上海地区正常生育力男性精液参考值初探

目的:回顾分析上海地区志愿捐精者与正常生育力男性精液分析各项主要参数的分布特征,比较两组男性精液质量的差别,探讨上海地区男性精液参数的正常参考值下限。方法:2010年10月至2011年7月上海市人类精子库招募正常生育力男性41例,健康捐精者100例,按《世界卫生组织人类精液检查与处理实验室手册》(第5版)进行精液常规检测,评估精液体积、精子浓度、前向运动(PR)精子百分率、精子总数和PR精子总数的均值,标准差,并进行t检验。同时统计正常生育力组上述各参数的分布,得出精液特征参数的正常参考值下限。结果:健康捐精组与正常生育力组精液常规各项主要参数(精液体积、精子浓度、PR精子百分率、精子总数、PR精子总数)间差异无统计学意义(P<0.05)。上海地区正常生育力男性精液参考值下限(P<0.05)为:浓度≥27.3×106/ml、PR≥8.1%、体积≥0.82 ml、精子总数≥44.73×106/1次射精、PR精子总数≥24.68×106/1次射精。结论:在评估男性生育力时,精子总数和PR精子总数可能是比精子浓度、精液体积和PR精子百分数更具参考价值的评价指标。

Reference values of semen parameters for normal fertile men in Shanghai

Objective: To analyze the distribution characteristics of the main semen parameters of healthy semen donors and normal fertile men in Shanghai,compare the semen quality between the two groups,and investigate the normal reference values of the semen parameters of the fertile population in Shanghai.Methods: We obtained semen samples from 100 healthy donors and 41 fertile men,performed semen analyses according to the WHO(2010) guidelines,and determined the semen volume,sperm concentration,sperm progressive motility,total sperm count and total progressively motile sperm count.We analyzed the distribution of the semen parameters of the normal fertile men,and obtained the lower limits of their normal reference values.Results: There were no statistically significant differences in the main semen parameters between the healthy donors and normal fertile men(P<0.05).The lower reference limits for the semen parameters of normal fertile men in Shanghai(P<0.05) were as follows: sperm concentration ≥ 27.3×106/ml,sperm progressive motility ≥ 8.1%,semen volume ≥ 0.82 ml,total sperm count ≥ 44.73×106 per ejaculate,and total progressively motile sperm count ≥ 24.68 × 106 per ejaculate.Conclusion: For the evaluation of male fecundity,total sperm count and total progressively motile sperm count may be two better predictors than others.