Melatonin hormone profile in infertile males

Melatonin is a hormone produced by the pineal gland. There is much controversy about its relationship to the male reproductive process. In this study, seminal plasma as well as the serum melatonin levels were studied in different infertile male groups and were correlated with their semen parameters and hormonal levels. One hundred twenty male cases subdivided into six equal groups were consecutively included; fertile normozoospermic men, oligoasthenozoospermia (OA), OA with leucocytospermia, OA with varicocele, non-obstructive azoospermia (NOA) with high serum follicle stimulating hormone (FSH) and NOA with normal FSH. Semen analysis, estimation of melatonin, FSH, testosterone (T) and prolactin (PRL) hormone was carried out. Mean level of serum melatonin was higher than its corresponding seminal concentrations in all investigated groups with a positive correlation between their levels (r = 0.532, p = 0.01). Serum and seminal plasma melatonin levels in all infertile groups were reduced significantly compared with their levels in the fertile group. The lowest concentrations were in OA with leucocytospermia group. Melatonin in both serum and semen demonstrated significant correlation with sperm motility (r = 607, 0.623 respectively, p = 0.01). Serum melatonin correlated positively with serum PRL (r = 0.611, p = 0.01). It may be concluded that melatonin may be involved in the modulation of reproductive neuroendocrine axis in male infertility. Also, low levels of melatonin in semen were observed in infertile groups having reduced sperm motility, leucocytospermia, varicocele and NOA.     

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.     

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.     

Heme oxygenase enzyme activity in human seminal plasma of fertile and infertile males

This work aimed to assess heme oxygenase (HO) enzyme activity relationship with different human semen parameters. One hundred and twenty men were divided according to their sperm count and clinical examination into: obstructive azoospermia (n = 20), nonobstructive azoospermia (NOA) (n = 25), oligozoospermia (n = 35) and normozoospermia (n = 40). Semen analysis, western blot for HO-1 and HO-2, and estimation of seminal plasma HO enzyme activity chemically in the form of bilirubin concentration were carried out. Seminal plasma HO enzyme activity was very low in OA specimens, low in NOA, moderate in oligozoospermia while higher in normozoospermia (mean +/- SD; 6.26 +/- 2.2, 81.4 +/- 35.5, 283.8 +/- 90.1, 657.4 +/- 227.6 pmol ml(-1) min(-1)) with significant differences. Western blot analysis demonstrated HO-2 expression in all studied groups whereas HO-1 was highly expressed in fertile normozoospermic group compared with other groups. There was positive correlation between seminal plasma HO enzyme activity and sperm concentration, sperm motility percentage, motile spermatozoa ml(-1) and sperm normal morphology per cent. It is concluded that HO enzyme activity in the human seminal plasma is related to spermatogenesis and sperm-motility processes.     

Seminal plasma anti-Müllerian hormone level correlates with semen parameters but does not predict success of testicular sperm extraction (TESE)

AIM: To assess seminal plasma anti-Müllerian hormone (AMH) level relationships in fertile and infertile males. METHODS: Eighty-four male cases were studied and divided into four groups: fertile normozoospermia (n = 16), oligoasthenoteratozoospermia (n = 15), obstructive azoospermia (OA) (n = 13) and non-obstructive azoospermia (NOA) (n = 40). Conventional semen analysis was done for all cases. Testicular biopsy was done with histopathology and fresh tissue examination for testicular sperm extraction (TESE) in NOA cases. NOA group was subdivided according to TESE results into unsuccessful TESE (n = 19) and successful TESE (n = 21). Seminal plasma AMH was estimated by enzyme linked immunosorbent assay (ELISA) and serum follicular stimulating hormone (FSH) was estimated in NOA cases only by radioimmunoassay (RIA). RESULTS: Mean seminal AMH was significantly higher in fertile group than in oligoasthenoteratozoospermia with significance (41.5 +/- 10.9 pmol/L vs. 30.5 +/- 10.3 pmol/L, P < 0.05). Seminal AMH was not detected in any OA patients. Seminal AMH was correlated positively with testicular volume (r = 0.329, P = 0.005), sperm count (r = 0.483, P = 0.007), sperm motility percent (r = 0.419, P = 0.021) and negatively with sperm abnormal forms percent (r = -0.413, P = 0.023). Nonsignificant correlation was evident with age (r = -0.155, P = 0.414) and plasma FSH (r = -0.014, P = 0.943). In NOA cases, seminal AMH was detectable in 23/40 cases, 14 of them were successful TESE (57.5%) and was undetectable in 17/40 cases, 10 of them were unsuccessful TESE (58.2%). CONCLUSION: Seminal plasma AMH is an absolute testicular marker being absent in all OA cases. However, seminal AMH has a poor predictability for successful testicular sperm retrieval in NOA cases.     

