Variation of semen quality in normal men

To examine the amount of variability in semen analysis results and whether there is any effect of season, 673 specimens provided by seven normal, healthy men (61-205 specimens/subject) over 72-324 weeks were assessed for sperm concentration, ejaculate volume, motility and motility index. Noticeable sample to sample variations were found. The largest proportion of the overall variance was due to within-subject differences, e.g., sperm concentration (54%), ejaculate volume (59%), percentage motility (96%) and motility index (74%). Although changes in semen-analysis results occurred over the year, no consistent trend was seen. No evidence was found to suggest that the differences were due to modifications of the methods employed by the laboratory, or to the change of season.     

Within-subject variation of seminal parameters in men with infertile marriages

As little information exists on the semen variability in infertile men, this study aimed at analysing the within-subject variability of semen from men with infertile marriages included in an intrauterine insemination (IUI) programme. Five ejaculates from each of 436 men (2180 specimens) were analysed. The within-subject coefficients of variation (CV(w)) were high for all parameters (semen volume, sperm concentration, forward motility and combined parameters), ranging from 0.73 for the total motile sperm count to 0.27 for the semen volume. Nevertheless, within-subject fluctuations were smaller than the between-subject variability, as indicated by high Intraclass Correlation Coefficient (ICC) values, which, however, significantly lowered when 相似文献   

Variation in, and inter-relationship between, prostaglandin levels and other semen parameters in normal men

In each of 135 ejaculates from 46 healthy men, semen volume, various sperm parameters and the level of prostaglandins (PGs) were determined. Data were analysed to determine the within- and between-subject variability, the effect of abstinence period and the correlation between different parameters. Data which did not reveal a Gaussian distribution were transformed logarithmically. For all variables the between-subject variance exceeded the variation within subjects (P less than 0.001). Variation in time of abstinence between 1 and 3 days influenced semen volume and sperm content as well as the content of 19-hydroxylated PGs, but did not affect sperm motility or the concentration of PGE or PGF. A significant negative correlation was found between the seminal content of PGE and PGF and the total sperm count as well as the sperm concentration. Sperm motility was related to the balance between the content of 19-hydroxy PGE and 19-hydroxy PGF but not to their separate concentrations. The ratio between 19-hydroxy PGE and 19-hydroxy PGF did not change when the time of abstinence differed. Synthesis of the two 19-hydroxylated PGs seemed to be regulated by the same mechanism, but their hydroxylation capacity still varied considerably between individuals.     

巨噬细胞对不育男子精液质量的影响

本文应用免疫细胞化学方法,研究正常生育男子、不育男子精液中巨噬细胞水平变化,同时,分析精液质量参数.结果显示不育组精液巨噬细胞显著增高;巨噬细胞阳性组与阴性组比较,活动率,活动力,尾部肿胀率均显著降低,畸形率明显增高;尾部肿胀率,畸形率与巨噬细胞含量分别呈负相关和正相关.研究提示在男性不育症患者精液中巨噬细胞有较高发生率,精液巨噬细胞数量变化可影响精液质量,造成男性不育的机理有待进一步研究.     

禁欲时间对人类精液参数的影响

目的探讨禁欲时间对精液参数的影响。方法回顾性分析85名供精者精液常规分析记录的精液量、密度、活动率、前向运动精子比率（a＋b）％、精子总数和前向运动精子总数，结果按禁欲时间分为〉3d（组1）、〈5d（组2）和≥5d（组3）3个组。结果在精液量和精子总数方面：组1、组2和组3均值逐渐升高，而组3与组1、组2比较差异有显著性意义；密度方面：组1、组2和组3均值逐渐升高，但3组之间比较差异无显著性意义；在活动率与（a＋b）％方面：组1、组2和组3均值逐渐降低，组1与组2、组3比较差异有显著性意义；而在前向运动精子总数方面，组1、组2和组3均值也是逐渐升高，但仅组1与组3比较差异有显著性意义。结论禁欲时间对精液参数有一定的影响，禁欲时间越长，一次排出的精子活动率及（a＋b）％越低；而精液量、精子密度、精子总数、活动精子总数及前向运动精子总数等数值越高。要想获得最高的（a＋b）％，禁欲时间≤3d最好；要想获得较好的（a＋b）％与前向运动精子总数，禁欲时间以〉3d、〈5d最好。     

Geographical differences in semen characteristics: Comparing semen parameters of infertile men of the United States and Iraq

