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。     

男性不育患者精浆尿酸的检测及临床意义初探

目的 :检测男性不育患者精浆尿酸的含量 ,并探讨其与不育的关系。　方法 :2 0 0 3年 2～ 8月就诊的男性不育患者 1 6 3例 ,分为 4组 :梗阻性无精子症组 ,1 5例 ;非梗阻性无精子症组 ,36例 ;少精子症组 ,4 3例 ;弱精子症组 ,6 9例。 2 0例正常生育男性为正常对照组。上述各组均作精液参数分析及精浆尿酸含量的测定。　结果 :正常对照组精浆尿酸含量为 (396 .9± 5 3.1 ) μmol/L ,显著高于梗阻性无精子症组 [(79.5± 1 8.1 ) μmol/L]、非梗阻性无精子症组[(2 4 5 .8± 76 .5 ) μmol/L]、少精子症组 [(2 6 2 .2± 79.2 ) μmol/L]和弱精子症组 [(2 5 1 .4± 75 .4 ) μmol/L](P均 <0 .0 1 )。其中 ,梗阻性无精子症组精浆尿酸含量又显著低于其他各不育症组 (P均 <0 .0 1 ) ,其余各不育症组间精浆尿酸含量差异无显著性 (P >0 .0 5 )。　结论 :精浆中尿酸作为生殖系统中的一种重要抗氧化物 ,可能在男性生殖中具有一定意义。     

精浆和血清生殖激素与精液质量的关系

目的为了评估精液质量不同的男性精浆和血清生殖激素的浓度与精子浓度及活动力的关系,探索精浆与血清生殖激素的关系。方法对301名男性进行精液检查,按照精液的质量参数将受试对象分成4组:精液正常组(n=176),弱精子症组(n=66),少精子症组(n=40)和非梗阻性无精子症组(n=19)。采用电化学发光免疫法测定各组受试对象血清卵泡刺激素(FSH)、黄体生成素(LH)、泌乳素(PRL)、孕酮(P)、睾酮(T)和雌二醇(E2)六项生殖激素和精浆PRL、T、P和E2四项生殖激素的浓度,比较组间差异并进行相关性分析。结果精液正常组和弱精子症组血清FSH和E2的浓度显著低于少精子症组和非梗阻性无精子症组(P0.05),精液正常组血清LH和P的浓度显著低于弱精子症、少精子症和非梗阻性无精子症的人群(P0.05);而精液正常、弱精子症和少精子症三组精浆PRL的浓度则高于非梗阻性无精子症组(P0.05)。除了非梗阻性无精子症组,受试者血清FSH的浓度与其精子浓度呈负相关(r分别为-0.350、-0.273和-0.448,P0.05)。精液正常组精浆PRL的浓度和精子的浓度之间呈正相关(r=0.269,P0.05);在少精子症组中,亦有相同趋势的相关性(r=0.432,P0.05)。结论精浆PRL及血清FSH的浓度能够反映精子浓度或活动力,在男性不育的病因分析中具有一定的指导价值。     

双侧附睾肿块伴不育患者α-葡糖苷酶结果分析

目的:通过测定不育患者精浆α-葡糖苷酶含量与双侧附睾肿块大小和精子密度的关系,探讨α-葡糖苷酶在附睾梗阻性无精子症诊断中的价值。方法:根据精子密度将76例不育患者分为正常精子密度组(n=27),少精子症组(n=21),梗阻性无精子症组(n=28),分别测定不育患者和正常对照人群的性激素、精浆α-葡糖苷酶及WBC染色,各组分别行阴囊触诊和阴囊B超检查双侧附睾肿块的大小。结果:梗阻性无精子症组精浆α-葡糖苷酶含量(22.01±6.10)U/m l与各组比较差异有显著性(P<0.05),且精浆α-葡糖苷酶含量和双侧附睾肿块体积(r=-0.417,P<0.05)与白细胞(r=-0.342,P<0.05)呈负相关。结论:α-葡糖苷酶在判断附睾肿块导致的梗阻性无精子症中有一定的诊断价值。     