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     

不育病人精浆胆固醇酯转运蛋白的检测

目的 :检测不育病人精浆胆固醇酯转运蛋白 (cholesterolestertransferprotein ,CETP)的含量 ,并探讨其与不育的关系。　方法 :随机选择 163例不育病人及 15例生育男性 ,行精液常规分析及精浆CETP浓度测定 ,其中5 5例不育病人同时测定了血清CETP含量。　结果 :不育病人及生育男性精浆CETP含量分别为 ( 2 .2 1± 1.2 3 )μg/L和 ( 1.40± 0 .45 ) μg/L ,两组间差异无显著性 (P >0 .0 5 ) ;在不育病人中 ,无精子症组 (n =2 9)、少弱精子症组(n =5 8)、少精子症组 (n =15 )、弱精子症组 (n =44 )及正常精子症组 (n =17)间CETP含量差异也无显著性 (P >0 .0 5 )。精浆平均CETP含量仅占血清的 1/ 10 0 0 ,不育病人精浆及其血清CETP含量间并无相关性 (r =0 .0 0 9,P>0 .0 5 )。　结论 :精浆CETP含量极低 ,与精子密度、活率的改变无关 ,可能保证了精子在未进入女性生殖道前膜结构与功能的完整性     

alpha-1,4-Glucosidase activity in infertile oligoasthenozoospermic men with and without varicocele

This work aimed to assess seminal alpha-1,4-glucosidase activity in infertile oligoasthenozoospermic men associated with and without scrotal varicocele. Eighty men were investigated. They were divided into three groups: group 1 (n = 20), fertile normozoospermic men; group 2 (n = 30), oligoasthenozoospermia with varicocele; and group 3 (n = 30), oligoasthenozoospermia without varicocele. The patients underwent medical history, clinical examination, conventional semen analysis and estimation of seminal plasma alpha-1,4-glucosidase activity by double-beam spectrophotometer method and serum testosterone by radioimmunoassay method. There was a significant decrease in the mean seminal alpha-1,4-glucosidase activity levels in infertile men versus controls (mean +/- SD; 7.66 +/- 0.433, 2.088 +/- 0.565, 5.384 +/- 0.85 mU ml(-1) respectively). Mean serum testosterone levels demonstrated nonsignificant differences between studied groups. Seminal alpha-1,4-glucosidase activity levels demonstrated significant correlation with sperm count, sperm motility percentage and serum testosterone in oligoasthenozoospermia with varicocele group and demonstrated nonsignificant correlation in other groups. It is concluded that varicocele-induced hypoxia is the adverse effect that causes both oligoasthenozoospermia and decreased seminal alpha-1,4-glucosidase levels.     

