生育与不育男性精浆总抗氧化能力分析

目的:分析生育与不育男性精浆中总抗氧化能力(TAC)及其在男性生育中意义。方法:225例男性不育患者分为6组,分别为:梗阻性无精子症组(n=10),非梗阻性无精子症组(n=42),少精子症组(n=20),弱精子症组(n=78),少弱精子症组(n=57),以及正常精子症组(n=18)。28例正常生育男性作为对照(生育组)。分别采用计算机辅助精液分析(CASA)系统进行精液参数分析,采用比色法检测精浆TAC水平。结果:生育组男性精浆TAC为(19.82±6.33)U,梗阻性无精子症组(1.71±1.33)U,非梗阻性无精子症组(12.73±9.44)U,少精子症组(10.85±6.64)U,弱精子症组(13.88±8.24)U,少弱精子症组(11.20±7.02)U,正常精子症组(18.07±8.73)U;与生育组精浆TAC[(19.82±6.33)U]相比,在各不育症组中,除正常精子症组精浆TAC与生育组差异无显著性外,其余各组均显著低于生育组(P<0.01)。精浆TAC与精子密度(r=0.182,P<0.05)和a级精子(r=0.150,P<0.05)呈显著正相关。结论:精浆中TAC水平与男性不育密切相关,精浆中过低的TAC水平可能是引起男性不育的病因之一。     

两种精子分析系统的比较研究

目的:评估自动化精子质量分析仪SQA-V与计算机辅助精液分析(CASA)系统之间各主要参数的差异性及其在不育和生育男性精液质量分析中的应用。方法:用SQA-V和CASA系统分别检测12例正常生育者和73例不育患者新鲜精液标本,分别分析精子密度、精子活动率、活动精子浓度、精子活动力指数、精子头侧向位移、鞭打频率、精子曲线运动速度、精子前向运动速度、平均路径速度、直线性及前向性运动速度等参数,针对两者进行相关性分析。结果:不育组和生育组男性各项指标间存在显著差异,两种分析系统检测的精子密度之间(r=0.58,P<0.01)、活动精子浓度之间(r=0.75,P<0.01)、平均精子速度(SQA-V)和精子路径速度(CASA)之间(r=0.59,P<0.01)具有较好的一致性,SQA-V的活动精子指数(SMI)和CASA的前向性、曲线运动速度、精子运动的直线性、前向运动速度、平均路径速度、鞭打频率等参数具有显著相关性(P<0.05)。结论:SQA-V和CASA系统比较,在各主要参数上具有较好的一致性,能够反映临床不同组群患者精液的差异性。     

不育男性精浆酸性磷酸酶和锌与精液参数分析

目的:探讨不育男性精浆中酸性磷酸酶和锌水平与精子密度及精子活力的关系。方法:对21例正常生育男性、169例不育男性精浆中酸性磷酸酶和锌分别进行检测,并作白细胞染色计数。结果:①不论按精子密度分组或按精子活力分组,不育各组精浆中酸性磷酸酶含量明显低于正常对照组(P<0.01),但不育各组之间的差异无显著性意义(P>0.05);②不论按精子密度分组或按精子活力分组,不育各组精浆锌含量仅死精子症组低于正常对照组(P<0.05);③按精子密度分组,各组标本之间白细胞计数的差异用秩和检验分析,不育各组白细胞计数的平均秩次明显大于正常对照组(P<0.001);按精子活力分组,不育各组精浆白细胞计数均高于正常对照组(P<0.05),死精子症组除外(P>0.05)。④精浆中酸性磷酸酶及锌含量均与白细胞计数不相关(r=0.088,P=0.162;r=0.119,P=0.057)。结论:精浆中酸性磷酸酶水平下降和白细胞增多均可导致精子密度和精子活力降低,可作为男性不育的诊断指标;不育患者精浆中锌离子水平虽然低于正常对照组,但无显著性差异。     