男性不育病人精液中磷脂酶A2的测定及其临床意义

目的 :探讨人精液中磷脂酶A2 (PLA2 )含量测定在男性不育症中的临床意义。　方法 :以自制的 2株PLA2单克隆抗体建立酶联免疫吸附试验 (ELISA)、免疫细胞化学法 (ICC)和流式细胞术 (FCM)等 3种方法 ,分别检测男性不育病人精浆及精子头部PLA2的含量 ,并与生育组进行比较。精液常规分析采用计算机辅助精液分析系统 (CASA)进行。　结果 :男性不育病人精浆中PLA2含量分别为 :无精子症组 (31.13± 14 .4 9)ng ml,少精子症组 (17.71±12 .4 5 )ng ml,精子数目正常组 (16 .4 6± 11.31)ng ml;与生育组 [(8.0 9± 3.15 )ng ml]相比差异均有极显著性 (P <0 .0 1) ;精浆中PLA2含量与精子密度呈显著负相关 (r=- 0 .6 0 2 ,P <0 .0 5 ) ,而与精子活动力及活率无显著相关性 (r=0 .2 6 6和r=- 0 .2 0 0 ,P均 >0 .0 5 ) ;ICC和FCM试验均提示 ,生育组精子头部PLA2含量显著高于各不育组病人 ,且FCM试验显示差异有极显著性 (P <0 .0 1)。　结论 :精浆中PLA2与男性生育密切相关 ,精子头部PLA2含量缺乏可能是引起男性不育的病因之一。精液中PLA2含量测定方法的建立可为探讨男性不育的发病机制提供有力的依据。     

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     

少弱精子症和正常生育男性精液中尿激酶及其受体含量的研究

目的:通过研究精子正常和异常男性精浆和精子中尿激酶及受体含量差异,以了解尿激酶及受体与男性生育力的关系。方法:采用双抗体夹心ELISA法测定22例正常生育男性和44例少弱精子症男性精浆和精子中尿激酶及受体的含量。结果:①正常男性精浆尿激酶平均含量为(4 803.69±602.78)mU/L,与少弱精子症组[(4 061.35±736.23)mU/L]相比,差异有显著性(P<0.01)。正常生育男性精子尿激酶平均含量为(30.29±3.16)mU/106个精子,与少弱精子症组[(20.51±4.2)mU/106个精子],差异有显著性(P<0.01)。②正常生育男性精子尿激酶受体平均含量为(12.97±3.11)mU/106个精子相比,与少弱精子症组[(6.09±1.45)mU/106个精子]相比,差异有显著性(P<0.01)。③精子和精浆中尿激酶含量和精子活率和活力呈显著正相关。结论:尿激酶和男性生育力相关,少弱精子症和正常生育男性精液中尿激酶及其受体含量存在差异。     

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。     

少精子症患者血清、精浆中游离睾酮水平的测定及意义

目的 :通过测定少精子症患者血清、精浆中游离睾酮 (FT)水平 ,分析血清、精浆FT与少精子症的关系。　方法 :正常对照组 (n =4 4 )、少精子症组 (n =4 4 )男性于上午 8:0 0～ 10 :0 0留取血标本 ;正常对照组 (n =30 )、少精子症组 (n =37)同时留取精液。男性精液常规分析判断精子密度 ,放射免疫分析法测定血清、精浆中FT水平。　结果 :少精子症患者血清中FT浓度为 [(94 .88± 4 2 .0 4 )pmol/L],与正常对照组 [(97.5 0± 4 6 .96 )pmol/L]相比差异无显著性 (P >0 .0 5 ) ,但少精子症患者精浆中FT浓度 [(0 .5 2± 0 .4 4 ) pmol/L]显著低于正常对照组 [(2 .0 1±0 .32 )pmol/L],P <0 .0 1。　结论 :精浆中FT的测定较早反映睾丸的功能 ,有利于少精子症患者的早期诊断和治疗。     

