showed a positive correlation with sperm concentration and motility, and serum AMH showed a positive correlation with sperm concentration and semen volume. DFI was 3-fold higher in the male factor group and showed a negative correlation with sperm motility. Blood plasma TAC was negatively related to sperm concentration. The results confirm that AMH and inhibin B are markers of Sertoli cell function. Sperm DNA damage is moderately increased in male factor infertility, and is negatively associated with sperm motility. A negative association between antioxidant activity and sperm concentration suggests that even minimal oxidative stress may influence sperm concentration. However, there was no significant relationship between hormone concentrations, sperm DNA damage and total antioxidant capacity, suggesting other mechanisms for sperm dysfunction.     

Peptide and steroid hormone concentrations in human seminal plasma

Concentrations of peptide (alpha fraction of human chorionic gonadotropin [alpha-hCG], beta fraction of human chorionic gonadotropin [beta-hCG], luteinizing hormone [LH], follicle-stimulating hormone [FSH], and prolactin [PRL] ) and steroid hormones (testosterone [T], dihydrotestosterone [DHT], estrone [E1], estradiol [E2] and delta 4-androstenedione [A] ) were measured in the seminal plasma of 193 men. They were divided into three groups: group 1--patients attending an infertility clinic; group 2--normal volunteers of proven fertility; and group 3--men vasectomized at least 1 year prior to the study. Correlations among concentrations of hormones in seminal plasma and characteristics of the spermogram were studied. Seminal concentrations of alpha-hCG, beta-hCG, LH, T, and DHT were significantly higher in subjects with sperm in their ejaculate than in vasectomized men. No differences were observed among the groups in seminal concentrations of FSH, PRL, A, E1, and E2. Concentrations of beta-hCG and LH were highly correlated with the numbers and motility of sperm in the ejaculates. Testosterone concentrations were significantly correlated with motility of sperm.     

An examination of blood steroid and gonadotropin concentrations in relation to fertility status and testicular function in men

Plasma concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), testosterone (T), and 17 beta-estradiol (E2) have been measured in men complaining of infertility in comparison with men of proven fertility. Subgrouping of patients was achieved on the basis of the presence or absence of sperm in the ejaculate and further by the concentration of sperm or by testicular score. The levels of plasma LH, FSH, PRL, and T were found to be significantly different in the fertile men, compared with both infertile men with sperm in their ejaculates and azoospermic men. There were no significant differences between the groups for E2. There appeared to be an inverse relationship between LH concentrations and sperm count in both fertile and infertile men. FSH levels did not vary significantly in the fertile men in relation to sperm count grouping but were significantly less than those found for the infertile men with sperm. Azoospermic patients with high testicular scores had FSH levels indistinguishable from those of the fertile men. The results are discussed in terms of testicular abnormalities and on the interrelationship between the hormones examined.