不育男性抗苗勒管激素与生殖激素及精液质量参数关系的研究

目的探讨男性不育患者精浆和血清抗苗勒管激素(AMH)与血清生殖激素及精液参数之间关系。方法选取2018年9～12月于我院生殖中心就诊的男性不育患者107例,按照《世界卫生组织人类精液检查与处理实验室手册(第五版)》操作规范检测精液体积、精子浓度、前向运动精子(PR)百分比、精子顶体酶、精子DNA完整性、正常形态精子率,根据精液参数分为4组:少精子症组(n=15)、弱精子症组(n=26)、少弱精子组(n=31)、正常精子组(n=35),比较各组患者精浆和血清AMH及血清FSH、LH、催乳素(PRL)、T、E2之间的差异,并对精浆和血清AMH与生殖激素及精液参数的相关性进行统计分析。结果弱精子症组血清AMH水平高于其他3组,但各组间差异无统计学意义(P>0.05);正常精子组精浆AMH水平[中位数(四分位距)]为1.28(7.71)ng/ml,显著高于少精子症组[0.11(1.26)ng/ml]和少弱精子组[0.16(2.15)ng/ml](P<0.05)。相关性分析显示,血清AMH与生殖激素及精液参数不存在相关(P>0.05);精浆AMH与血清FSH、LH呈负相关(P&...     

吸烟对男性精液质量的影响

目的 探讨吸烟对男性精液质量的影响.方法 应用伟力彩色精子质量分析系统对180例不育男性(96例不育吸烟组和84例不育非吸烟者)和112例正常生育男性精液从精液量、液化时间、精子总数、精子密度、精子活力、精子活率等参数方面进行分析.结果 (1)不育吸烟组、不育非吸烟组与正常对照组比较,精子活力、精子活率等参数显著降低(P＜0.05或P＜0.01),液化时间延长(P＜0.05),而精液量、精子密度和精子总数之间无显著性差异(P＞0.05);(2)不育吸烟组与不育非吸烟组相比,精子活力、精子活率显著降低(P＜0.05或P＜O.01);(3)小烟量组和短烟龄组与不育非吸烟组相比,精液各参数之间差异无显著性(P＞O.05).大烟量组和长烟龄组与不育非吸烟组相比,精子总数、精子密度、精子活力和精子活率都显著降低(P＜O.05或P＜0.01),液化时间显著延长(P＜0.01);(4)小烟量组和短烟龄组分别与大烟量组和长烟龄组相比,精子密度、液化时间、精子活力和精子活率等均有显著性差异(P＜0.0 1).结论 (1)吸烟对男性精液质量的不良影响存在量效和时效关系.(2)大量吸烟(日吸烟量＞20支)和长期吸烟者(烟龄＞10年)可能是引起男性不育的重要原因之一.     

微波辐射对雷达作业人员精液参数和生殖激素的影响

目的 评价微波辐射对雷达作业人员精液参数及生殖激素的影响.方法 随机抽取56名雷达作业人员为雷达组,46名同单位、同期的非雷达作业人员为对照组,常规留取研究对象的精液和血液标本,使用WLJY-9000伟力彩色精子质量全自动分析系统检测两组人员的精子密度、精子活动率和精子活力等精液参数,应用放射免疫技术检测两组人员的血液生殖激素水平.结果 雷达组人员精子密度为(38.44±23.20)×106/ml,精子活动率为(34.60±21.85)％,精子活力分别为A级精子(14.53±12.12)％、B级精子(10.45±7.36)％、C级精子(9.61±7.72)％、D级精子(65.23±22.18)％,血清睾酮为(5.04±1.25)nmol/L;对照组人员精子密度为(59.21±26.87)×106/ml,精子活动率为(87.52±10.59)％,精子活力分别为A级精子(62.38±17.26)％、B级精子(18.05±9.79)％、C级精子(5.94±3.17)％、D级精子(13.63±9.96)％,血清睾酮为(6.26±1.67)nmol/L.与对照组比较,雷达组精子密度、精子活动率、a级精子、b级精子以及血清睾酮水平均明显下降,而c、d级精子水平明显上升,差异均具统计学意义(P＜0.05).结论 微波辐射对精液参数和血清睾酮可以产生不良影响,提示加强雷达作业人员的个人防护,制定预防保护措施,对提高男性生殖健康保健十分必要.     

