精子形态学分析在诊断男性不育症中的应用

目的探讨精子形态学分析在诊断男性不育症中的应用。方法选择2008年7月1日至2010年6月29日在英德市妇幼保健院就诊的不孕夫妇,男方至少行精液分析2次,在第一次精液分析时即进行精子形态学分析。精液分析采用JZF-Ⅰ型精液分析系统,精子形态学分析采用改良巴氏法染色,应用Microsort Excel进行分析。结果进行精液分析共402例次,进行精子形态学分析共173例次。精子密度0~180×109/L,平均(55.3±32.2)×109/L,75.1%的病例精液密度为20~100×109/L,仅13.3%为少精症,无精症占1.5%;a级精子为(14.0±9.9)%,b级精子为(10.6±7.8)%,a级+b级大于50%者仅占0.6%,超过半数的为30%~50%(51.1%),精子形态学分析,仅有20.5%病例是正常的(>14%)。结论无精症显然与不育相关,精子活动力低下或精子畸形率过高更能预示不孕因素,精液分析和精子形态学分析可以作为男性不育的首要筛查手段,以防止过度治疗。

Application of sperm morphology analysis in diagnosing male infertility

Objective To investigate the application of sperm morphology analysis to the diagnosis of male infertility.Methods The infertile couples in out-patient department from July 1,2008 to June 29,2010 were selected.All males underwent semen analysis for at least 2 times and sperm morphology analysis for 1 time.Results Total 402 cases of semen analysis and 173 cases of sperm morphology were analyzed.Sperm concentration was 0-180×109/L,with anaverage of（55.3± 32.21）×109/L,75.1% were with in 20-100×109/L,only 13.3% were oligozoospermia,and azoospermia accounted for 1.5%;51.1% of the cases had 30%-50% rapid progressive sperms（a grade＋b grade）,and only 0.6% were normal according to the WHO standard（a grade＋b grade50%）.Only 20.5% of the cases had14% normal sperm morphology.Conclusion Azoospermia is obviously related to infertility.Asthenospermia or high sperm deformity may predict the infertility factors.Analysis of semen and spermmorphology should be used as the fIrst screening method for out-patient infetile couples to prevent excessive treat ment.