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。     

不育男性抗苗勒管激素与生殖激素及精液质量参数关系的研究

目的探讨男性不育患者精浆和血清抗苗勒管激素(AMH)与血清生殖激素及精液参数之间关系。方法选取2018年9~12月于我院生殖中心就诊的男性不育患者107例,按照《世界卫生组织人类精液检查与处理实验室手册(第五版)》操作规范检测精液体积、精子浓度、前向运动精子(PR)百分比、精子顶体酶、精子DNA完整性、正常形态精子率,根据精液参数分为4组:少精子症组(n=15)、弱精子症组(n=26)、少弱精子组(n=31)、正常精子组(n=35),比较各组患者精浆和血清AMH及血清FSH、LH、催乳素(PRL)、T、E 2之间的差异,并对精浆和血清AMH与生殖激素及精液参数的相关性进行统计分析。结果弱精子症组血清AMH水平高于其他3组,但各组间差异无统计学意义(P>0.05);正常精子组精浆AMH水平[中位数(四分位距)]为1.28(7.71)ng/ml,显著高于少精子症组[0.11(1.26)ng/ml]和少弱精子组[0.16(2.15)ng/ml](P<0.05)。相关性分析显示,血清AMH与生殖激素及精液参数不存在相关(P>0.05);精浆AMH与血清FSH、LH呈负相关(P<0.05),与血清T呈正相关(P<0.05);精浆AMH与精子总数、精子浓度、PR%呈正相关(P<0.05),与其他精液参数不相关(P>0.05)。结论不育男性精浆AMH与血清生殖激素及精子浓度、活力具有一定的相关性,一定程度上反映睾丸生精功能,对男性不育的诊断和治疗有一定的参考作用。     

miR-34b在男性不育患者精浆中的表达及其临床意义

目的研究精浆游离miR-34b在体外不同条件下的稳定性及其与男性不育症患者精液参数的关系。方法选取男性不育症患者80例和同期因女方因素不孕前来检查的生育力评估正常的健康男性20例为正常对照组,将8例正常的精液标本分别在室温和-80℃下放置,以不同时间点检测精浆miR-34b的稳定性。采用实时荧光定量PCR检测精浆游离miR-34b的相对含量,精子浓度及精子活力用计算机辅助精子分析系统,精子存活率采用低盐膨胀实验检测,正常精子形态百分率采用Diff-Quick染色法。分析男性不育症组和正常对照组精液参数及miR-34b表达量的差异,对精浆游离rniR-34b在男性不育组精浆中的诊断价值进行ROC曲线分析,并采用Pearson直线相关分析miR-34b与男性不育组精液各参数的相关性。结果精浆游离miR-34b在室温和低温下不同时间点表达量无明显变化(F=0.13,P=0.97;F=0.35,P=0.84)。与正常组比较发现,男性不育组精浆游离miR-34b表达下调(P0.01)。两组的精子浓度、精子存活率、前向运动精子百分率(PR)和正常形态精子百分率均有差异(P0.01)。ROC曲线显示miR-34b能够较好的区分不育组与健康对照组,曲线下面积分比(AUC)为0.85(0.79-0.95,95%)。Pearson直线相关分析发现男性不育患者精浆miR-34b表达量与精子密度(r=0.28,P0.05)、精子活率(r=0.56,P0.01)、前向运动精子百分率(r=0.41,P0.01)正相关,与精子形态无相关性(r=O.15,P0.05)。结论精浆miR-34b在室温下稳定,并能在-80℃条件下长期保存,在男性不育患者精浆中表达下调,并与精子浓度、精子存活率、前向运动精子百分率呈正相关,与精子形态无相关性。     

男性不育病人精液中磷脂酶A2的测定及其临床意义

目的 :探讨人精液中磷脂酶A2 (PLA2 )含量测定在男性不育症中的临床意义。　方法 :以自制的 2株PLA2单克隆抗体建立酶联免疫吸附试验 (ELISA)、免疫细胞化学法 (ICC)和流式细胞术 (FCM)等 3种方法 ,分别检测男性不育病人精浆及精子头部PLA2的含量 ,并与生育组进行比较。精液常规分析采用计算机辅助精液分析系统 (CASA)进行。　结果 :男性不育病人精浆中PLA2含量分别为 :无精子症组 (31.13± 14 .4 9)ng ml,少精子症组 (17.71±12 .4 5 )ng ml,精子数目正常组 (16 .4 6± 11.31)ng ml;与生育组 [(8.0 9± 3.15 )ng ml]相比差异均有极显著性 (P <0 .0 1) ;精浆中PLA2含量与精子密度呈显著负相关 (r=- 0 .6 0 2 ,P <0 .0 5 ) ,而与精子活动力及活率无显著相关性 (r=0 .2 6 6和r=- 0 .2 0 0 ,P均 >0 .0 5 ) ;ICC和FCM试验均提示 ,生育组精子头部PLA2含量显著高于各不育组病人 ,且FCM试验显示差异有极显著性 (P <0 .0 1)。　结论 :精浆中PLA2与男性生育密切相关 ,精子头部PLA2含量缺乏可能是引起男性不育的病因之一。精液中PLA2含量测定方法的建立可为探讨男性不育的发病机制提供有力的依据。     