The declining trend of male fecundity is a major global health and social concern. Among numerous other confounding factors, variations in male fertility parameters in different regions have repeatedly been suggested to be influenced by geographic locations. The impact of overall lifestyle, behavioural patterns, ethnicity, work stress and associated factors upon health differ greatly between developed and developing countries. These factors, individually or in combination, affect male reproductive functions ensuing the discrepancies in semen qualities in connection with geographic variations. However, reports comparing semen characteristics between developed and developing countries are sparse. The present study finds its novelty in presenting a comparison in semen parameters of infertile men in the United States (n = 76) that fairly represents the population of a highly developed region and Iraq (n = 102), the representative of male populations of a developing region. Samples were collected and analysed according to WHO (WHO laboratory manual for the examination and processing of human semen, WHO; 2010) criteria by means of the Mann–Whitney test. The US population demonstrated lower sperm concentration, total count, and total and progressive sperm motility with a higher seminal total antioxidant capacity (TAC) as compared to the Iraqi population. This report encourages further investigations concerning the confounding factors leading to such alterations in semen qualities between these two geographic areas.     

不育男性精子染色质结构与精液常规参数的关系

目的 研究不育男性精子染色质结构参数与精液常规参数的关系.方法 采集36例男性不育患者和18例健康对照者的精液标本,用TUNEL法检测精子DNA碎片化,CMA3染色法检测精子染色质包装质量,按照世界卫生组织标准(1999)检测精液常规参数.结果 不育组的精子TUNEL阳性率和CMA3阳性率均显著高于健康对照组,差异具有统计学意义(P＜0.05),精液常规参数正常的不育男性精子TUNEL阳性率和CMA3阳性率也显著高于健康对照组,差异具有统计学意义(P＜0.05),精子TUNEL阳性率和CMA3阳性率与精液常规参数之间具有显著的相关性(P＜0.05).结论 不育男性的精子染色质结构检测结果与健康男性存在显著差异,精子染色质结构检测可提供反映男性生育能力的信息.     

男性不育精液中NO与UA含量的关系

目的探讨人精液中一氧化氮(NO)与尿酸(UA)含量的关系,及对精子质量的影响。方法参照WHO标准方法,进行精液常规分析,按精子密度、活动率不同分为(正常、＜20、20～40、＞40) 4个组。采用镀酮镉还原荧光法检测NO代谢产物硝酸盐(NO_3~-)。采用尿酶一过氧化物酶偶联法检测精液尿酸含量。结果70例不育组精液中尿酸含量和NO含量为(236．4±47．8)μmol/L、(78．7±1．6)μmol/L与正常生育组(398．6±52．3)μmol/L、(41．8±1．6)μmol/L呈显著性差异(P＜0．01)。将尿酸含量与NO含量进行相关性分析,两者呈显著性负相关(r=-0．96,P＜0．05)。不育各精子密度和活动率组精液尿酸含量随精子密度及活动率增加而上升,NO含量随之下降(P＜0．01)。结论精液尿酸含量测定可作为评价精子受活性氧损害的重要指标,证明尿酸对活性氧尤其在医学领域极为重视的NO损害精子具有保护性作用。     

The impact of body mass index on semen parameters in infertile men

This hospital‐based, prospective study was conducted to evaluate the relationship between body mass index (BMI) and various semen parameters in infertile men. A total of 439 men presented for infertility evaluation were assessed by basic infertility evaluation measures including semen analysis and BMI calculation. The main outcome measure was the relationship between BMI groups [BMI: 18.5–24.9 kg/m² (normal weight), 25–29.9 kg/m² (overweight) and ≥30 kg/m² (obese)] and different semen parameters [volume, concentration, motility and morphology]. The mean BMI was 29.67 ± 5.89. Most of patients (82.91%) were overweight or obese. The 3 BMI groups were comparable in semen parameters (P > 0.05). BMI had a negative correlation with various semen parameters. However, this correlation was significant only with sperm concentration (P = 0.035). We concluded that sperm concentration was the only semen parameter which showed significant reduction with higher BMI in infertile men.     

Oestrogen receptor alpha gene polymorphisms relationship with semen variables in infertile men

This study aimed to assess the association of oestrogen receptor alpha (ER‐α) gene polymorphisms and semen variables in infertile oligoasthenoteratozoospermic (OAT) men. In all, 141 men were grouped into fertile men (n = 60) and infertile OAT men (n = 81). They were subjected to assessment of semen analysis, acrosin activity, serum reproductive hormones and genotyping of ER‐α gene. Frequencies of p and x alleles in ER‐α gene PvuII and XbaI polymorphisms were more prevalent among fertile men compared with infertile OAT men. Presence of P and X alleles was associated with increased incidence of male infertility for genotypes PP, XX compared with genotypes pp and xx (OR = 2.8; 95% CI: 2.36–6.97; P = 0.001 and OR = 4.1, 95% CI: 1.49–11.39; P = 0.001, respectively). The mean of semen variables and sperm acrosin activity were significantly higher in cases associated with pp than PP and in xx than XX genotypes of ER‐α gene. Mean levels of all serum reproductive hormones demonstrated nonsignificant differences in different ER‐α genotypes except oestrogen that was elevated in PP and XX ER‐α gene genotypes. It is concluded that as oestrogen is concerned in male gamete maturation, ER‐α gene polymorphisms might play a role in the pathophysiology of male infertility.     