吸烟对男性精液质量的影响及相关性研究

目的 :探讨吸烟对男性精液质量的影响及相关性。　方法 :30 1例不育男性 (110例非吸烟者和 191例吸烟者 ) ,对照组为 6 1例已生育 1个或 1个以上子女的健康男性 (无吸烟史 )。根据吸烟量和烟龄分为不同吸烟量组和不同烟龄组。检测了精液各参数 (精液量、精液pH、精子计数、精子存活率及前向运动级别等 )和精浆Zn、Cu、超氧化物歧化酶 (SOD)含量。　结果 :中、大量或长时间吸烟组精液量 ,精子计数 ,精子存活率及前向运动级别 ,精浆Zn、Cu和SOD含量较非吸烟组显著降低 ,精液pH显著升高 (P均 <0 .0 1)。精子计数 ,精子存活率及前向运动级别 ,精浆Zn、Cu、SOD含量与吸烟量和烟龄之间呈高度负相关 (P <0 .0 1)。　结论 :吸烟对精液各参数的影响存在着量 效和时 效关系 ,中、大量吸烟或烟龄长者可能对男性生育有不良影响     

男性精液中阴道加德纳菌感染对精液质量参数影响的初步探讨

目的 探讨男性精液中阴道加德纳菌(Gardnerella vaginalis,Gv)感染对男性精液质量的影响,探索男性不育症的病因.方法 收集217例男性精液标本,应用巢式聚合酶链反应(nPCR)技术进行Gv检测,同时行精液常规分析检测、抗精子抗体(混合抗球蛋白反应,MAR法)检测.结果 217例标本中,17例检测到Gv阳性(7.8％),Gv阳性组和阴性组在精液量、精液粘度方面无明显差别(P＞0.05),而两组在精子密度、精子活率、PR、精子畸形率、精液pH值、精液白细胞症检出率、MAR等精液质量参数方面存在明显差别,差异有统计学意义(P＜0.01).结论 男性精液中Gv感染可能是影响精液质量,可能是导致男性不育的原因之一.     

海南不同民族不育男性精液质量分析

目的 分析海南地区少数民族和汉族不育男性精液质量状况,为海南地区不育男性患者在诊断与治疗方面提供科学依据。方法 回顾性分析2020年1月至2021年12月男性不育患者1 682例的临床资料。按民族分为少数民族组(367例)和汉族组(1 315例)。比较两组间患者年龄、精液质量指标(精液量、精液液化时间异常率、精子浓度、精子活动率、前向运动精子百分率、精子正常形态百分率)、精子异常类型发生率。结果 两组中患者年龄、精液量、少精子症、弱精子症、无精子症的发生率比较,均无统计学意义(P>0.05);但少数民族组精液液化时间异常率(10.40%)、畸形精子症的发生率(29.70%)均高于汉族组(6.60%、27.00%),差异均具有统计学意义(P<0.05);少数民族组精子浓度66×10⁶/mL、精子活动率(49.38±15.85)%、前向运动精子百分率(44.54±15.67)%、精子正常形态百分率(3.86±2.02)%均显著低于汉族组的73×10⁶/mL、(55.16±12.67)%、(48.85±12.73)%和(4.90±2.5...     

海岛不育男性精液质量及其影响因素的研究

目的探讨海岛不育男性精液质量及其影响因素。方法采用统一调查表,对舟山市生殖研究中心门诊的228例不育症男性患者进行流行病学问卷调查及精液常规分析(SFA);并对数据进行统计学处理。结果研究对象的平均精子密度、a级、b级精子和正常形态精子的百分率分别为23.34×106/ml、35.16%、9.38%和59.27%。对精液质量异常的可能危险因素进行多因素logistic回归分析显示,吸烟:OR=1.169,95%CI=(1.044~1.310);饮酒:OR=1.186,95%CI=(1.055~1.333);不育时间:OR=0.822,95%CI=(0.719~0.940);以蔬菜水果为主要摄入副食类:OR=0.284,95%CI=(0.090~0.894);以混合副食为主要摄入类:OR=0.365,95%CI=(0.175~0.762)。结论研究对象的精子数量、活力和形态基本达到WHO建议的参考值范围,但精子前向运动的能力偏低。吸烟与饮酒行为可能是精液质量的危险因素;副食品摄入类型与精液质量有关,其中,与海产品为主要摄入类型相比,以蔬菜水果类和混合副食品为主要摄入类型的饮食习惯可能对精液质量具有保护作用。     