Role of seminal osmolarity in the reduction of human sperm motility

Mammalian sperm at ejaculation are suspended in the seminal plasma, a heterogeneous mixture deriving from the testicular/epididymal fluid and from secretions of seminal vesicles, prostate and bulbourethral glands. Biochemical characteristics of seminal fluid change along the male reproductive tract when considering its inorganic and organic composition and pH but it is known that in each region of the male genital tract seminal osmolarity is higher than that of serum. It has been previously demonstrated that in invertebrate and vertebrate sperm, seminal plasma osmolarity influences sperm motility and activity, and human sperm have been shown to possess osmosensitive calcium entry pathway that controls important functions such as acrosome reaction and oocyte penetration. In the present study, we have determined seminal plasma osmolarity in a large number of normozoospermic fertile and asthenozoospermic infertile subjects correlating it with sperm motility percentages and kinematic characteristics determined utilizing a computerized motion analysis system. Our results confirm that seminal plasma osmolarity is higher than that of serum (336.1 +/- 20.2 vs. 291.1 +/- 6.9 mOsm/L, respectively). Normozoospermic subjects show seminal osmolarity values that are significantly lower with respect to asthenozoospermic patients (317.8 +/- 12.2 vs. 345.2 +/- 22.6 mOsm/L, p<0.001), irrespective of the cause of asthenozoospermia. Seminal plasma osmolarity negatively correlates with sperm progressive motility percentages and kinetic characteristics (curvilinear velocity, linear velocity, linear coefficient and lateral displacements of sperm head). Furthermore, when sperm from fertile subjects were suspended in medium with an osmolarity increasing from 300 to 600 mOsm, sperm motility percentages and kinetics characteristics were progressively reduced and nearly abolished when medium osmolarity was 600 mOsm. On the contrary, when sperm from asthenozoospermic subjects with high semen osmolarity were resuspended in medium with lower osmolarity, sperm motility parameters improved significantly. Sperm motility parameters did not correlate with seminal plasma concentrations of sodium, potassium, chloride with a weak correlation only with seminal calcium concentration. No correlations are present between seminal plasma osmolarity and ionic composition.In conclusion, the present study confirms and extends the knowledge that, in human, seminal plasma osmolarity is higher than that of serum and demonstrates that seminal osmolarity influences sperm motility characteristics and then it may contribute to the pathogenesis of some forms of asthenozoospermia and male infertility.     

Expression of IL-12, IL-10, PGE2, sIL-2R and sIL-6R in seminal plasma of fertile and infertile men

The involvement of cytokines and other immunoregulatory factors in male infertility is still unclear. In the present study we compared the levels of IL-12, IL-10, PGE2, sIL-2R and sIL-6R in the seminal plasma (SP) of fertile and infertile men. Four groups were included: fertile donors (FERT), infertile men with azoospermia (AZOO), and infertile men with either oligoterato-asthenoazoospermia (OTA), or OTA with genital infection (OTA-INF). Cytokines and cytokine-soluble receptors in semen were evaluated by specific ELISA commercial kits. The levels of IL-12, sIL-2R and sIL-6R were similar in SP of fertile and infertile men. The mean levels of IL-10 in the SP of FERT, OTA and AZOO were 5.6 +/- 0.9, 4 +/- 2.8 and 8 +/- 3.5 pg ml-1, respectively, and did not differ significantly. The mean level of IL-10 in SP from OTA-INF (0.9 +/- 0.5 pg ml-1) was significantly lower than that for FERT (5.6 +/- 1.9 pg ml-1; P = 0.02) and AZOO (8.2 +/- 3.4 pg ml-1; P = 0.05), but not significantly different from that for OTA (3.7 +/- 2.1 pg ml-1). The mean SP level of PGE2 was significantly lower in SP of OTA-INF than FERT (7.67 +/- 2.26 and 19.67 +/- 3.69 micrograms ml-1, respectively; P < 0.02). In conclusion, the seminal plasma from fertile and infertile men contained similar levels of IL-12, sIL-2R and sIL-6R. However, the levels of IL-10 were significantly lower in SP from OTA-INF compared to FERT and AZOO. Our results indicate that specific cytokines and their soluble receptors are involved in the male reproductive system.     