Effect of smoking on semen quality of infertile men in Shandong, China

Aim: To study the effect of smoking on the semen quality in infertile men in Shandong Province, China. Methods:Adult non-drinker males attending the infertility clinic, including 110 non-smokers and 191 smokers, were recruited forthe study. Sixty-one fertile, non-smoker and non-drinker males, who had one or more children, served as the controls.The smokers were divided into subgroups according to the amount and duration of smoking. Semen parameters (semenvolume and sperm density, viability, motility, and morphology) were examined and seminal plasma contents of Zn,Cu and superoxide dismutase (SOD) determined. Results: The semen volume and acidity, and the sperm density,viability and forward progression, as well as the seminal plasma contents of Zn, Cu and SOD were much lower in themedium, heavy and long-term smokers than in the non-smokers ( P < 0.01). The sperm density, viability and forwardprogression, and the seminal plasma Zn, Cu and SOD levels were negatively correlated with the amount and duration     

The effectiveness of Korean herbal medicine in infertile men with poor semen quality: A prospective observational pilot study

We examined the effects and safety of Korean herbal medicine (MYOMI‐14) to treat infertile men with low semen quality. This study included 17 patients who received MYOMI‐14 for 10 weeks. The primary outcomes were the mean differences between sperm test values. The secondary outcomes were changes in the Fertility Quality of Life and the difference in skin temperature between the thigh and scrotum. Adverse events were also monitored. The average values of sperm concentration, sperm progressive motility and total motile sperm count significantly improved after MYOMI‐14 treatment (36.2%, 51.7% and 55.5%, respectively; p < 0.05). The core Fertility Quality of Life and the difference in skin temperature between the thigh and scrotum did not change significantly. No adverse events were observed. MYOMI‐14 improved the semen quality of infertile men without adverse effects. Additional studies in a larger population and longer prospective randomised clinical trials are needed to confirm these results.     

Effects of clinical stage and immunological status on semen analysis results in human immunodeficiency virus type 1-seropositive men

Summary. Complete semen analyses including computer-assisted sperm motility and morphology assessments were performed to determine if semen and sperm differed between HIV-seropositive men and fertile controls, or differed with symptoms, or CD4+ peripheral cell count categories. Previous studies included small numbers of men and presented conflicting conclusions. Two hundred and fifty non-vasectomized HIV-seropositive men and 38 fertile controls each provided one semen sample. Non-parametric statistics were used to analyse both continuous and nominal data. Fertile men had significantly greater semen volume, sperm concentration, percent motility, percent rapid and linear motility and total strictly normal spermatozoa than HIV seropositive men. Neither total number nor subtypes of leukocytes in semen differed between the two groups. Among the HIV seropositive men, significant differences in semen analyses were found between CD4+ cell count, clinical, and AIDS categories. Lower CD4+ cell counts (<200 mm⁻³) were associated with significantly lower percent motility, percent normal sperm morphology by strict criteria, significantly more spermatids in semen, and higher percentages of teratozoospermia, oligoasthenoteratozoospermia and leukocytospermia. Healthier men, based on clinical categories, had significantly more normal shaped spermatozoa and fewer had azoospermia, oligoasthenoteratozoospermia or leukocytospermia. Many HIV-seropositive men have normal semen analyses, but as the disease progresses more defects are found, particularly in strict criteria sperm morphology.     

计算机辅助精液分析男性不育患者精子运动参数与精子活力的相关性

目的探讨计算机辅助精液分析精子运动参数在评价男性不育患者精子活力中的价值。方法按《WHO人类精液及精子-宫颈黏液相互作用实验检验手册》标准,采用国产WLJY-9000伟力彩色精子质量检测系统对276例男性不育患者的精液进行平均直线运动速度、平均曲线运动速度、运动的前向性、运动的直线性、运动的摆动性、平均路径速度、精子活力及分级等进行检测并分析其相关性。结果276名男性不育患者的平均精子活力为（48.93±19.10）%,分级为A级（32.11±17.25）%、B级（17.03±8.91）%、C级（10.14±5.99）%。平均直线运动速度、平均曲线运动速度、运动的前向性、运动的直线性、运动的摆动性、平均路径速度与精子活力的相关系数分别为0.60（P〈0.01）、0.59（P〈0.01）、0.51（P〈0.01）、0.55（P〈0.01）、0.52（P〈0.01）、0.67（P〈0.01）。结论计算机辅助精液分析精子运动参数平均直线运动速度、平均曲线运动速度、平均路径速度是反映精子活力的有效指标,精子运动参数对男性不育的诊断和生育能力的评估具有实用意义。     