Effect of renal transplantation on sperm quality and sex hormone levels

OBJECTIVE: To assess the effect of successful renal transplantation on semen variables, sexual function and sex hormone profiles in a clinical trial. PATIENTS AND METHODS: Thirty patients on haemodialysis underwent renal transplantation; before and after surgery, their sperm density, motility and morphology were analysed, follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin and testosterone levels measured and compared, and sexual function assessed using an abbreviated version of the International Index of Erectile Function (IIEF), with a successful outcome defined as a level of satisfaction of 4 or 5 on a 5-point scale. The paired t-test was used to assess the statistically significance of differences in all analyses. RESULTS: Sperm motility improved significantly (P < 0.001) but there were no significant changes in morphology or density (P = 0.33 and 0.068, respectively). Testosterone levels increased and FSH, LH and prolactin decreased significantly (P < 0.05) after renal transplantation. The IIEF showed that of the 30 patients, 14 were impotent before surgery and only six remained so afterward (P < 0.05). CONCLUSION: Although sperm morphology and density did not improve after renal transplantation, there were highly significant changes in sperm motility. Hormonal levels in patients on haemodialysis improved after transplantation and returned to nearly normal; sexual function was also significantly better. Further studies are needed to confirm these results.     

氰戊菊酯对大鼠精子及生殖激素的影响

目的探讨氰戊菊酯(Fen)对雄性大鼠精子计数、活力以及生殖激素的影响。方法成年雄性SD大鼠,分别以0、20、40、80mg/kg剂量的Fen连续灌胃染毒15和30d,按常规方法进行精子计数和精子活力检测,应用放射免疫法和化学发光免疫法测定大鼠血清卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)、雌二醇(E2)和睾丸匀浆中T、E2水平。结果Fen染毒15d时,与0mg/kg组相比,40mg/kg剂量组精子数量明显减少(P<0.01),20和40mg/kg组睾丸匀浆中T水平显著降低(P<0.01,P<0.05),血清LH、FSH水平随染毒剂量的增加而升高,且FSH水平和染毒剂量有显著的剂量-效应关系(P<0.05);Fen染毒至30d时,各组间精子数量差异不显著,与0mg/kg组相比,40mg/kg剂量组(a+b)级精子活力显著降低(P<0.05),血清LH、FSH水平随染毒剂量的增加而升高,但差异不显著。结论Fen对雄性大鼠有明显的生殖毒性作用,能够改变血清和睾丸中的生殖激素水平。     

Effect of follicle-stimulating hormone on sperm quality and pregnancy rate

Aim: To evaluate the possible links between ultrastructural sperm quality and the clinical pregnancy rate in infertile males treated with FSH before intracytoplasmic sperm injection (ICSI). Methods: Forty-four infertile males with idiopathic oligo-asthenozoospermia were randomly allocated to the treated (n=24) and non-treated (control,n=20) groups. Semen analysis was carried out by light and transmission electron microscopy (TEM) before and 12 weeks after FSH therapy. ICSI was performed in all couples. Results: TEM revealed a significant improvement in sperm quality after FSH treatment, particularly in men with their partners achieving clinical pregnancy. The pregnancy rate was 33% in the treated group and 20% in the control. Conclusion: Results highlight a positive role of FSH therapy in infertile males before ICSI, which was correlated with an increased pregnancy rate in treated couples.We believe that improved sperm ultrastructure after FSH therapy could positively influence the quality and early stage of embryo development, thereby increasing the probability of embryo implantation.     

Effects of different calcineurin inhibitors on sex hormone levels in transplanted male patients

Hormonal abnormalities in male patients with end-stage renal diseases are primarily organic and related to uremia as well as the other comorbid factors that frequently contribute to chronic renal failure and concomitant drug administration. The restoration of hormonal profiles after successful renal transplantation is still controversial. Immunosuppressive drugs may influence hormonal profiles. Our cross-sectional study of 37 male kidney transplant recipients investigated two groups according to their calcineurin inhibitor therapy, namely 21 cyclosporine versus 16 tacrolimus patients. The two groups were matched for age, graft function, mean duration of dialysis before transplantation, and duration of follow-up after transplantation. There was no statistical significant difference in baseline circulating levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (TTE), and prolactin (PRL) between the two groups. We found that calcineurin inhibitors have favorable effects on sexual hormone levels of male renal transplant patients and that there is no difference in baseline hormone levels between cyclosporine- and tacrolimus-treated male patients.     

