精路炎症对精子密度和活率的影响

目的　了解精路炎症患者精子密度和活率的变化及其对生育影响。方法　选取慢性前列腺炎患者 5 0例 ,慢性附睾炎患者10例和正常生育者 10例 ,对其精液常规参数进行比较。结果　前列腺炎组的精子密度与正常组无显著差异 ,而精子活率显著低于正常组 (P <0 .0 5 ) ;附睾炎组精子密度和精子活率与正常组均无显著差异。结论　慢性前列腺炎患者的精子活率较正常生育者明显降低 ,而附睾炎患者无变化 ,提示慢性前列腺炎对生育可能有影响     

ⅢB型前列腺炎对精液参数的影响

目的:探讨非炎症性慢性骨盆疼痛综合征(CAPⅢB)对精液参数的影响。方法:检测74例CAPⅢB患者及46例正常男性的精液参数,以美国国立卫生研究院前列腺炎症状评分(NIHCPSI)评估患者症状情况。比较CAPⅢB患者与对照组的精液参数的差别,分析CAPⅢB患者慢性骨盆疼痛症状程度及持续时间与精液主要参数的关系。结果:CAPⅢB患者精液参数中的精液量、液化时间及精子活动力与对照组相比,差异有显著性(P值分别为0.008、0.007及0.001),而精液pH值、精子密度、精子活率和精子畸形百分率两组间相比,差异无显著性(P>0.05)。CAPⅢB患者CPSI评分与精液量、液化时间及精子活动力间无显著相关性(P>0.05),慢性骨盆疼痛症状持续时间与液化时间有显著正相关性(r=0.283,P=0.015),慢性骨盆疼痛症状持续时间与精子活动力呈显著负相关(r=-0.296,P=0.011)。结论:CAPⅢB患者精液量增加,液化时间延长,精子活动力下降;而症状轻重程度与精液量、液化时间及精子活动力无关。     

精浆尿酸的检测及其与精液参数的相关性研究

目的:建立精浆尿酸(UA)的检测方法并探讨精浆UA水平与精液参数的相关性。方法:根据检测血清UA的方法加以改良建立检测精浆UA的方法,并观察批内变异和不同技术人员检测结果之间的差异以评价方法的可接受性。同时分析138例男性精浆UA水平与患者年龄、禁欲时间、精液量、pH、精子密度、活动率、a+b级精子百分率和正常形态精子百分率之间的相关性。结果:精浆UA检测方法的批内变异为9.16%,2位技术人员的检测结果没有显著性差异(P=0.541)。精浆UA水平与正常形态精子百分率呈正相关(r=0.350,P=0.025),与精子活动率和a+b级精子百分率有呈正相关的趋势(r=0.147和0.156,P=0.085和0.068),而与精液分析其他参数如精液量、pH、精子密度、禁欲时间以及患者年龄等无相关性。结论:通过对血清UA检测方法加以改良可以建立可接受的精浆UA检测方法。精子形态学、活动率及a+b级精子百分率可能与精浆UA水平高低有关。     

肾移植前后男性精液质量变化的对比分析

目的　探讨尿毒症患者肾移植前后精液质量的变化。　方法　检测 10例尿毒症患者肾移植手术前后以及 12例正常对照者的精液 ,并对 3组精液主要参数进行比较。　结果　肾移植前后和正常对照者的精子活动力分别为 (13.8± 2 .8) %、(48.3± 7.2 ) %和 (6 3.8± 3.6 ) % ;精子存活率分别为 (2 4 .2± 4 .1) %、(76 .3± 3.9) %和 (80 .4± 2 .2 ) % ;精子正常形态率分别为 (15 .6± 2 .3) %、(17.7±1.9) %和 (33.8± 3.7) %。肾移植术后患者的精子活动力、存活率明显好于术前 ,差异有显著性意义(P均 <0 .0 1) ;与正常对照组比较 ,差异无显著性意义 (P均 >0 .0 5 ) ;精子正常形态率肾移植前后比较 ,差异无显著性意义 (P >0 .0 5 )。　结论　成功的肾移植可以改善尿毒症患者的精液质量。     