Secular and seasonal changes in semen quality among young Danish men: a statistical analysis of semen samples from 1927 donor candidates during 1977-1995

The objective of this study was to investigate whether semen quality has changed during the years 1977-1995 in a group of unselected semen donor candidates, and to determine whether semen quality is subject to seasonal variation, by analysis of time- and season-related changes in semen quality using multiple regression and ANOVA. The study was based on analysis of the first semen sample delivered by 1927 semen donor candidates in Copenhagen during the period 1977-1995, with determination of semen volume, sperm concentration, total sperm count, percentage motile spermatozoa, and a semiquantitative sperm motility score. Multiple linear regression analysis with year, sexual abstinence and season as covariates showed a significant increase in mean sperm concentration from 53.0 x 10(6)/mL in 1977 to 72.7 x 10(6)/mL in 1995 (p < 0.0001) and in mean total sperm count from 166.0 x 10(6) to 227.6 x 10(6) (p < 0.0001). Mean semen volume and percentage motile spermatozoa did not change. Sperm motility deteriorated, as the spermatozoa in 74.2% of the samples were of excellent motility in 1977-1980 compared to only 41.9% in 1993-1995 (chi 2 = 130.0, p < 0.0001). Analysis of variance showed significant variation between seasons regarding sperm concentration (p < 0.0001) and total sperm count (p < 0.0001). Highest sperm counts were found in spring, with a mean concentration (95% C.I.) of 77.6 x 10(6)/mL (71.9-83.7), and lowest in summer, with a mean of 57.5 x 10(6)/mL (50.1-65.4). No other semen parameter varied with season. It is concluded that sperm counts increased, whereas sperm motility decreased, in a group of Danish semen donor candidates, from 1977 to 1995. Due to the retrospective design and the anonymity of the donors, we were unable to control for variation in donor age, and we cannot exclude the possibility that some donor candidates were selected by being accepted as donors by other semen donor services in Copenhagen. With these limitations in mind, we suggest our results should be interpreted cautiously and regarded as a contribution to the ongoing dispute on whether or not there is a continuous decrease in sperm quality. The seasonal variations found in sperm concentration and total sperm count were pronounced and were not attributable to seasonal differences in the length of sexual abstinence. Additionally, the same seasonal pattern was observed in five successive year-intervals. These findings strongly indicate that human testicular function is influenced by season, a phenomenon well known in many lower mammals.     

Chemiluminescence in semen of infertile men

Summary. Luminol-dependent chemiluminescence (CL) can be used to determine the production of reactive oxygen species (ROS) by cells. Enhanced formation of ROS in human semen was reported to be of pathological significance for a disturbed sperm function. To investigate incidence of elevated CL-signals in semen samples and their correlation to conventional semen parameters, CL-signals in the semen of both 49 consecutive infertile men and 20 controls were measured. Semen was analysed according to WHO-criteria including bovine mucus-penetration- and water-test. A CL-signal of 1.5 × 10⁵ counts min⁻¹/2 × 10⁶ spermatozoa was considered to be the upper normal limit. The CL in infertile men's semen was elevated with statistically significant differences in oligozoospermia patients/controls ( P < 0.0001) and normozoo-spermia patients/controls ( P < 0.05). In the group with elevated CL-signals, a higher percentage of spermatozoa with a pathologic morphology was detected ( P = 0.05). In the groups with pathologic results of eosin- and water-tests, the CL-counts were elevated ( P < 0.006; P < 0.03). The spermatozoa motility in the group with elevated CL-counts was significantly reduced after 4 h ( P < 0.05). The CL-signals correlated inversely with the results of the bovine mucus-penetration-test ( r = -0.67, P < 0.0001). In conclusion, semen samples of 28% of our patients showed elevated CL-signals; these were associated with pathological results of membrane integrity-tests. The negative correlation of CL with the results of Penetrak®-test reflects its importance to depict the functional capacity of spermatozoa.     

