James William H
The Galton Laboratory, University College London, Wolfson House, 4 Stephenson Way, London NW 1 2 HE, UK.
Hum Reprod. 2007 May;22(5):1197-9. doi: 10.1093/humrep/dem020. Epub 2007 Feb 15.
The Reprostat Steering Committee asks for the best monitors of reproductive health. In many European countries, some deleterious agents have caused declines over the past half-century in both dizygotic (DZ) twinning rates and sperm counts. No strong evidence suggests that these declines have reversed, though they may have ceased in some countries. Here attention is only directed at potential secular changes in the proximate biological determinants of fertility (ovulation, coitus, semen quality, fertilization, spontaneous fetal loss and 'dead time'). The most comprehensive biological monitor of reproductive health is the 'natural' DZ twinning rate (viz the rate of DZ twinning in the absence of any medical intervention around the time of conception). At present, natural DZ twins are augmented by twins produced by new techniques. So efforts should be made to estimate the annual numbers of these iatrogenic twins in each European country. Then it would be possible to follow the movements of each national natural DZ twinning rate, and thus to continue monitoring a useful measure of reproductive health that has been available in most European countries for many years. Efforts should be made to assess the sperm quality of volunteer donors in each European country.
前列腺增生研究指导委员会需要了解生殖健康的最佳监测指标。在许多欧洲国家，一些有害因素导致过去半个世纪里异卵双胞胎出生率和精子数量均有所下降。虽然在一些国家这些下降趋势可能已停止，但尚无有力证据表明下降趋势出现了逆转。本文仅关注生育的直接生物学决定因素（排卵、性交、精液质量、受精、自然流产和“等待时间”）可能存在的长期变化。生殖健康最全面的生物学监测指标是“自然”异卵双胞胎出生率（即在受孕前后未进行任何医学干预情况下的异卵双胞胎出生率）。目前，自然异卵双胞胎中新增了通过新技术产生的双胞胎。因此，应努力估算每个欧洲国家每年医源性双胞胎的数量。这样就有可能追踪各国自然异卵双胞胎出生率的变化，从而继续监测这一在大多数欧洲国家已沿用多年的生殖健康有用指标。应努力评估每个欧洲国家志愿捐献者的精子质量。