血清抑制素B在鉴别梗阻性与非梗阻性无精子症中的意义

目的通过测定血清抑制素B（INHB）并与卵泡刺激素（FSH）和精浆中性α-葡糖苷酶（α-Glu）等经典指标比较,评价INHB在鉴别诊断梗阻性（OA）和非梗阻性无精子症（NOA）中的应用价值,并对睾丸精子发生障碍作出预判。方法实验采集健康生育男性组（n=60）,以睾丸活检为金标准确定OA组（n=39）和NOA组（n=77）,留取血液和精液标本,进行精液常规分析,检测血清INHB、FSH和精浆中性α—Glu的水平;采用受试者工作特征（ROC）曲线法,通过计算ROC曲线下面积,确定切点值并分析评价检测指标的敏感性和特异性。结果本实验室健康育龄男性血清INHB的95％参考值范围为：20．37-206．21pg／ml。血清INHB、FSH、精浆中性α—Glu、血清INHB／FSH比值以及INHB＋FSH联合在OA组与NOA组之间均差别显著,具有统计学意义（P〈0．01）。其中血清INHB的曲线下面积最大,为0．985,诊断价值最高,敏感性为97．4％,特异性为92．2％,切点值为49．89pg／ml。结论血清INHB比血清FSH、精浆中性α—Glu、血清INHB／FSH比值或INHB＋FSH联合指标在鉴别OA与NOA方面具有更好的敏感性与特异性。     

不育男性精浆总抗氧化能力与精子运动功能的关系

目的:研究不育男性精浆总抗氧化能力(TAC)与精子运动能力和方式之间的关系,探讨精浆TAC水平在男性生育中的临床意义。方法:113例精子密度正常的不育男性,28例正常生育男性作为对照组。精液于37℃液化后采用计算机辅助精液分析(CASA)系统进行精液常规分析,采用比色法进行精浆TAC分析。结果:正常生育组精浆TAC为(19.82±6.33)U,不育男性精子密度正常组精浆TAC为(14.37±8.45)U,不育男性精子密度正常组与正常生育组比较存在显著性差异(P<0.01)。精浆TAC与a级精子百分率(r=0.208,P<0.05)和(a+b)级精子百分率(r=0.231,P<0.05)呈显著正相关,精浆TAC与精子运动参数中的前向性(r=0.200,P<0.05)、直线性(r=0.208,P<0.05)、曲线速度(r=0.189,P<0.05)、直线速度(r=0.210,P<0.05)、平均移动速度(r=0.215,P<0.05)及鞭打频率(r=-0.248,P<0.01)之间有显著的相关性,其中前向性、直线性、直线速度、曲线速度、平均移动速度与TAC呈正相关(P<0.05),而鞭打频率与TAC呈负相关(P<0.01)。精浆TAC与摆动性、侧摆幅度、平均移动角度之间无显著相关。结论:精浆中TAC水平与精子运动能力和运动方式密切相关,适宜的精浆TAC为精子运动提供了良好的外部环境,精浆中过低的TAC水平与精子运动能力下降和运动方式改变有关,可能是引起男性不育的病因之一。精浆中TAC分析可为探讨男性不育的发病机制以及临床用药提供依据。     

The value of epididymal protease inhibitor in differential diagnosis between obstructive azoospermia and non-obstructive azoospermia

There are no efficient and noninvasive clinical tests to distinguish between obstructive azoospermia (OA) and non-obstructive azoospermia (NOA). Epididymal protease inhibitor (Eppin) protein is secreted specifically by testes and epididymides in male reproductive system. It does not exist in seminal plasma of patients with OA in theory. The seminal plasma from 40 normal men and 46 azoospermic patients was detected via Western blot for investigating the presence and characteristics of Eppin protein to distinguish between OA and NOA. The cases were diagnosed as NOA whether Eppin in seminal plasma was positive via Western blot analysis. The cases were diagnosed as OA when samples were Eppin-negative. Additionally, percutaneous epididymal sperm aspiration (PESA) and percutaneous testicular sperm aspiration (PTSA) were performed on these patients at the same time as the diagnostic criteria to compare with Western blot analysis. Eppin detection in seminal plasma showed similar effectivity with PESA/PTSA in differential diagnosis between OA and NOA. Compared with PESA/PTSA, Eppin detection is a new, efficient and noninvasive method which has good clinical application.     

