近13年国内正常男子精子质量变化趋势的文献分析

目的 :研究近 13年来中国人精子质量变化趋势。方法 :用散点图和直线回归法 ,描述和分析 1985年～ 1997年间国内公开发表的 36篇文献中 ,有生育力的男性 2 318人的平均精子密度和平均精液量的变化趋势。结果 :平均精子密度和平均精液量均未发现有明显的下降趋势 ,回归方程分别为 y=1991.618- 0 .0 0 2 4 54x( P>0 .0 5)和 y=1992 .519- 0 .4 64x( P>0 .0 5)。结论 :近 13年来我国正常男子的精子质量没有明显下降。     

广州地区健康男性精液质量调查

目的：评估广州及其周边地区健康男性的精液质量情况。方法选择广东地区1040例正常男性志愿者进行精液质量检查及流行病问卷调查。结果1040例健康男性的精液量、精子总数、精子浓度、前向运动率和精子正常形态率的第5百分位数值分别为1.5 ml、51.58×106/一次射精、20.30×106/ml、20.29%和4%,其中所有参数均达到世界卫生组织的精液分析正常值标准有740例（71.15%）,≥40岁组精子前向运动率和精子正常形态率与＜30岁组及30~39岁组比较差异有统计学意义（P＜0.05）。结论广州地区健康男性精液参数中精液体积、精子总数、精液浓度以及精子正常形态率的第5百分位数值均达到世界卫生组织的标准,精子的前向运动率则低于世界卫生组织的标准,评估男性精液质量时要考虑年龄对精液参数的影响。     

Cigarette Smoking is Associated with Decreased Sperm Density

Objectives To study the association between cigarette smoking and sperm density in men of reproductive age. Methods We enrolled 224 male employees of a modern petrochemical plant in Nanjing, China. These men had no prior history of infertility or other reproductive diseases. Epidemiologic data, including information on smoking and other occupational and lifestyle exposures were obtained by a questionnaire interview. Semen specimens were collected from each participant and analyzed according to the WHO guidelines. Regression analyses were performed to estimate the effect of smoking on sperm density. Results Approximately 67% of the subjects had ever smoked cigarettes. Different measurements of smoking behavior were each associated with decreased sperm density. There was a significant dose-response trend between the tertites of total smoking amount in pack-years and sperm density. As compared to men who never smoked, current smokers had a significant reduction in sperm density (-13.3×106/ml; 95% CI, - 24     

成都地区1536例男性不育症患者计算机辅助精液质量分析

目的：研究成都地区男性不育症患者精液质量状况。方法：采用计算机辅助精液分析技术,检测1536例以不育为主诉的男性精液标本的质量。结果：1536份精液标本中精液常规质量参数正常的占30．21％,精子活动率异常占33．27％,精子活力异常占65．89％,患者年龄与精液量、精子浓度、精子活动率和精子活力无显著相关性,精子活动率、精子活力与精子运动参数VCL、VSL、VAP、MAD、ALH、BCF、LIN、WOB及STR有显著地相关性。结论：成都地区不育夫妇的男性精液质量异常主要表现为精子活动率和精子活力的降低,但是因精液质量下降所致男性不育与患者的年龄无关。     

Has Sperm Count Declined in the General Male Danish Population during the Last Several Decades？ A Study on the Relation of Sperm Count and Birth Year

It has been hypothesized that during the last several decades human sperm count has declined because of prenatal exposure to environmental chemicals. We examined the relation between semen.quality and birth year among 8608 men born from 1922 to 1971 and who from 1968 to t992 consulted 4 Danish medical centers because of barren marriage, Data were obtained from medical records and by a postal questionnaire to a subset of the population. The sperm concentration was significantly declining with increasing year of birth in 2 of the 4 centers, but this association disappeared when confounders were adjusted for. Within the subset of men born during 1955--1970 comprising 36% of the entire poputatlon we revealed a decrease of the average sperm concentration by 1.6 millionlml (95% CI: 0.7-2.5) per one advancing year of birth. This finding was consistent across all the 4 centers and robust to adjustment for effects of calendar period, season and duration of sexual abstinence. Effects of age were accounted for by restriction of the sample to men between 20 and 45 years. The findings are compatible with environmental impact in the prenatal period after 1955 but are far from unequivocal evidence that the sperm count in the general male Danish population has changed during the past decades.     

