Bar-Hava I, Perri T, Ashkenazi J, Shelef M, Ben-Rafael Z, Orvieto R
Department of Obstetrics and Gynecology, Rabin Medical Center, Golda Campus, Petah Tiqva, 49100, Israel.
Gynecol Endocrinol. 2000 Dec;14(6):433-6. doi: 10.3109/09513590009167715.
We assessed the value of requesting a second semen sample provided within 1 hour of the first in cases of unacceptable ejaculate quality (compared to previous occasions) or very poor semen characteristics. The study population consisted of 109 males with severe oligo-terato-astenospermic (OTA) syndrome in an assisted reproduction program. Semen volume, sperm count and sperm motility were recorded in the first and second samples with a Makler Counting Chamber before sperm processing, and total motile sperm in the ejaculate was calculated. Differences in sperm parameters between the consecutive samples were determined by paired-sample t test. In 36 cases (33%) the second sample was found to be superior in quality to the first and was therefore used for the fertilization process. Of the 12/109 cases in which the first ejaculate demonstrated no motile sperm, five (41%) had detectable motile sperm in the second (total 0.1 x 10(6), 0.2 x 10(6), 0.3 x 10(6), 8.4 x 10(6) and 20.8 x 10(6)). We conclude that a request for second ejaculate immediately after the first in males with poor semen quality or no detectable motile sperm can yield a better sample in a significant percentage of cases. Using this method, clinicians can avoid the utilization of elaborate sperm processing techniques and the need for unnecessary micromanipulative fertilization.
我们评估了在精液质量不可接受（与之前情况相比）或精液特征极差的情况下，要求在首次精液样本采集后1小时内提供第二次精液样本的价值。研究对象为109名参与辅助生殖项目的重度少弱畸精子症（OTA）综合征男性。在精子处理前，使用Makler计数室记录首次和第二次样本的精液体积、精子计数和精子活力，并计算射精中的总活动精子数。连续样本间精子参数的差异通过配对样本t检验确定。在36例（33%）中，发现第二次样本质量优于第一次，因此用于受精过程。在首次射精无活动精子的12/109例中，5例（41%）在第二次射精中有可检测到的活动精子（总数分别为0.1×10⁶、0.2×10⁶、0.3×10⁶、8.4×10⁶和20.8×10⁶）。我们得出结论，对于精液质量差或无可检测到的活动精子的男性，在首次射精后立即要求采集第二次射精样本，在相当比例的病例中可获得质量更好的样本。使用这种方法，临床医生可以避免使用复杂的精子处理技术以及不必要的显微操作受精。