生育与不育男性血清和精浆褪黑素检测及其意义

目的 :检测生育与不育男性精浆褪黑素 (MLT)浓度并探讨在男性生育中的意义。　方法 :年龄为 2 6～ 36岁的生育男性 (18例 )和年龄为 2 3～ 36岁的不育男性 (99例 ) ,其中 ,后者又分为正常精子症组 (13例 )、少精子症组(2 7例 )、弱精子症组 (31例 )、少弱精子症组 (17例 )和少弱畸精子症组 (11例 )。分别采集静脉血和精液 ,采用酶联免疫吸附实验 (ELISA)检测血清和精浆中MLT浓度。　结果 :血清MLT浓度在生育与不育男性之间无显著性差异 ,各组精浆MLT浓度均低于相应的血清值。生育组精浆MLT浓度与各不育组相比无显著性差异 ,而少弱精子症组和少弱畸精子症组MLT浓度下降较为明显 ,但尚未达到统计学意义 (P >0 .0 5 )。　结论 :本研究结果表明 ,精浆MLT可能对精子功能具有一定作用 ,其具体作用机制尚需进一步深入的研究。     

Zinc levels in seminal plasma of fertile and infertile men

Zinc levels were measured in seminal plasma from 78 men classified on the basis of spermogram analyses into five groups: normo-, oligo-, astheno-, oligoastheno- and azoospermia. Higher zinc levels were found in seminal plasma from the group of asthenozoospermia men in comparison to normo-, oligoastheno- (p less than 0.001), oligo- and azoospermia men (p less than 0.01), while no significant differences appeared when other group pairs were compared. Seminal plasma zinc levels were positively correlated with sperm density (r = 0.6358, p less than 0.01) in asthenozoospermia men, whereas a significant negative correlation was seen in all groups between percentage forms showing normal progressive motility and zinc concentration in seminal plasma. Although zinc is required in seminal plasma for normal spermatozoon functionality, excessively high levels of this ion may be related with defective motility in asthenozoospermia samples.     

Seminal fibronectin in fertile and infertile males

This study aimed to assess seminal plasma fibronectin in fertile and infertile males. Ninety infertile males were investigated; asthenozoospermia (n = 27), asthenoteratozoospermia (n = 30), oligoasthenoteratozoospermia (n = 33) compared with 20 healthy fertile controls. They were subjected to semen analysis, seminal plasma fibronectin estimation by radial immune diffusion, serum testosterone (T) and follicle stimulating hormone (FSH) estimation by ELISA. There was significant increase of seminal plasma fibronectin among different infertile groups compared with the controls. Significant negative correlation was elicited between seminal fibronectin and sperm count, sperm motility grades A, B, A + B, sperm velocity, linear velocity, linearity index, sperm normal forms and serum T. Seminal fibronectin showed significant positive correlation with grade D sperm motility and serum FSH. ROC curve analysis discriminating controls and other infertile groups demonstrated criteria value of < 674 mg l(-1) (sensitivity 100% and specificity 96.4%). It is concluded that increased seminal fibronectin is associated with decreased sperm count and sperm motility.     

血清抑制素B对非阻塞性无精子症睾丸精子存在的预测价值

目的:探讨血清抑制素B(INHB)对非阻塞性无精子症(NOA)患者睾丸精子存在与否的预测价值。方法:分别对40例NOA、20例阻塞性无精子症(OA)及10例正常生育男性以双抗体夹心ELISA法测定其血清INHB水平。并用化学发光法检测了上述研究对象的卵泡刺激素(FSH)水平。结果:NOA患者的血清FSH[(21.34±12.15)IU/L]明显高于OA组和正常生育男性组[(3.94±1.52)IU/L和(4.27±2.84 IU/L],而血清INHB水平[(53.15±58.74)ng/L]明显低于后两者[(162.49±78.38)ng/L和(228.49±110.68)ng/L]。正常生育男性与OA组患者的血清INHB水平差异无显著性(P>0.05)。NOA患者血清INHB水平与其睾丸精子抽吸(TESE)的结果有相关性(r=0.528,P<0.01)。TESE获得精子者血清INHB水平[(90.31±72.18)ng/L]显著高于TESE无精子者[(19.54±20.38)ng/L,P<0.01];而两者的血清FSH差异无显著性(P>0.05)。结论:血清INHB可作为预测TESE的参考指标。血清INHB的测定有望替代睾丸活检确定睾丸精子的存在与否。     