精浆尿酸的检测及其与精液参数的相关性研究

目的：建立精浆尿酸（UA）的检测方法并探讨精浆UA水平与精液参数的相关性。方法：根据检测血清UA的方法加以改良建立检测精浆UA的方法,并观察批内变异和不同技术人员检测结果之间的差异以评价方法的可接受性。同时分析138例男性精浆UA水平与患者年龄、禁欲时间、精液量、pH、精子密度、活动率、a＋b级精子百分率和正常形态精子百分率之间的相关性。结果：精浆UA检测方法的批内变异为9.16%,2位技术人员的检测结果没有显著性差异（P=0.541）。精浆UA水平与正常形态精子百分率呈正相关（r=0.350,P=0.025）,与精子活动率和a＋b级精子百分率有呈正相关的趋势（r=0.147和0.156,P=0.085和0.068）,而与精液分析其他参数如精液量、pH、精子密度、禁欲时间以及患者年龄等无相关性。结论：通过对血清UA检测方法加以改良可以建立可接受的精浆UA检测方法。精子形态学、活动率及a＋b级精子百分率可能与精浆UA水平高低有关。     

糖尿病患者与健康男性精液参数的比较性研究

目的通过分析男性糖尿病(DM)患者精液的主要参数,明确糖尿病导致男性生育能力损伤在精液方面的具体指标。方法采集2013年3月至2014年5月期间在本研究机构就诊的且已经在我院内分泌科确诊为糖尿病、并有生育需求的就诊患者与正常育龄男性对照研究。两组均按照25~35岁、36~45岁分为两个年龄段组。采集其精液观测精液量、酸碱度(pH)、液化时间、精子密度、精子总数、各级精子百分率。所得数据进行统计学分析比较。结果糖尿病患者精液量减少、精液液化时间延长、(a+b)级精子减少,这几项均与正常组人群存在显著性差异;精液的pH、精子密度、c级和d级精子均与正常组比较没有显著性差异。结论糖尿病患者精液质量下降主要引起了精液量、精液液化时间、精子活力的异常,从而导致男性生育能力降低。     

输精管吻合术后男性生育力的临床观察

目的 观察输精管吻合术后男性的生育力恢复情况.方法 对158例男性成功复通患者进行前瞻性队列研究,观测术后l、6、12、24个月的精液参数变化和随访配偶妊娠情况.对复通后生育组与未生育组之间的相关影响因素进行比较,并采用Logistic回归分析法进行相关性分析.结果 158例复通者在术后1、6、12、24月后的精子密度的均值分别为:(10.1±1.3)106/ml、(13.3±1.5)106/ml、(20.6±7.1)106/ml、(19.4±3.1)106/ml,前向运动精子百分率的均值分别为:(21.3±6.5)％、(34.2±6.9)％、(53.1±8.6)％和(45.9±12.1)％,精子正常形态百分率(％)的均值分别为:(10.7±2.1)％、(16.2±4.5)％、(28.5±5.5)％和(25.7±7.2)％.其中有81例(5 1.3％)在术后12个月的精子密度、前向运动精子百分率、精子正常形态百分率的均值达正常参考范围.复通后24个月内配偶总妊娠率为65.9％ (105/158),术后6、12、24个月各精液参数值与1月比较,P＜ 0.01.Logistic回归分析结果表明,配偶受孕与精子正常形态百分率呈正相关(r=0.189,P=0.000),和配偶年龄呈负相关(r=-0.171,P=0.004),与其他因素无关.结论 输精管吻合术后男性精液质量随时间变化而改善,1年后超过一半复通者的精子密度、前向运动精子百分率、精子正常形态百分率可达到正常参考范围.配偶受孕率随着精子正常形态百分率的增加而增加,随着配偶年龄的增加而降低.     

慢性非细菌性前列腺炎患者精液质量改变和抗生素治疗效果

目的 :观察慢性非细菌性前列腺炎 (CAP)对精液质量的影响和抗生素对CAP的治疗效果。　方法 :对诊断为CAP的 86例患者进行精液分析 ,同时测定血清和精浆的抗精子抗体 (AsAb) ,并和 2 0例正常男性进行比较。然后把 86例CAP患者随机分成用抗生素组和未用抗生素组共 2组 ,每组 4 3例 ,用抗生素组除选用 3种抗生素序贯治疗外 ,其余治疗 2组相同。连续治疗 3个月 ,每个月随访 1次。　结果 :CAP患者精子活动率、前向运动精子百分率和正常形态精子均明显低于正常对照组 (P <0 .0 0 5 ) ;精浆和血清AsAb阳性率均明显高于正常对照组 (P <0 .0 1 )。应用抗生素组精子活动率、前向运动精子百分率和正常形态精子等提高均明显大于未用抗生素组 (P <0 .0 5 ) ,临床治疗效果也明显优于未用抗生素组 (P <0 .0 5 )。　结论 :CAP使精液质量和男性生育力下降。抗生素治疗可明显改善CAP患者的精液质量 ,并提高CAP的治疗效果     