精浆抗精子抗体与精液主要参数相关性分析

目的:了解男性不育症患者精浆抗精子抗体(AsAb)对精子主要参数的影响。方法:对126例男性不育症患者的精液标本进行精子质量分析,同时用金标免疫斑点法进行精浆抗精子检测,然后对检测抗精子抗体阳性和抗精子抗体阴性患者分组进行精子质量参数的统计学分析。结果:126例男性不育患者中,精浆抗精子抗体阳性44例,阳性率为34.9%;阴性82例,阴性率为65.1%。抗精子抗体阴性组精子密度、活动率、活动力等主要参数明显高于阳性组,两组比较,差异具统计学意义(P<0.01)。结论:抗精子抗体对精子有凝集和制动作用,对精子密度、活动率等主要参数有明显的影响,是导致男性免疫性不育的重要因素之一。     

精子形态与精子密度、活力关系研究

目的探讨精子形态与精子密度和活力的关系。方法592例男性不育患者,采用计算机辅助精液分析方法（CASA）检测精子密度和活力,采用Diff-quick染色法进行精子形态分析。根据精子密度分为〈5×10^5／ml、（5—20）×10^6／ml和≥20×10^6／ml3组;根据精子活力分为〈10％、10％-30％、31％-50％和〉50％4组。比较各组间精子形态正常率的差异。结果随着精子密度、活力的降低,精子形态正常率亦明显降低,组间比较差异有统计学意义（P〈0．01）。结论精子形态与精子密度和活力密切相关,临床应结合精子形态和其他参数评价男性生育力。     

精子头部解剖参数与精子顶体酶的关系

目的分析精子形成过程中精子形态变化对顶体酶的影响,探讨精子可能的发生过程。方法选择30份精液标本,要求患者为继发不育,精子密度≥20×106/ml,活力≥50%,禁欲3-5d,手淫取精。精液液化后,一部分行计算机辅助精子动态分析,一部分行精子顶体酶检测,一部分离心沉淀瑞-吉染色后行计算机辅助精子形态学分析加人工校正,统计分析精子顶体酶与精子头部解剖参数的关系。结果精子顶体酶与精子头部的长宽比呈显著正向相关关系（r=0.580,P=0.048）,与顶体比呈显著负向相关关系（r=-0.614,P=0.034）。结论精子的顶体酶是伴随着精子细胞向精子的变态过程中,形态上逐渐拉长变细,胞浆逐渐浓缩丢失而逐渐形成的。     

1096例精液常规检查结果分析

目的通过对男性精液的常规检测分析,了解精子总数与精液分析各项参数间的关系,以及精子总数减少的原因.方法 按照,采用西班牙SCA精子质量分析系统,配合载物台温控仪以及MACRO计数板做全套相关参数分析.结果 在1096例精液标本常规检查中,精子密度＜20×106/ml...     

飞行环境对飞行人员精液参数的影响

目的研究停飞后7天对飞行人员精液参数的影响。方法 22例男性飞行人员,平均飞行时间（1691.76±804.19）h。禁欲3～5天,然后分别于停飞后1天之内以及脱离飞行环境后7天留取精液标本,记录精液量、液化时间、pH值,利用WEILI-9000电脑精液自动分析仪检测其精子密度、各级精子活力等常规参数。结果停飞后1天之内精液常规参数检查结果：精液量（3.30±0.69）ml,液化时间（33.3±13.7）min,pH值（7.3±0.2）,精子密度（76.24±7.73）×106/ml,a、b、c、d级精子百分率分别为（27.64±12.49）%、（14.10±5.84）%、（49.39±12.27）%、（8.52±1.14）%;脱离飞行环境后7天精液常规参数检查结果：精液量（3.0±0.8）ml,液化时间（32.5±10.6）min,pH值（7.5±0.3）,精子密度（77.43±5.65）×106/ml,a、b、c、d级精子百分率分别为（40.88±10.17）%、（24.25±4.51）%、（28.02±10.89）%、（6.85±5.58）%。脱离飞行环境后7天,精液pH值、a、b级精子百分率较飞行后1天之内显著上升（P〈0.01）,c级精子百分率显著降低（P〈0.01）,精液量、液化时间、pH值、精子密度方面没有明显差异（P〉0.05）。结论脱离飞行环境后7天可显著改善飞行人员精子活力参数。     