精索静脉曲张不育患者精浆颗粒溶素与精液质量的相关性分析

目的探讨颗粒溶素在精索静脉曲张(VC)患者精液的表达水平及临床意义。方法选择2016年9月至2017年7月在本院就诊的80例男性不育患者作为观察组,其中45例为原发性VC(VC不育组),35例患者不合并VC(非VC不育组)。同时,本研究选取30例健康男性为可育对照组。检测所有入组精液精子密度、精子活动率、精子正常形态比例以及颗粒溶素的表达水平。结果VC不育患者精浆颗粒溶素的表达水平均显著高于可育对照组;此外,与非VC不育患者相比较,VC不育患者精浆颗粒溶素水平更高;精浆颗粒溶素的表达与精子浓度(r=-0.364,P<0.001)、精子活力(r=-0.397,P<0.001)和精子正常形态(r=-0.441,P<0.001)均呈负相关。结论不育合并VC患者精浆颗粒溶素表达水平显著高于正常健康人群,且其表达水平与VC等级密切相关。     

溶脲脲原体引起男性不育的机理研究——Ⅱ.对精子运动的影响

本研究观察了正常生育男性与精液溶脲脲原体培养阳性的不育男性的精子运动。用比浊法比较了两组男性精液中快速运动精子的百分率与其平均速度。此外,用血清型4溶脲脲原体人工感染正常生育男性的精子。结果表明,不育男性快速运动精子的百分率与平均速度均显著低于正常生育男性;而正常生育男性的精子受血清型4溶脲脲原体感染后,精子的活率及活力的下降。提示溶脲脲原体(血清型4)对人精子的运动具有抑制作用,可能是造成男性不育的一个因素。     

司机职业对男性不育患者精子活力和动力学参数的影响及相关性研究

目的 探讨乌鲁木齐地区司机职业对男性不育患者精子活力和动力学参数的影响及相关性研究.方法 应用WLJY-9000型精子质量检测系统对157例不育男性(司机组72例、非司机组85例)和125例正常生育男性精子的直线运动速度(VSL)、曲线速度(VCL)、平均路径速度(VAP)、平均移动角度(MAD)、侧摆幅度(ALH)、鞭打频率(BCF)、前向性(STR)、直线性(LIN)、摆动性(WOB)精子活力及其分级进行检测并分析其相关性.结果 不育组与正常生育组相比,精子活力、VSL、VCL、VAP、LIN和STR显著降低(P<0.05或P<0.01);司机组与非司机组相比,精子活力、VSL、VCL、VAP和MAD显著降低(P<0.05或P<0.01),而BCF显著升高(P<0.01);驾龄10年～组与0年～和5年～两组相比,精子活力、VSL、VCL、VAP、MAD、LIN、WOB和STR显著降低(P<0.05或P<0.01),而BCF显著升高(P<0.01);司机职业男性不育患者精子活力与VSL、VCL、VAP有显著正相关性,而与BCF有显著负相关性.结论 (1)司机职业可引起男性精子活力和动力学参数异常,驾车车龄对男性精子质量的影响存在时效关系,长时间驾车可能是引起男性不育的重要原因之一;(2)VSL、VCL、VAP和BCF是反映司机职业不育男性精子活力的有效指标.     

Assessment of seminal plasma laminin in fertile and infertile men

Aim： To assess laminin levels in the seminal plasma of infertile and fertile men, and to analyze the correlation of laminin levels with sperm count, age, sperm motility and semen volume. Methods： One hundred and twenty-five recruited men were equally divided into five groups according to their sperm concentration and clinical examination： fertile normozoospermia, oligoasthenozoospermia, non-obstructive azoospermia （NOA）, obstructive azoospermia （OA） and congenital bilateral absent vas deferens （CBAVD）. The patients＇ medical history was investigated and patients underwent clinical examination, conventional semen analysis and estimation of seminal plasma laminin by radioimmunoassay. Results： Seminal plasma laminin levels of successive groups were： 2.82 ± 0.62, 2.49 ± 0.44, 1.77 ± 0.56, 1.72 ± 0.76, 1.35 ± 0.63 U/mL, respectively. The fertile normozoospermic group showed the highest concentration compared to all infertile groups with significant differences compared to azoospermic groups （P 〈 0.05）. Testicular contribution was estimated to be approximately one-third of the seminal laminin. Seminal plasma laminin demonstrated significant correlation with sperm concentration （r = 0.460, P 〈 0.001） and nonsignificant correlation with age （r = 0.021, P = 0.940）, sperm motility percentage （r = 0.142, P = 0.615） and semen volume （r = 0.035, P = 0.087）. Conelusion： Seminal plasma laminin is derived mostly from prostatic and testicular portions and minimally from the seminal vesicle and vas deferens. Estimating seminal laminin alone is not conclusive in diagnosing different cases of male infertility.     