男性不育患者精浆exosome中miR-184水平变化及临床意义

目的:探讨男性不育患者精浆外泌体(exosome)中miR-184的水平变化及临床意义。方法:收集2015～2019年在江苏省中医院、东部战区总医院及温州医科大学附属第一医院就诊的97例无精子症患者、96例弱精子症患者及同期募集的92例正常生育男性精浆标本,分离精浆exosome后运用透射电镜、Nanosight和Western印迹对exosome进行鉴定;运用实时荧光定量PCR(qRT-PCR)检测exosome miR-184的水平,统计分析miR-184变化、临床价值及与精液参数的相关性,进一步用生物信息学方法预测和分析miR-184靶基因、相关信号通路及与男性不育关系。结果:透射电镜、Nanosight和Western印迹结果显示,精浆中含有大量exosome。qRT-PCR结果显示,无精子症患者精浆exosome miR-184水平显著低于正常对照[0.227 (0.092, 0.790)vs 0.650 (0.408, 1.061)](P0.01),弱精子症患者精浆exosome中miR-184水平显著高于正常对照[1.176 (0.661, 1.946)vs 0.650 (0.408, 1.061)](P0.01)。受试者工作特征曲线(ROC)分析结果显示,精浆exosome miR-184无精子症、弱精子症患者的曲线下面积(AUC)为0.866(95%CI 0.815～0.916)和0.724(95%CI 0.653～0.795);区分弱精子症和无精子症患者的AUC为0.964(95%CI 0.943～0.985)。相关性分析显示,弱精子症患者精浆exosome miR-184水平与精子浓度呈显著正相关(r=0.243,P=0.017),与前向运动精子百分率呈显著负相关(r=-0.407,P=0.006)。生物信息学分析发现miR-184的靶基因显著富集于男性生殖和精子发生密切相关的蛋白调控通路。结论:男性不育患者精浆exosome miR-184水平与正常生育男性具有统计学差异,具备作为男性不育辅助诊断标志物潜能并可能参与男性不育的发生发展。     

Analysis of lipid peroxidative levels in seminal plasma of infertile men by high-performance liquid chromatography

For the purpose to evaluate the significance of lipid peroxidative products on male infertility, the levels of malondialdehyde (MDA), which is one of the final products of lipid peroxidation in seminal plasma, were determined. Ninety-three male infertile patients were divided into obstructive azoospermic group (12 cases), non-obstructive azoospermic group (15 cases), oligozoospermic group (21 cases), asthenozoospermic group (19 cases), oligoasthenozoospermic group (16 cases) and oligoasthenoteratozoospermic group (10 cases). Eighteen fertile males were included in the control group. MDA concentrations of seminal plasma in the fertile and infertile men were detected by high-performance liquid chromatography (HPLC). The results showed that the concentration of MDA in seminal plasma differed significantly between the control group and all the infertile groups (P < 0.01) except the obstructive azoospermic group, between the oligoasthenozoospermic group and the oligozoospermic and asthenozoospermic groups (P < 0.01), and between the oligoasthenoteratozoospermic group and the oligozoospermic and asthenozoospermic groups (P < 0.01). MDA concentration of seminal plasma in the oligoasthenoteratozoospermic group differed significantly from that in the oligoasthenozoospermic group (P <0.05). The results suggested that detection of MDA concentrations in seminal plasma by HPLC has an indicative value on the diagnosis of male infertility induced by overproduction of reactive oxygen species in male reproductive system.     

Seminal transferrin levels in seminal plasma of fertile and infertile men.

Seminal plasma transferrin levels as well as serum FSH and LH levels were measured in fertile (normozoospermic) and infertile (oligozoospermic and azoospermic) men in an effort to find out whether transferrin levels correlated with sperm density and serum FSH and LH levels. Seminal plasma transferrin levels were found to be significantly lower (p < 0.0005) in the infertile group than the fertile group. Seminal plasma transferrin levels can be regarded as a functional parameter of Sertoli cell function in men.     

Significance of malondialdehyde concentration in seminal plasma of infertile men

Objective: To determine the concentration of malondialdehyde (MDA), product of lipid peroxidation, in seminal plasma and evalu ate its significance. Methods: Ninety-three cases of infertile pa tients were divided into the obstructive azoospermic (12 cases), the non-obstructive azoospermic (15 cases), the oligozoospermic (21 cases), the asthenozoospermic (19 cases), the oligoastheno zoospermic (16 cases) and the oligoasthenoteratozoospermic (10) groups. Eighteen fertile males served as the controls. MDA con centration was assessed by high-performance liquid chromatogra phy (HPLC). Results: With the exception of the obstructive azoospermic group, the MDA concentration in the seminal plasma was significantly different between the control group and the infer tile groups (P<0.01) as well as between the different infertile groups. Conclusion: Determination of MDA concentration in the seminal plasma is helpful to the diagnosis of male infertility induced by overproduction of reactive oxygen species.     