梅州市男性不育患者精液质量分析

目的:分析梅州市不育男性患者精液质量,了解该地区不育男性精液质量现状。方法:应用精子质量分析系统对梅州市2 524例不育男性患者的精液质量进行分析。结果:该地区男性不育主要原因为精子活率降低(80.11%),其次依次为精子活力降低(66.56%)、少精症(28.17%)、精液量过少(10.62%)、精液液化不良(9.63%)、精液黏稠度升高(5.78%)、无精子症(4.99%)、精子畸形症(2.69%)。结论:精子活率降低和精子活力降低是引起梅州市男性患者不育的最主要原因。     

rhTNF-α对正常人精子运动及其超微结构影响的实验研究

目的 :观察 rh TNF- α在体外对正常人精子的运动及其超微结构的影响。方法 :2 6例健康成年男性手淫法获得精液。Percoll梯度离心法得到的精子为精子模型 ,将精子密度调整为 1 0× 1 0 6 /ml;在 37℃、5 % CO2 的环境中 ,分别与终浓度为 60 pg/ml、90 pg/ml、2 70 pg/ml的 rh TNF- α孵育 ,同时设立对照组。在 0 .5 h和 4h时间段取样 ,CASA观察实验组和对照组精子的运动能力 ,TEM观察实验组和对照组精子的超微结构。结果 :与对照组相比较 60 pg/ml、90 pg/ml、2 70 pg/ml各组的精子运动能力明显降低 ( P<0 .0 1 )。精子超微结构发生程度不同的变化 :细胞膜变薄、扭曲或呈波浪状改变 ,大部分精子细胞膜不连续 ;细胞膜与顶体外膜间隙增宽 ,透亮度增强 ,顶体变厚 ,甚至可见顶体外膜破裂 ,顶体内容物流失 ;线粒体密度降低 ,透光度增强 ,严重者线粒体外形变圆 ,内有空泡形成 ;核膜与核内染色质未发生改变 ;纤维轴丝 9+ 2模式未改变。结论 :rh TNF- α可降低精子运动能力 ,同时破坏精子的顶体和膜结构而降低精子受精能力     

Semen parameters at different age groups of male partners of infertile couples

As a good number of couples are coming to infertility clinics to have children at advanced ages, it is essential to know whether advanced paternal age is associated with diminished semen quality and a higher risk of infertility. This retrospective study was done to see the effects of age on semen quality, a well-known indicator of fertility status. Semen parameters of smokers and non-smokers in the study population were also analyzed. A sample of 1121 male partners of infertile couples (aged 25-55 years) who came to an infertility clinic for treatment were included into the study. In addition to clinical history including lifestyle, medical and occupational details and physical examination, their semen samples were examined. Semen volume (ml), sperm concentration (x 10(6)/ml), motility (%), rapidly progressing (%), slowly progressing (%), non-progressive (%) motility and morphology (%) were measured. Semen volume showed IQR 1.5-3.0 ml, and significant decreasing trend with increasing age (r = -0.070, p<0.05). Sperm motility and rapidly progressing motility showed significant decrease (IQR 40.0-70.0, r = -0.115, p<0.01 and IQR 20.0-50.0, r = -0.107, p<0.01 respectively) with increasing age. There was no significant difference between semen parameters of smokers and non-smokers in the study population. This study shown that semen volume, sperm motility and rapidly progressing motility were significantly decreased with increasing age.     