人精子透明质酸酶活性测定的临床意义

目的 :测定人精子透明质酸酶 (HYD)活性并分析其与精液常规参数之间的相关性。　方法 :用改良Singer法测定 14 6例男性精子HYD活性 ,常规检测精子密度、活动率和正常形态百分率。　结果 :精子HYD活性与密度、活动率及与正常形态百分率存在显著相关性 (r值分别为 0 .65、0 .63和 0 .72 ,P均 <0 .0 1)。不育男性精子密度在 4 0× 10 6 /ml以上组的HYD活性明显高于精子密度少于 2 0× 10 6 /ml以下组 (P <0 .0 1)。不育男性精子活动率 >60 %组的HYD活性明显高于 <3 0 %组 (P <0 .0 1)。　结论 :精子HYD活性测定是评价精子功能的有效指标之一     

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...     

细胞因子IL-1β和TNF-α mRNA在人精子表达的变化及意义

目的：了解IL－1β和TNFα在人精子表达的变化及意义。方法应用逆转录聚合酶链式反应（RT－PCR）检测13例正常生育者、30例不育者及30例慢性及30例慢性前列腺炎患者精子IL－1β和TNFα mRNA表达。结果不育精子中IL－1β和TNFα mRNA表达增显著低于正常生育者（P＝0．018和P＝0．046）。慢性前列腺炎患者精子中TNFα mRNA的表达显著低于正常生育者（P＝0．018）。而IL－1βmRNA表达与正常生育者相比差别无显著性意义（P＝0．42）。IL－1β和TNFα mRNA－NA在不育者与慢性前列腺炎患者精子中的表达差别无显著性意义（P＝0．49和P＝0．62）。结论某些因素可能干扰不育症患者精子IL－1βTNFα合成,导致精液质量下降及不育。生殖道炎症也可能影响精子TNFα表达,其机制和意义有待进一步研究证实。     

Reappraisal of the hypo-osmotic swelling test to improve assessment of seminal fertility status

The hypo-osmotic swelling (HOS) test has been proposed as a useful assay for evaluation of the functional competence of the human sperm membranes. To assess this further, the HOS-test was evaluated in 187 semen samples collected from fertile men and from male patients consulting for infertility. These samples were classified as normal, oligo-, astheno- or oligoasthenozoospermic on the basis of their standard semen variables. The percentage of total sperm tail swelling and of sperm exhibiting different tail swelling patterns was recorded. In the fertile men and in the group of patients with normal semen variables, significantly more (P less than 0.001) HOS-reactive sperm were observed after hypo-osmotic treatment in comparison with those groups exhibiting abnormal semen parameters. Swelling of the sperm in a hypo-osmotic medium was highly correlated with both progressive motility (r = 0.62, P less than 0.001) and sperm viability (r = 0.65, P less than 0.001). A weak positive correlation was also observed between sperm swelling and sperm morphological features (r = 0.31, P less than 0.005) and between sperm swelling and sperm concentration (r = 0.31, P less than 0.005). No significant correlation was observed between sperm swelling and in-vitro sperm fertilizing capacity as assessed by the zona-free hamster oocyte penetration assay. However the majority of the semen samples (87.3%) showing a normal penetration rate (greater than or equal to 10%) also exhibited a 60% (or higher) reaction in the HOS-test.(ABSTRACT TRUNCATED AT 250 WORDS)     

慢性前列腺炎治疗过程中精液质量变化的观察

目的研究慢性前列腺炎对男性生育力的影响。方法对112例男性前列腺炎患者（CP组）和96例相同年龄组健康人群（NCP组）的精液进行比较、分析;对CP组患者行口服抗生素＋α受体阻滞剂治疗之后复查精液,对比治疗前、后数据。结果慢性前列腺炎患者精液中反映生育功能的关键指标与健康男性差异有统计学意义,对慢性前列腺炎患者行口服抗生素＋α受体阻滞剂治疗之后,精液质量有显著改善。结论慢性前列腺炎对男性的精液质量有不利影响;治疗慢性前列腺炎有助于男性提高精液质量。     

