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弱精子症:大样本分析

Asthenozoospermia: analysis of a large population.

作者信息

Curi S M, Ariagno J I, Chenlo P H, Mendeluk G R, Pugliese M N, Sardi Segovia L M, Repetto H E H, Blanco A M

机构信息

Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquimica, UBA Hospital de Clińicas José de San Martin, Buenos Aires, Argentina.

出版信息

Arch Androl. 2003 Sep-Oct;49(5):343-9. doi: 10.1080/01485010390219656.

Abstract

Spermatozoa travel a long distance to meet and fertilize the oocyte, so sperm motility is a requisite for normal fertilization. Asthenozoospermia, or low sperm motility, is a common cause of human male infertility. This is a retrospective study (1992-1999) to document the prevalence of this pathology in infertile men and to clarify the probable factors associated to its etiology. The prevalence was 18.71% for asthenozoospermia and 63.13% for asthenozoospermia associated with oligo- and/or teratozoo-spermia; thus, 81.84% of the studied samples had altered motility. Leukocytospermia, the ratio of germ cells/sperm, anti-sperm antibodies, consistency, biochemical markers of accessory sex glands, and sperm response after swim-up were studied in normospermic (N), asthenozoospermic (A), and combined asthenozoospermic (C) samples. No significant difference was found in the frequency of leukocytospermia among groups. The rate of germ cells/(spermatozoa + germ cells) between C and N (p < .01) and C and A (p < .01) was statistically different, while no difference was found on comparing N and A. MAR-test over 40% was found in 6% of the A samples and 7.6% of the C, while no positive values were observed in the N group. The percentage of hyperviscous samples was higher in the low sperm motility samples than in the normal group. Data on concentration of the biochemical markers seem to be decreased in asthenozoospermia. Pure and combined asthenozoo-spermia showed different behavior in sperm recovery after swim-up. Two different asthenozoospermias could be defined: the pure one where sperm environment is involved (immunological factor, hyperviscosity, and secretory gland function) and the combined, where the testis is comprised.

摘要

精子需要长途跋涉才能与卵母细胞相遇并使其受精,因此精子活力是正常受精的必要条件。弱精子症,即精子活力低下,是男性不育的常见原因。这是一项回顾性研究(1992 - 1999年),旨在记录这种病理状况在不育男性中的患病率,并阐明与其病因相关的可能因素。弱精子症的患病率为18.71%,与少精子症和/或畸形精子症相关的弱精子症患病率为63.13%;因此,81.84%的研究样本存在活力改变。对正常精子样本(N)、弱精子症样本(A)和合并弱精子症样本(C)研究了白细胞精子症、生殖细胞/精子比例、抗精子抗体、精液黏稠度、附属性腺生化标志物以及上游后的精子反应。各组间白细胞精子症的发生率无显著差异。C组与N组(p <.01)以及C组与A组(p <.01)之间的生殖细胞/(精子 + 生殖细胞)比率存在统计学差异,而N组与A组比较无差异。在6%的A样本和7.6%的C样本中发现MAR试验值超过40%,而N组未观察到阳性值。低精子活力样本中高黏稠样本的百分比高于正常组。弱精子症患者生化标志物的浓度数据似乎有所下降。单纯性和合并性弱精子症在上游后的精子回收率方面表现不同。可以定义两种不同类型的弱精子症:单纯型,涉及精子环境(免疫因素、高黏稠度和分泌腺功能);合并型,涉及睾丸。

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