Colonisation of the male reproductive tract in asymptomatic infertile men: Effects on semen quality

The objective was to explore presence/detection of microorganisms in the male reproductive tract (PMMRT) in asymptomatic patients undergoing infertility treatment and their effects on semen quality in our region. This study enrolled 205 men (mean age, 35.9 years) in a single-centre, tertiary university hospital from December 2015 to December 2016. We used the modified Meares–Stamey test, real-time polymerase chain reaction (rt-PCR) and the National Institutes of Health Chronic Prostatitis Sympton Index (NHI-CPSI) questionnaire to address this issue. No patient met the prostatitis criteria by the modified Meares–Stamey 4-sample test, 33 (16.1%) were positive for rt-PCR in the first-voided urine for any of the Mycoplasma (Ureaplasma urealyticum/parvum, Mycoplasma hominis/genitalium) and C. trachomatis was detected in two cases (1%), and three for rt-PCR in semen for HPV high-risk genotypes non-16/18 (1.5%). Significant statistical differences were reported among patients with and without PMMRT in terms of lower rate of progressive spermatozoa (PR) (p < .034), total motile sperm count (p < .028), normal morphologic forms, especially in the sperm head (p < .001) and highest viscosity (p < .012). It was concluded that PMMRT, specially Mycoplasmas, in asymptomatic infertility men, affects semen quality. The NIH-CPSI questionnaire was not a valid initial screening to subsequently evaluate the presence of prostatitis/PMMRT.     

用传统方法与计算机辅助精液分析软件CRISMAS分析166名丹麦青年男性精液样本的结果比较

本研究以166名丹麦青年男性精液为样本,通过评估精于浓度和活力来比较传统精液分析与计算机辅助精液分析方法（CASA）（哥本哈根Rigshospitalet图像屋精子运动分析系统,CRISMAS软件4．6版本）。CRISMAS软件测定精子的浓度把精子活力分为三类。传统分析方法将精子活力分为四种状态。为了便于二者的比较,本文将传统的四种状态根据精子速度等级重新分为三个状态：rapidly progressive（A）,slowly progressive（B）和non-progressive（C＋D）。两种方法所研究的参数之间都有显著差异（P〈0．001）。与传统方法相比,CRISMAS高估了精子浓度以及快速运动精子的比例,因而低估了慢速运动和非运动精子。为分析研究结果是否会随精液分析时间而起伏变动,将精液分析结果按分析同期分为四个层次。结果表明CRISMAS对活力的分析结果比传统分析方法稳定,但两种方法都未表现出任何趋势。显然,无法比较CRISMAS CASA和传统分析方法在精子浓度和精子活力方面的分析结果。在临床上使用该软件时以及用其研究这些精子特性时需要说明这一点。     

Does computerized image analysis of sperm movement enhance the predictive value of semen analysis for in-vitro fertilization results?

The influence of semen quality on fertilization rates in an in-vitro fertilization (IVF) programme was studied by analysing both conventional semen parameters and computerized movement characteristics. The study was based on 407 inseminated oocytes which were obtained from 50 patients in 113 laparoscopies. Sperm concentration did not correlate strongly with the fertilization rate. Sperm motility and morphology were the most meaningful parameters in predicting fertilization success. A drop in fertilization rate was found when sperm motility or normal morphology were below 40%. Sperm velocity measured in semen was the only sperm movement parameter which correlated with the fertilization rate, albeit weakly. The latter was reduced when average sperm velocity in semen was less than 50 microns/sec. Conventional semen parameters seem to be more predictive of the fertilizing potential of an ejaculate than movement characteristics obtained by computerized image analysis.     

Improvements in semen parameters in men treated with clomiphene citrate—A retrospective analysis

Clomiphene citrate (CC) is commonly used off‐label for the treatment of male infertility, yet there is limited data to guide patient selection. To identify a subset of patients more likely to benefit from CC, we aimed to define predictors of improvement in semen parameters among men receiving CC. We retrospectively analysed 151 men treated with at least 25 mg CC daily for male infertility and/or hypogonadism at two institutions between 2004 and 2014. Men previously on testosterone were excluded. The primary outcome was change in semen parameters. Variables included baseline patient characteristics, pre‐treatment hormone profiles and pre‐treatment semen analyses. A total of 77 men met inclusion criteria. Median length of therapy was 2.8 months. There was significant improvement in sperm concentration (14–21 million/ml; p = 0.002) and total motile count (TMC; 13–28 million; p = 0.04). One third of patients who began with fewer than 5 million motile spermatozoon improved to a TMC > 5 million, increasing reproductive options to include intrauterine insemination. Patient characteristics, pre‐treatment hormone profile and degree of oligozoospermia did not predict treatment response. While no predictors of improvement were identified, clinically useful response rates are described for use in shared decision‐making.