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输精管切除术前人群中精液参数异常的比例较高。

High percentage of abnormal semen parameters in a prevasectomy population.

作者信息

Pasqualotto Fábio Firmbach, Sobreiro Bernardo Passos, Hallak Jorge, Athayde Kelly Silveira, Pasqualotto Eleonora Bedin, Lucon Antônio Marmo

机构信息

Divisão de Clínica Urológica, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.

出版信息

Fertil Steril. 2006 Apr;85(4):954-60. doi: 10.1016/j.fertnstert.2005.09.032.

Abstract

OBJECTIVE

To evaluate semen characteristics, testicular volume, and hormonal levels of normal fertile men requiring vasectomy for sterilization.

DESIGN

Retrospective study.

SETTING(S): Academic medical centers.

PATIENT(S): A total of 889 patients underwent a vasectomy for sterilization.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Semen volume, sperm concentration, motility, and morphology according to the World Health Organization (WHO); complex motion parameters evaluated by computer-assisted semen analyzer; FSH, LH, and T levels; and both testicular volumes.

RESULT(S): When compared with the WHO values, 87.2% of the patients presented normal sperm morphology below the normal level. The other semen parameters (semen volume, pH, sperm concentration, and sperm motility) differed from the WHO parameters in 6%-32.2% of patients. Semen volume and sperm concentration presented a progressive increase according to the duration of sexual abstinence. However, patients with 5 days or more of abstinence had a decrease in sperm motility. Mean testicular size had the strongest correlation with serum FSH levels, total sperm count, and sperm concentration.

CONCLUSION(S): Low sperm motility and morphology were found in men who request a vasectomy for sterilization. Semen volume and sperm concentration present a progressive increase and sperm motility a decrease according to the duration of sexual abstinence. Sperm concentration had stronger correlations with testicular size than did sperm quality. Therefore, the WHO normal values need to be reconsidered.

摘要

目的

评估因绝育而需要进行输精管切除术的正常生育男性的精液特征、睾丸体积和激素水平。

设计

回顾性研究。

地点

学术医疗中心。

患者

共有889例患者接受了绝育输精管切除术。

干预措施

无。

主要观察指标

根据世界卫生组织(WHO)标准的精液量、精子浓度、活力和形态;通过计算机辅助精液分析仪评估的复合运动参数;促卵泡激素(FSH)、促黄体生成素(LH)和睾酮(T)水平;以及双侧睾丸体积。

结果

与WHO标准值相比,87.2%的患者精子形态正常但低于正常水平。其他精液参数(精液量、pH值、精子浓度和精子活力)在6%-32.2%的患者中与WHO标准不同。精液量和精子浓度根据禁欲时间呈逐渐增加趋势。然而,禁欲5天或更长时间的患者精子活力下降。平均睾丸大小与血清FSH水平、总精子计数和精子浓度的相关性最强。

结论

因绝育而要求进行输精管切除术的男性存在精子活力和形态较低的情况。精液量和精子浓度根据禁欲时间呈逐渐增加趋势,而精子活力则下降。精子浓度与睾丸大小的相关性比精子质量更强。因此,需要重新考虑WHO的正常标准值。

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