Comparison of zinc concentrations in blood and seminal plasma and the various sperm parameters between fertile and infertile men

The aim of the study was to examine the relationships between concentrations of zinc in blood and seminal plasma and sperm quality among infertile and fertile men. One hundred seven male (infertile group) partners of couples who were undergoing investigation for infertility with no known cause for the infertility and 103 men (fertile group) whose wives were pregnant at the time of the study were recruited. The subjects' blood and seminal plasma concentration of zinc were determined by atomic absorption spectroscopy. Except for semen volume, all the other semen parameters for the infertile men were significantly lower than those for the fertile group. The geometric means of the seminal plasma zinc concentration were significantly lower in the infertile group compared with those in the fertile group; 183.6 mg/L (range, 63-499) versus 274.6 mg/L (range, 55-420). There were no significant differences in the geometric means of the blood zinc concentration between the 2 groups. Seminal plasma zinc concentration was significantly correlated with sperm density (r = 0.341, P < .0001), motility (r = 0.253, P < .0001), and viability (r = 0.286, P < .0001). On the basis of the findings of this study and those of other reports, zinc may contribute to fertility through its positive effect on spermatogenesis.     

Total anti-oxidant status: a biochemical predictor of human male fertility

The objective of the study was to assess whether seminal plasma total antioxidant status (TAS) can be used as a biochemical predictor of male fertility and its variation in different categories of infertile male subjects in our population. The study population consisted of 28 fertile and 127 infertile [teratozoospermic (30), asthenoteratozoospermic (30), azoospermic (21), oligoastheno-teratozoospermic (20), polyzoospermic (15) and oligozoospermic (11)] male subjects. Seminal plasma was separated by centrifugation and stored at minus 80 degree Celsius. Semen was analysed using computer-assisted semen analysis according to WHO criteria. Seminal plasma TAS was estimated by colorimetric method using Randox total antioxidant status kit. TAS of fertile male subjects was significantly (P < 0.001) higher than that of infertile patients. In whole studied population, seminal plasma TAS showed a significant positive correlation with sperm concentration (P < 0.001), sperm motility (P < 0.0001), and spermatozoa with normal morphology (P < 0.0001). In conclusion, this study suggests that TAS of seminal plasma is one of the important factors contributing to male infertility, and it can be used as a biochemical predictor for male fertility.     

Assessment of seminal granulysin in infertile men with varicocele

Varicocele has a common association with male infertility, but its exact role is still debated. Apoptosis has been suggested as one of the mechanisms of varicocele‐associated infertility. Granulysin is a molecule that plays a role in apoptosis with no previous study about its role in male infertility. This case‐controlled study aimed to assess seminal plasma granulysin level in infertile patients with varicocele. This study involved 90 men that were allocated into fertile normozoospermic men (n = 20), infertile men without varicocele (n = 30) and infertile men with varicocele (n = 40). These men were subjected to history taking, clinical examination, semen analysis and estimation of seminal granulysin. In general, seminal granulysin level was significantly elevated in infertile men compared with fertile men. Infertile men with varicocele showed significantly higher seminal granulysin compared with infertile men without varicocele, in bilateral varicocele cases and in grade III varicocele. Seminal granulysin level was negatively correlated with sperm concentration, sperm motility, sperm normal forms percentage and testicular volumes. It is concluded that increased seminal granulysin has a negative impact on spermatogenesis in infertile men in general and in infertile men associated with varicocele in particular.     

Seminal plasma anti-Müllerian hormone level correlates with semen parameters but does not predict success of testicular sperm extraction (TESE)

