Andrology Unit of the Department of Urology, Erasmus MC Rotterdam, Rotterdam, the Netherlands.
Fertil Steril. 2010 Oct;94(5):1748-52. doi: 10.1016/j.fertnstert.2009.10.030. Epub 2009 Dec 11.
To establish the diagnostic value of sperm chromatin structure assessment for the evaluation of male factor infertility, in addition to conventional andrological workup.
Cross-sectional controlled study.
A tertiary referral andrology clinic.
PATIENT(S): Two hundred seventy-nine male partners of infertile couples.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): The DNA fragmentation index (DFI) determined by the sperm chromatin structure assay (SCSA), semen parameters, serum levels of reproductive hormones, and World Health Organization (WHO) classification of male factor subfertility.
RESULT(S): In all patient categories, except those including patients with hypogonadotrophic hypogonadism, sperm antibodies, or normospermia, DFI was significantly higher compared with in proven fertile controls. After classification of the quality of spermatogenesis based on mean testicular volume (<10 ml vs. >15 ml), follicle stimulating hormone (FSH; > 10 U/L vs. <5 U/L), and inhibin-B (<100 nmol/L vs. >150 nmol/L), the DFI was significantly higher in patients with poor spermatogenesis (35.9%) than in patients with normal spermatogenesis (25.9%). In a multiple regression analysis, the teratozoospermia index, sperm vitality, and FSH were significant determinants of the DFI level. Male age was associated with DFI, but leukocytospermia, body mass index, and smoking were not confounders of DFI.
CONCLUSION(S): Impaired spermatogenesis, irrespective of the WHO classification of male factor subfertility, is generally associated with an increase of sperm DNA damage.
除了传统的男科检查外，建立精子染色质结构评估对男性因素不孕的诊断价值。
横断面对照研究。
一家三级转诊男科诊所。
279 对不孕夫妇的男性伴侣。
无。
精子染色质结构分析（SCSA）确定的 DNA 碎片指数（DFI）、精液参数、生殖激素血清水平和世界卫生组织（WHO）男性因素亚生育力分类。
在所有患者类别中，除了包括低促性腺激素性性腺功能减退症、精子抗体或正常精子症患者外，DFI 均明显高于证实的正常生育对照组。根据平均睾丸体积（<10 ml 与>15 ml）、卵泡刺激素（FSH；> 10 U/L 与<5 U/L）和抑制素-B（<100 nmol/L 与>150 nmol/L）对生精质量进行分类后，DFI 在生精不良患者（35.9%）中明显高于生精正常患者（25.9%）。在多元回归分析中，畸形精子指数、精子活力和 FSH 是 DFI 水平的重要决定因素。男性年龄与 DFI 相关，但白细胞精子症、体重指数和吸烟不是 DFI 的混杂因素。
无论男性因素亚生育力的 WHO 分类如何，受损的生精功能通常与精子 DNA 损伤增加有关。