处理后精液参数对夫精人工授精结局的影响

目的探讨精子形态学变化及处理后前向运动精子总数(PTMS)对以男性因素为主的宫腔内人工授精(IUI)妊娠结局的影响。方法回顾性分析163例共266个男性因素为适应证的IUI周期,依照注入活动精子数分比较各组妊娠率,同时按Krüger’s精子形态学严格标准法比较精子正常形态率对IUI妊娠率的影响。结果 266个周期中,临床妊娠39周期,周期妊娠率为14.66%,PTMS<10×106(A组)、10×106≤PTMS<20×106(B组)、PTMS≥20×106(C组)这三组发热妊娠率分别为8.57%、12.87%和21.05%,其中A组和C组比较差异具有统计学意义(P<0.05),而精子正常形态<2%(Ⅰ组)、2%~4.5%(Ⅱ组)、5%~14.5%(Ⅲ组)、≥15%(Ⅳ组)这四组的妊娠率分别为3.03%、15.23%、15.11%和20.83%,第Ⅰ组和第Ⅳ组比较具有统计学意义(P<0.05)。结论在男性因素为主的IUI周期中,精子正常形态率<2%及精液处理后PTMS<10×106时周期临床妊娠率明显下降。     

Anti-spermatogenic Effects of Ethanol Extract of Mucuna Urens

Objective To investigate the age-long claim by the locales that the food thickener, M. urens seed, has antispermatogenic, hence, antifertility effects in man. Methods Eight-week old male Albino rats were used as the mammalian model for this study. They were assigned to four groups of 6 rats each and treatment with the ethanol extract was for a period of 14 d. The treatment regimes were 70 mg/kg, 140 mg/kg, 210 mg/kg and 0 mg/kg BW in groups A, B, C and D, respectively. Extracts were prepared by Soxhlet extraction using 80% ethanol as the extracting solvent. The stock solution was prepared by dissolving 1 g of the paste extract in 10 ml corn oil （vehicle） to make up 100 mg/ml concentration. At the end of the treatment, sperm from the distal caudal epididymis was collected and analyzed for sperm count, sperm motility and sperm morphology. Results Significant reduction was observed in sperm count and sperm motility （P〈0.05）. The mean sperm count for group A was 6.27±0.02×10^6, for group B was 6.16±0.02×10^6 and group C had 6.0±0.0×10^6 sperm cells The control （group D） had a mean sperm count of 6.50±0.09×10^6 which was higher than that of any treated group. Results of the sperm motility test gave the following mean rates for motile sperm cells after treatment： group A, 57.6±% 2.1; group B, 50.0±4.0; group C, 45.0±4.0. The control had the highest mean motility rate of 72.3±2.1. The observed sperm abnormalities included unusual head with large acrosome, looped tailpiece, mid piece with distal droplet, pin head, pyriform head and long hook.Conclusion The anti-spermatogenic effects of the extract on the sperm in the Albino rat may lead to reduction of fertility.     

捐精志愿者支原体感染后用药对精液质量的影响

目的 评估支原体感染后用药治疗对精液质量的影响。方法统计2016年1月至2019年12月在广东省人类精子库支原体筛选检查阳性的445例志愿者经口服药物治疗前后的精液分析资料,志愿者连续用药2周,停药1周及2个月后再次进行精液检查。比较志愿者用药前、用药后1周、用药后2个月精液质量的变化。结果用药前、用药后1周、用药后2个月精液量分别为(3.85±1.37)mL、(3.81±1.48)mL、(3.79±1.37)mL,差异无统计学意义（P=0.362）;用药前后精子浓度分别为(96.98±35.35)×106·mL-1、(90.18±40.68)×106·mL-1、(88.57±34.44)×106·mL-1,用药后精子浓度降低,差异有统计学意义（P=0.008）;用药前后前向运动精子百分比分别为(60.52±9.45)%、(58.02±12.23)%、(59.41±11.15)%,用药后前向运动精子百分比降低,差异有统计学意义（P=0.004）;用药前后非前向运动精子百分比分别为(3.19±1.79)%、(3.31±2.02)%、(3.38±2.19)%,差异无统计学意义（P=0.904）;用药前后不动精子百分比分别为(36.28±9.22)%、(38.68±12.10)%、(37.20±11.07)%,用药后不动精子百分比升高,差异有统计学意义（P=0.004）;用药前后总精子数分别为(365.06±167.44)×106、(335.77±184.76)×106、(324.47±146.87)×106,用药后总精子数降低,差异有统计学意义（P=0.003）;用药前后前向运动精子总数分别为(220.76±105.31)×106、(194.68±112.45)×106、(193.27±93.29)×106,用药后前向运动精子总数降低,差异有统计学意义（P=0.039）。结论支原体用药治疗对精液质量有较大影响,主要体现在降低精子浓度和精子活力,使不动精子占比增加,对精液量没有显著影响;总精子数和前向运动总精子数显著降低。     