AIM: To assess seminal plasma anti-Müllerian hormone (AMH) level relationships in fertile and infertile males. METHODS: Eighty-four male cases were studied and divided into four groups: fertile normozoospermia (n = 16), oligoasthenoteratozoospermia (n = 15), obstructive azoospermia (OA) (n = 13) and non-obstructive azoospermia (NOA) (n = 40). Conventional semen analysis was done for all cases. Testicular biopsy was done with histopathology and fresh tissue examination for testicular sperm extraction (TESE) in NOA cases. NOA group was subdivided according to TESE results into unsuccessful TESE (n = 19) and successful TESE (n = 21). Seminal plasma AMH was estimated by enzyme linked immunosorbent assay (ELISA) and serum follicular stimulating hormone (FSH) was estimated in NOA cases only by radioimmunoassay (RIA). RESULTS: Mean seminal AMH was significantly higher in fertile group than in oligoasthenoteratozoospermia with significance (41.5 +/- 10.9 pmol/L vs. 30.5 +/- 10.3 pmol/L, P < 0.05). Seminal AMH was not detected in any OA patients. Seminal AMH was correlated positively with testicular volume (r = 0.329, P = 0.005), sperm count (r = 0.483, P = 0.007), sperm motility percent (r = 0.419, P = 0.021) and negatively with sperm abnormal forms percent (r = -0.413, P = 0.023). Nonsignificant correlation was evident with age (r = -0.155, P = 0.414) and plasma FSH (r = -0.014, P = 0.943). In NOA cases, seminal AMH was detectable in 23/40 cases, 14 of them were successful TESE (57.5%) and was undetectable in 17/40 cases, 10 of them were unsuccessful TESE (58.2%). CONCLUSION: Seminal plasma AMH is an absolute testicular marker being absent in all OA cases. However, seminal AMH has a poor predictability for successful testicular sperm retrieval in NOA cases.     

Effect of smoking on seminal plasma ascorbic acid in infertile and fertile males

This work aimed to assess the relationship of seminal ascorbic acid levels with smoking in infertile males. One hundred and seventy men were divided into four groups: nonobstructive azoospermia [NOA: smokers (n = 20), nonsmokers (n = 20)]; oligoasthenozoospermia [smokers (n = 30), nonsmokers (n = 20)]; asthenozoospermia [smokers (n = 20), nonsmokers (n = 20)] and normozoospermic fertile men [smokers (n = 20), nonsmokers (n = 20)]. The patients underwent medical history, clinical examination, conventional semen analysis and estimation of ascorbic acid in the seminal plasma calorimetrically. There was a significant decrease in the mean seminal plasma ascorbic acid levels in smokers versus nonsmokers in all groups (mean +/- SD; 6.03 +/- 2.18 versus 6.62 +/- 1.29, 7.81 +/- 1.98 versus 9.44 +/- 2.15, 8.09 +/- 1.98 versus 9.95 +/- 2.03, 11.32 +/- 2.15 versus 12.98 +/- 12.19 mg dl(-1) respectively). Fertile subjects, smokers or not, demonstrated significant higher seminal ascorbic acid levels than any infertile group. Seminal plasma ascorbic acid in smokers and nonsmokers was correlated significantly with sperm concentration (r = 0.59, 0.60, P < 0.001), sperm motility (r = 0.65, 0.55, P < 0.001) and negatively with sperm abnormal forms per cent (r = -0.53, -0.50, P < 0.001). Nonsignificant correlations were elicited with semen volume (r = 0.2, 0.09) or liquefaction time (r = 0.03, 0.06). It is concluded that seminal plasma ascorbic acid decreased significantly in smokers and infertile men versus nonsmokers and fertile men, and is significantly correlated with the main sperm parameters: count, motility and normal morphology. Also, cigarette smoking is associated with reduced semen main parameters that could worsen the male fertilizing potential, especially in borderline cases.     

Soluble Fibrinogen-like protein 2 plays a role in varicocele induced male infertility

Varicocele is the most common cause of male infertility. Several theories have been proposed to explain how varicocele induces infertility. The role of epididymis in male infertility is not fully well established. Fibrinogen-like protein 2 is one of serine proteases and is a potent coagulant in membranous form and immune-modulator in soluble form (sFGL-2) and expressed in the epididymis. There are no previous reports about its possible role in varicocele. This case-controlled study aimed to evaluate the seminal level of sFGL-2 in infertile men with varicocele and in men with idiopathic infertility. This study included 85 participants divided into three groups; 25 normal fertile men, 30 infertile men with varicocele and 30 infertile men of idiopathic cause. Clinical examination, Doppler ultrasound, semen analysis and measurement of seminal level of sFGL-2 were done to all participants. Seminal level of sFGL-2 was significantly elevated in infertile than normal fertile men. Seminal level of sFGL-2 showed negative correlations with sperm concentration, motility and normal morphology. Seminal level of sFGL-2 had a positive correlation with seminal liquefaction time. This study concluded that seminal level of sFGL-2 is increased in infertile men with idiopathic cause and with varicocele induced infertility and affects seminal liquefaction.