血清和精浆抑制素B在无精子症诊断中的应用研究

目的:评价血清和精浆抑制素B浓度在诊断梗阻性和非梗阻性无精子症中的应用价值。方法:测定25例正常生育者(正常对照组),37例梗阻性无精子症以及33例非梗阻性无精子症者的血清卵泡刺激素(FSH)、血清和精浆抑制素B浓度,对无精子症者行睾丸病理Johnsen评分。结果:精浆和血清抑制素B浓度比值在正常对照组和非梗阻性无精子组分别为2.17和3.63,差异无显著性(P=0.29);在梗阻性无精子症组两者比值为0.18,与正常对照组和非梗阻性无精子症组比较显著降低(P<0.01)。结论:精浆和血清抑制素B浓度比值可用于临床诊断梗阻性和非梗阻性无精子症。     

无精子症患者瘦素水平及其临床应用价值初探

目的:检测无精子症患者的精浆及血清瘦素(leptin,Lep)水平,探索精浆、血清Lep单独以及联合血清卵泡刺激素(FSH)鉴别梗阻性无精子症(OA)和非梗阻性无精子症(NOA)的方法及意义。方法:选取OA患者45例、原因不明的NOA患者41例,精液参数正常对照30例。无精子症患者行附睾/睾丸细针穿刺精子抽吸术及睾丸活检,所有研究对象均检测血清FSH、精浆及血清Lep。用Fisher判别分析结合ROC曲线法,对单个或多个联合指标进行分析评价。结果:在体重指数无差别的情况下,与精液参数正常对照者相比,OA患者精浆Lep水平显著增高,有统计学意义(P=0.048);NOA患者血清FSH(P=0.000)、血清Lep(P=0.000)及精浆Lep(P=0.000)都显著增高。与OA患者相比,NOA患者血清FSH(P=0.000)、血清Lep(P=0.006)及精浆Lep(P=0.033)都显著增高。在区别OA及NOA方面,精浆Lep及血清Lep的ROC曲线下面积(AUCROC)分别为0.658、0.702,均显著大于0.5,P值分别为0.014、0.002;精浆Lep、血清Lep及FSH三者联合,AUCROC最大(0.953),且以0.026×精浆Lep+0.05×血清Lep+0.106×FSH-2.197为联合指标值,以-0.289为临界值(≥临界值,判定为NOA),其敏感度及特异度均达到最高,分别为0.878及0.902。结论:在鉴别OA和NOA方面,精浆及血清Lep水平有一定价值,联合精浆Lep、血清Lep及FSH,可能优于单个指标。     

生育与不育男性精浆总抗氧化能力分析

目的:分析生育与不育男性精浆中总抗氧化能力(TAC)及其在男性生育中意义。方法:225例男性不育患者分为6组,分别为:梗阻性无精子症组(n=10),非梗阻性无精子症组(n=42),少精子症组(n=20),弱精子症组(n=78),少弱精子症组(n=57),以及正常精子症组(n=18)。28例正常生育男性作为对照(生育组)。分别采用计算机辅助精液分析(CASA)系统进行精液参数分析,采用比色法检测精浆TAC水平。结果:生育组男性精浆TAC为(19.82±6.33)U,梗阻性无精子症组(1.71±1.33)U,非梗阻性无精子症组(12.73±9.44)U,少精子症组(10.85±6.64)U,弱精子症组(13.88±8.24)U,少弱精子症组(11.20±7.02)U,正常精子症组(18.07±8.73)U;与生育组精浆TAC[(19.82±6.33)U]相比,在各不育症组中,除正常精子症组精浆TAC与生育组差异无显著性外,其余各组均显著低于生育组(P<0.01)。精浆TAC与精子密度(r=0.182,P<0.05)和a级精子(r=0.150,P<0.05)呈显著正相关。结论:精浆中TAC水平与男性不育密切相关,精浆中过低的TAC水平可能是引起男性不育的病因之一。