Effects of altered epididymal sperm transit time on sperm quality

The epididymal sperm transit time seems to have an important role in the process of sperm maturation, and it seems that alterations to the transit can harm the process. The aim of the present work was to evaluate the influence of altered sperm transit time through the epididymis on sperm parameters and fertility of rats, as well as the role of testosterone in the alterations. Sprague–Dawley adult male rats were randomly assigned to four different groups and were treated for 12 days: (i) 10 μg/rat/day DES, to accelerate the transit; (ii) 6.25 mg/kg/day guanethidine sulphate, to delay the transit; (iii) same treatment as group 1, plus androgen supplementation; (iv) control animals received the vehicles. Guanethidine treatment delayed the sperm transit time through the epididymal cauda, provoking increased sperm reserves in this region. Animals exposed to DES showed an acceleration of sperm transit time in the epididymis, and consequently decreased sperm density in both epididymal regions, the caput-corpus and cauda, and diminished sperm motility. In both cases sperm production was not altered. Testosterone supplementation was able to restore the transit time to values close to normality, as they were higher than in the control rats. The same occurred in relation to sperm motility. Rats exposed to DES presented lower fertility after in utero artificial insemination using sperm collected from the proximal cauda epididymis. Therefore, it was concluded that the acceleration of rat sperm transit time appeared to harm normal sperm maturation, thus decreasing sperm quality and fertility capacity, in an androgen-dependent way.     

精液质量对ICSI卵子受精与胚胎发育的影响

目的 探讨不同精液质量的ICSI(卵泡浆内单精子显微注射)周期中卵子受精与胚胎发育潜能间的差异.方法 采用回顾性资料分析的方法,比较了中心71例ICSI治疗周期.女方正常者根据精液质量分为严重少弱畸精子组(A组,n=31)与非严重少弱畸精子组(B组,n=24),非严重少弱畸精子组合并女方异常为C组(n=16).从形态学方面评估三组中受精率、(two pronuclear,2PN)率、异常受精率、未受精率、卵裂率、可用胚胎率、优质胚胎率、不可用胚胎率等实验室指标间的差异.结果 三组在卵子受精率、2PN率、异常受精率、未受精率、卵裂率、可用胚率、优质胚胎率和不可用胚胎率等方面比较,差异均无统计学意义(P＞0.05).但B组的受精率(72.29±23.1 2)低于C组(85.49±1 8.59),两组差异有统计学意义(P＜0.05);未受精率B组(22.81±22.83)高于C组(14.51±18.59),两组差异有统计学意义(P＜0.05).结论 从形态学上看,ICSI前的精液质量对卵子受精及胚胎发育没有明显影响.     

手术体位对腹腔镜脾切除术操作的影响

目的探讨不同的手术体位在腹腔镜脾切除术时对操作的影响.方法利用腹腔镜对43例病人进行脾切除术,并对术中出现的情况、手术体位与脾脏的大小、解剖关系及手术难易程度等进行总结性分析.结果43例病人无术中及术后并发症出现.不论何种体位,体外B超脾脏长径＞15cm者手术难度明显增加,手术时间延长.结论大多数腹腔镜脾切除术可以采用右斜卧位完成,对于长径＞15cm的脾脏,采用右侧卧位可能更为有利.腹腔镜脾切除术是脾脏手术的最佳方法之一.     

