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丹麦年轻男性精液质量的长期及季节性变化:对1977年至1995年间1927名供精候选人精液样本的统计分析

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

作者信息

Gyllenborg J, Skakkebaek N E, Nielsen N C, Keiding N, Giwercman A

机构信息

University Department of Growth and Reproduction, Rigshospitalet 5064, Copenhagen, Denmark.

出版信息

Int J Androl. 1999 Feb;22(1):28-36. doi: 10.1046/j.1365-2605.1999.00137.x.

Abstract

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.

摘要

本研究的目的是通过使用多元回归和方差分析来分析精液质量与时间和季节相关的变化,调查1977年至1995年间一组未经挑选的精液捐献候选者的精液质量是否发生了变化,并确定精液质量是否存在季节性变化。该研究基于对1977年至1995年期间哥本哈根1927名精液捐献候选者提供的第一份精液样本的分析,测定了精液体积、精子浓度、精子总数、活动精子百分比以及半定量精子活力评分。以年份、禁欲时间和季节作为协变量的多元线性回归分析显示,平均精子浓度从1977年的53.0×10⁶/mL显著增加到1995年的72.7×10⁶/mL(p<0.0001),平均精子总数从166.0×10⁶增加到227.6×10⁶(p<0.0001)。平均精液体积和活动精子百分比没有变化。精子活力下降,因为在1977 - 1980年期间,74.2%的样本中的精子具有优秀的活力,而在1993 - 1995年期间只有41.9%(χ² = 130.0,p<0.0001)。方差分析显示,季节之间在精子浓度(p<0.0001)和精子总数(p<0.0001)方面存在显著差异。春季的精子计数最高,平均浓度(95%置信区间)为77.6×10⁶/mL(71.9 - 83.7),夏季最低,平均为57.5×10⁶/mL(50.1 - 65.4)。没有其他精液参数随季节变化。得出的结论是,在1977年至1995年期间,一组丹麦精液捐献候选者的精子计数增加,而精子活力下降。由于该研究的回顾性设计以及捐献者的匿名性,我们无法控制捐献者年龄的变化,并且我们不能排除一些候选捐献者被哥本哈根其他精液捐献服务机构接受为捐献者而被挑选出来的可能性。考虑到这些局限性,我们建议应谨慎解释我们的结果,并将其视为对关于精子质量是否持续下降的持续争议的一项贡献。在精子浓度和精子总数中发现的季节性变化很明显,并且不能归因于禁欲时间长度的季节性差异。此外,在连续的五个年份区间中观察到了相同的季节性模式。这些发现强烈表明,人类睾丸功能受季节影响,这一现象在许多低等哺乳动物中是众所周知的。

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