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.     

Bradykininase and protease inhibitors in seminal plasma of fertile and infertile men.

The level of protease acrosin in the seminal plasma of oligozoospermic men was significantly higher than that of normozoospermic men. The amount of bradykininase in the seminal plasma was very high in both normozoospermic and oligozoospermic patients. When the acrosin and kininase content was referred to one million spermatozoa, seminal plasma kininase was significantly enhanced in oligozoospermic men, while the acrosin activity was similar in normozoospermic fertile men and infertile men. Human seminal plasma inhibitor I (HUSI I) increased along with sperm count. Human seminal plasma inhibitor II (HUSI II) showed no change. The motility of spermatozoa was depressed in oligozoospermic patients.     

Transferrin in Seminal Plasma of Fertile and Infertile Men

The levels of transferrin in seminal plasma of a large sample of infertile men (n = 287) were measured by radioimmunoassay. A group of recently pregnancy-proven fertile men (n = 20) was used as control and a small group (n = 6) of vasectomized men was studied to determine the origin of seminal transferrin. Infertile men had lower transferrin values than fertile men, although the difference was not significant in the case of normozoospermic infertile men (0,05 less than p less than 0,1); in the case of oligozoospermic infertile men the difference was highly significant (p less than 0,001). The values of transferrin in severely oligozoospermic, azoospermic and vasectomized subjects suggested that 60% of seminal transferrin could be of testicular origin. In infertile patients transferrin fall along with sperm count; there is a strong correlation between transferrin and sperm density. FSH levels were measured in a group of severely oligozoospermic and azoospermic patients (n = 41); although the patients with elevated FSH had lower transferrin levels than the patients with FSH within the normal range, the difference was not significant. The results of this study show that transferrin could be a useful marker of seminiferous tubular function but more work is needed to assess its relevance for clinical practice.     

Follicle-stimulating hormone receptor polymorphism and seminal anti-Müllerian hormone in fertile and infertile men

Follicle-stimulating hormone (FSH) is fundamental for Sertoli cell function stimulating spermatogenesis and follicular growth by a specific receptor (FSHR). This work aimed to investigate the occurrence of Asn and Ser FSHR gene variants and its relationship with seminal anti-Müllerian hormone (AMH) among normozoospermic and infertile oligoasthenozoospermic (OAT) males. Eighty-two Caucasian males grouped into normozoospermic healthy controls (n = 30) and infertile OAT males (n = 52). FSHR gene variants were determined by DNA from anti-coagulated blood and underwent polymerase chain reaction (PCR) amplification and electrophoresis in detecting amplification products. AMH in seminal plasma was determined by ELISA. The results showed that the frequency of FSHR gene variants among fertile men was 46.7% Asn/Asn (N680S), 33.3% Asn/Ser, and 20% Ser/Ser, whereas among OAT men were 34.6%, 38.5% and 26.9% respectively with nonsignificant differences. Seminal AMH was significantly higher in fertile than infertile OAT men. There was significant increase in seminal AMH with Asn/Asn variant of FSHR gene than those with Asn/Ser or Ser/Ser. It is concluded that FSH gene variants showed no difference in distribution between fertile or infertile OAT men. However, when correlated with seminal AMH values, there was an increase in Asn/Asn in men with high seminal AMH.     

Lack of correlation of selenium level in human semen with sperm count/motility

Considering the importance of selenium (Se) in male fertility, its concentration was measured in 211 semen samples from 211 normozoospermic, oligozoospermic, asthenozoospermic, and azoospermic men using the hydride generation atomic absorption spectrophotometry. No significant correlation of any kind existed between Se level in the seminal plasma and sperm count or motility. In view of the known poor correlation of these two frequently used semen parameters with the incidence of pregnancy, the assessment of the fertilizing potential of normozoospermic ejaculates with low Se levels is warranted.