性激素对良性前列腺增生组织二氢睾酮结合容量的影响

目的 探讨睾酮(T)、雌二醇(E2)、孕酮(Po)对良性前列腺增生(BPH)组织二氢睾酮(DHT)结合容量的影响作用以及与BPH发生发展的关系.方法 27例BPH组织取自耻骨上经膀胱前列腺摘除术,制备组织提取液,乙醚萃取去除提取液中内源性类固醇激素,加入3H-DHT测定DHT结合蛋白的结合容量,并以3H-DHT等量和10倍量的T、E2、Po竞争结合蛋白从而影响组织DHT结合容最,观察结合容量的变化,分析结合容量变化与BPH的关系.结果 BPH组织胞质单纯DHT结合容量为(0.0160±0.0031)nmol/g湿组织,等量T、E2、Po作用的DHT结合容量分别为(0.0107±0.0011)、(0.0093±0.0017)和(0.0145±0.0033)nmol/g湿组织,T、E2组结合容量低于单纯DHT组,差异均有统计学意义(P＜0.01).Po组DHT结合容量与单纯DHT组比较,差异无统计学意义(P＞0.05).10倍量T、E2、Po作用的DHT结合容量分别为(0.0102±0.0014)、(0.0096±0.0006)和(0.0121±0.001 6)nmol/g湿组织,低于单纯DHT组,差异均有统计学意义(P＜0.01).结论 BPH组织胞质有很高的DHT结合容量,T、E2、Po可以影响结合容量,继而作用于BPH的发生和发展过程.     

Effects of pure human follicle-stimulating hormone (pFSH) on sperm quality correlate with the hypophyseal response to gonadotrophin-releasing hormone (GnRH)*

Summary. In 41 men with idiopathic infertility, the effect of pure follicle-stimulating hormone (pFSH) therapy on semen parameters was evaluated in relation to the results of the gonadotrophin-releasing hormone (GnRH) stimulation test in an open study. The patients showed a mean (± standard error) sperm concentration of 15.84 (±2.87) Mill, ml^?1, 41.02 (±4.19)% of the spermatozoa were motile and 46.16 (±2.36)% normo-morph before treatment. All patients were administered 150 IU pFSH subcutaneously three times weekly for 10 weeks. After therapy with pFSH, no significant differences compared with the pre-treatment sperm characteristics were observed (P>0.05) except for the velocity average path, VAP (P= 0.029). However, the stimulation factors of FSH in the GnRH test showed a significantly negative correlation with the pFSH mediated improvement of sperm concentration (r= ?0.662, P= 0.000002), of percentage of normo-morph spermatozoa (r= ?0.480, P=0.0015) and total count of motile spermatozoa per ejaculate (r=?0.567, P=0.00014). In consequence, the patients were divided into two groups depending on the stimulation factor of hypophyseal FSH secretion, FSH-SF. The cut-off point of the FSH-SF was set at 1.7 because the correlation analyses detected a 1.5–fold improvement of sperm parameters at this hypophyseal response on average. Pure FSH treatment increased the concentration of spermatozoa (P= 0.0007), the total count of motile spermatozoa in the ejaculate (P=0.015) as well as the computer-aided sperm motion parameters VAP (P=0.029) and velocity curve linear, VCL (P=0.049) in patients with FSH-SF<1.7, whereas in the patient group with FSH-SF>1.7 no improvement of semen parameters was found. Insufficient stimulation of hypophyseal FSH secretion may be a prerequisite but not a guarantee for responsiveness to pFSH treatment. The results of the present investigation suggest that FSH stimulation in the GnRH test should be taken into account in idiopathic infertile men before pFSH therapy.     

卵胞浆内单精子注射中小鼠卵细胞第一极体位置和形态对受精率和受精卵质量的影响

目的　探讨卵胞浆内单精子注射 (ICSI)中成熟卵细胞第一极体位置、形态对受精和胚胎质量的影响。　方法　6～ 10周龄雌性小鼠经促超排卵 ,收集成熟卵细胞 ,按第一极体形态不同分三级 ,将同一级别极体随机分 7组 (1、2、3、6、10、11、12点位 )分别行ICSI,观察其受精及卵裂情况。　结果　Ⅰ级极体在 11点位受精率最高 (P =0 .0 0 2 4 ) ,3点位最低 (P =0 .0 0 01) ;I级极体在 11点位产生的高评分原核最多 (P =0 .0 0 0 1) ,3点位最少 (P =0 .0 0 0 1)。Ⅰ级极体的受精率最高、高评分原核最多 ,II级和III级之间无明显差异。　结论　ICSI时卵细胞第一极体位置及形态对正常受精和胚胎质量会产生影响 ,尽可能将第一极体远离固定针、注射针及精子 ,卵细胞的第一极体呈圆形、光滑且完整 ,才能产生高受精率和高质量原核