精子DNA完整性对复发性流产的影响

目的 探讨精子DNA完整性与复发性流产的相关性.方法 病例来自于2015年1月至2016年6月在我院流产门诊就诊的夫妇,选取复发性流产患者丈夫作为研究组(n=37)和正常生育男性作为对照组(n=30).取两组精液进行常规分析,同时采用精子染色质结构分析法(SCSA)对研究对象精子DNA完整性进行检测.结果 复发性流产患者丈夫组与正常生育男性组精液的量[(3.61±0.8)mL vs(3.74±0.7)mL]、精子浓度[(130.86±69.47)×106/mL vs(141.97±80.44)×106/mL]、精子活力[(54.18±11.75)%vs(56.33±11.78)%]以及正常形态精子百分率[(13.19±8.93)%vs(14.27±8.78)%]比较差异均无统计学意义(P>0.05);复发性流产患者丈夫组精子DNA碎片指数为(28.33±7.97)%,低于正常生育男性组的(12.73±5.07)%,差异有显著统计学意义(P<0.01).结论 精子DNA完整性损伤可能是复发性流产的相关因素,SCSA对评估生育力具有临床意义.     

赖氨酸和锌对精子核浓集的影响

取正常及缺锌大鼠睾丸和附睾、正常人及男性不育者精子,制成苯胺蓝染色标本及电镜标本观察,并对确定为精浆低锌的男性不育者给于口服硫酸锌治疗,观察锌含量的变化。结果正常大鼠睾丸曲细精管中精原细胞及精母细胞染色深,精子细胞及精子染色渐淡,附睾头部精子较尾部精子染色深（尾部精子几乎不着色）。正常人苯胺蓝染色阳性（着色深）精子数明显少于不育者。电镜图显示睾丸精子、附睾头部及尾部精子核逐渐致密,正常人精子核致密均匀,多数不育者精子核呈粗颗粒状。结果还显示缺锌大鼠生精细胞和精子苯胺蓝染色较对照大鼠深,表明赖氨酸含量增加。精浆低锌者口服硫酸锌治疗后,精浆锌含量明显提高。因而作者认为,赖氨酸含量增加导致精子核浓集障碍,可能是男性不育的一个重要原因。而缺锌可能会导致生精细胞和精子赖氨酸含量增加,口服硫酸锌治疗精浆低锌的不育者有一定疗效     

精液分析仪与传统检测法的对比

目的:对传统的人工精液常规与精液质量分析仪(sperm quality analyzer,SQA-V)分析的精液结果进行比较。方法:对50例精液标本采用人工精液常规分析与SQA-V分别进行检测。结果:在检测精子密度、精子活率及A +B级精子活力百分率的结果上,精液质量分析仪有较好的重复性(其CV分别为1.63%、4.9%、5.76%),且与人工精液常规分析的结果有高度相关性,在统计学上差异无显著性(P<0.001)。结论:在精液常规分析中,传统人工精液常规分析与SQA-V具有较好的一致性,且SQA所特有的指标SMI值更能综合地反映精子质量,也是常规精液分析所无法获取的数值,故SQA对精液质量的分析在临床上诊断上具有一定的价值。     

白细胞对不育男子精液质量的影响

目的探讨精液中的白细胞对不育男子精液质量的影响。方法本研究采用过氧化物酶染色法检测男子精液中白细胞数量。结果48例标本中,10例精液正常生育者中无一例精液白细胞增多;38例不育者中精液白细胞增多者有31例(>1×106/ml),占81.6％。白细胞阳性者的精子活动率,活动力,尾部肿胀率均显著降低,畸形率和抗精子抗体阳性率明显增高。结论在男性不育患者精液中自细胞数量明显增高,精液白细胞数量的变化可影响精液的质量。