Sperm preparation: DNA damage by comet assay in normo- and teratozoospermics

The present study was carried out on semen samples of human fertile and infertile subjects, teratozoospermics (TZs) and idiopathics (IDs), with neat semen and sperm prepared by swim up or Percoll density gradient centrifugation procedures. Sperm morphology analysis revealed that only head and midpiece defects in TZs and IDs were significantly (P < 0.001) higher compared to fertile subjects. Infertile subjects indicated significantly higher (P < 0.001) sperm DNA damage compared to fertile subjects. Fertile subjects with sperm prepared from neat and Percoll density gradient centrifugation exhibited a comet tail DNA percentage of 20% and 15%, respectively. The TZs and IDs infertile subjects had higher levels of comet tail DNA of 33% and 25% and 25% and 19%, respectively. A significant (F = 24.01; P = 0.0059) decrease in mean comet head DNA percentage or sperm DNA integrity was observed in neat samples from fertile and infertile subjects by Repeated Measures ANOVA. In Percoll prepared samples from fertile, TZs, and IDs, there was a significant increase in sperm DNA integrity. Similarily, there was a decrease in abnormal sperm morphology in swim up and Percoll prepared sperm compared to neat samples. The Percoll density gradient centrifugation procedure yields sperm with an increase in sperm DNA integrity relative to swim up. Sperm DNA damage of TZs with both sperm preparation methods was significantly (P < 0.01) higher when compared to fertile and IDs. But the level of DNA damage was higher in IDs compared to fertile subjects. Compared to the other methods tested, the Percoll method yielded sperm with improved DNA integrity. In conjunction with semen analysis, the assessment of nuclear integrity improves the characterization of the semen sample and may be used as a tool for allocating the patients to specific assisted reproductive treatments.     

精浆游离L-肉毒碱水平及其与精子密度、活动率及活力的相关性研究

目的:研究正常生育及不育男性精浆中游离L-肉毒碱水平差异及其与精子密度、活动率(a+b+c级精子百分率)及活力(a+b级精子百分率)之间的相关性,探讨精浆中游离L-肉毒碱水平对男性生育力的影响及其在不育症检查和治疗中的作用。方法:分别采用高效液相色谱法和计算机辅助精液分析系统,测定了230例不育症患者(精子密度正常117例,少精子症81例,无精子症32例)和30例正常生育男性精浆中游离L-肉毒碱水平及精子密度、活动率、活力等参数。根据检查结果对不育症患者分组后,以SPSS12.0软件包进行统计学分析,比较各组间游离L-肉毒碱水平的差异以及游离L-肉毒碱水平与精子密度、活动率、活力之间的相关性。结果:正常生育组精浆游离L-肉毒碱水平明显高于不育组(P<0.01)。精液中精子密度越低、活力越弱,这种差异性越显著。相关性分析结果显示,精浆游离L-肉毒碱水平与精子密度呈显著正相关关系(r=0.521,P<0.01),与精子活动率和活力之间也具有正相关关系(r=0.319,P<0.01;r=0.251,P<0.01)。结论:精浆L-肉毒碱水平与精子密度、活动率和活力之间密切相关,其含量测定作为一项有用的生化指标,可为男性不育症检查及临床诊治和进行有关男性生殖功能机制研究提供参考。     

慢性前列腺炎伴不孕不育患者精液结果及精浆PSA和果糖的分析研究

目的：探讨慢性前列腺炎（CP）伴不孕不育患者精液质量及果糖和PSA的变化。方法：研究对象均为男性CP患者。根据精液液化时间是否大于60min分为两组：精液液化正常组22例,精液延迟液化组20例;另选择正常对照组15例。分析各组精液理化指标,并测定各组精浆中果糖和PSA的含量。结果：精液液化正常组、精液延迟液化组在精子密度、精子活率、活动A级和活动A＋B级较正常对照组差异有统计学意义（P〈0．01）;PSA浓度较正常对照组差异有统计学意义（P〈0．01）。精液延迟液化组果糖含量较正常对照组差异有统计学意义（P〉0．05）。结论：CP可以引起精子质量降低和化学组分的改变,有可能影响精液的液化过程,导致男性不育。     

Effect of varicocele on chromatin condensation and DNA integrity of ejaculated spermatozoa using cytochemical tests

Varicocele occurs in approximately 15% to 20% of the general male population and it is the most common cause of poor semen production and decreased semen quality. It has been demonstrated that patients with varicocele have a significantly higher DNA fragmentation index (DFI) and spermatozoa with nuclear anomalies than healthy fertile men. Therefore, the aim of this study was to evaluate sperm chromatin integrity in these patients. Sixty men referring to the andrology laboratory were categorised into three different groups: 20 infertile men with varicocele, 20 infertile men with abnormal semen parameters and 20 fertile men who had normal spermatogram were considered as control group. Semen analysis was performed according to WHO criteria. To evaluate sperm chromatin quality and DNA integrity, after fixation of sperm smears, aniline blue, toluidine blue, chromomycin A₃ and acridine orange staining were applied in three groups. The slides were analysed by light and fluorescent microscopy and to determine the percentage of mature or immature spermatozoa, 200 spermatozoa were counted in each slide. The results showed that the rates of aniline blue-reacted spermatozoa were significantly higher in infertile and varicocele patients than in the normal group ( P  < 0.001). In addition, with regard to chromomycin A₃, acridine orange and toluidine blue staining, there was a significant difference between the three groups ( P  < 0.001). The results showed that the varicocele samples contain a higher proportion of spermatozoa with abnormal DNA and immature chromatin than those from fertile men as well as infertile men without varicocele. Therefore, varicocele results in the production of spermatozoa with less condensed chromatin and this is one of the possible causes of infertility due to varicocele.     

Time-related decline in sperm motility patterns in men with cytotoxic antibodies

Sperm motility patterns in semen from 10 fertile nonautoimmune men (fertile control group) and 33 infertile men with various titers of cytotoxic sperm antibodies in their seminal plasma (group 1: titers less than or equal to 16, n = 6; group 2: titers 64 to 512, n = 12; group 3: titers greater than or equal to 1024, n = 15) were evaluated every 2 hours for 12 hours and finally at 24 hours. A significant decline in sperm swimming speed and linearity was observed at 6 hours in semen from 27 infertile men with sperm antibodies. Beginning at 8 hours, semen from sperm antibody-positive men in group 2 showed a significant decline in percentage motile sperm (p less than 0.001) compared to the fertile controls. The percentage motility in semen of donors in groups 1 and 3 was significantly lower than that in semen of fertile donors at 10 hours (p less than 0.05), 12 hours (p less than 0.01), and 24 hours (p less than 0.001). The mean velocity in groups 2 and 3 was significantly less than that in fertile controls at 10 and 12 hours (p less than 0.05). The linearity of sperm motility started to decline 4 hours after semen samples were obtained from sperm antibody-positive groups 2 and 3 in contrast to sperm antibody-negative fertile or infertile groups (p less than 0.05). It is concluded that the presence of cytotoxic sperm antibodies in the seminal plasma adversely affects sperm linearity as early as 4 hours after semen collection.(ABSTRACT TRUNCATED AT 250 WORDS)     

Male accessory gland infection frequency in infertile patients with chronic microbial prostatitis and irritable bowel syndrome

Recently, we reported an increased prevalence of chronic bacterial prostatitis (CBP) in patients with prostatitis syndromes (PS) and irritable bowel syndrome (IBS) compared with patients with PS alone. The aim of this study was to evaluate the frequency of male accessory gland infections (MAGI) in patients with CBP plus IBS and to compare the sperm parameters of patients with or without MAGI. Fifty consecutive patients with the following criteria were enrolled: (i) infertility; (ii) diagnosis of CBP; and (iii) diagnosis of IBS according to the Rome III criteria. The following two aged-matched control groups were also studied: infertile patients with CBP alone (n = 56) and fertile men (n = 30) who fathered a child within the previous 3 months. Patients and controls underwent to an accurate anamnesis, administration of the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) and the Rome III questionnaires for prostatitis and IBS, respectively, physical examination, and semen analysis. A significantly higher frequency of MAGI was found in patients with CBP plus IBS (82.0%) compared with the patients with CBP alone (53.6%) or the fertile men (0%). The presence of MAGI in the patients with CBP plus IBS was associated with a significantly lower sperm concentration, total number, and forward motility, and with a higher seminal leucocyte concentration compared with the patients with CBP alone and MAGI. Sperm normal morphology was similar in the groups of patients. All sperm parameters did not differ significantly in both the groups of patients without MAGI. The patients with CBP plus IBS had a significantly higher frequency of MAGI compared with the patients with CBP alone. This was associated with worse sperm parameters and, hence, poorer reproductive prognosis. We suggest to search for the presence of IBS in the patients with PS and in particular when CBP and/or worse sperm parameters are present.