在前来进行不孕评估的男性中，哪种孤立的精子异常与精子DNA损伤最为相关？
Which isolated sperm abnormality is most related to sperm DNA damage in men presenting for infertility evaluation.
作者信息
Belloc Stephanie, Benkhalifa Moncef, Cohen-Bacrie Martine, Dalleac Alain, Chahine Hikmat, Amar Edouard, Zini Armand
机构信息
Laboratoire d'Eylau-Unilabs, 55 rue Saint Didier, 75116, Paris, France.
出版信息
J Assist Reprod Genet. 2014 May;31(5):527-32. doi: 10.1007/s10815-014-0194-3. Epub 2014 Feb 25.
BACKGROUND
Sperm DNA damage is common in infertile men and is associated with poor semen parameters but the impact of an isolated sperm abnormality on sperm DNA damage has not been studied.
OBJECTIVE
To evaluate sperm DNA damage in a large cohort of infertile men with isolated sperm defects.
DESIGN, SETTING AND PARTICIPANTS: Retrospective study of 1084 consecutive, non-azoospermic infertile men with an isolated sperm defect: isolated oligozoospermia (iOligo), isolated asthenozoospermia (iAstheno) or isolated teratozoospermia (iTerato).
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS
We examined and compared clinical parameters, conventional semen parameters and %sperm DNA fragmentation (%SDF, assessed by flow cytometry-based Terminal deoxynucleotidyl transferase-mediated dUTP Nick End-Labeling assay) in the three groups of men.
RESULTS AND LIMITATIONS
The mean (±SD) %SDF was significantly higher in the iAstheno compared to the iOligo and iTerato groups (25.0 ± 14.0 vs. 19.2 ± 11.6 and 20.7 ± 12.1 %, respectively, P < 0.0001). Similarly, the proportion of men with high %SDF (>30 %) was significantly higher in the iAstheno compared to the iOligo and iTerato groups (31 % vs. 18 % and 19 %, respectively, P < 0.0001). In the group of 713 men with iAstheno, %SDF was positively correlated with paternal age (r = 0.20, P < 0.0001) and inversely correlated with %progressive motility (r = -0.18, P < 0.0001). In the subset of 218 men with iTerato, %SDF was also positively correlated with paternal age (r = 0.15, P = 0.018) and inversely correlated with %progressive motility (r = -0.26, P = 0.0001).
CONCLUSIONS
In this large cohort of infertile men with isolated sperm abnormalities, we have found that the sperm DNA fragmentation level is highest in the men with sperm motility defects and that 31 % of these men have high levels of sperm DNA fragmentation. The data indicate that poor motility is the sperm parameter abnormality most closely related to sperm DNA damage.
背景
精子DNA损伤在不育男性中很常见，且与精液参数不佳有关，但孤立的精子异常对精子DNA损伤的影响尚未得到研究。
目的
在一大群患有孤立精子缺陷的不育男性中评估精子DNA损伤情况。
设计、地点和参与者：对1084例连续的、非无精子症的不育男性进行回顾性研究，这些男性患有孤立的精子缺陷：孤立性少精子症（iOligo）、孤立性弱精子症（iAstheno）或孤立性畸形精子症（iTerato）。
结果测量和统计分析
我们检查并比较了三组男性的临床参数、常规精液参数以及精子DNA碎片率（%SDF，通过基于流式细胞术的末端脱氧核苷酸转移酶介导的dUTP缺口末端标记法评估）。
结果与局限性
与iOligo组和iTerato组相比，iAstheno组的平均（±标准差）%SDF显著更高（分别为25.0±14.0%、19.2±11.6%和20.7±12.1%，P<0.0001）。同样，与iOligo组和iTerato组相比，iAstheno组中%SDF高（>30%）的男性比例显著更高（分别为31%、18%和19%，P<0.0001）。在713例iAstheno男性组中，%SDF与父亲年龄呈正相关（r = 0.20，P<0.0001），与前向运动精子百分比呈负相关（r = -0.18，P<0.0001）。在218例iTerato男性子集中，%SDF也与父亲年龄呈正相关（r = 0.15，P = 0.018），与前向运动精子百分比呈负相关（r = -0.26，P = 0.0001）。
结论
在这一大群患有孤立精子异常的不育男性中，我们发现精子运动缺陷男性的精子DNA碎片水平最高，且这些男性中有31%的人精子DNA碎片水平较高。数据表明，精子活力差是与精子DNA损伤最密切相关的精子参数异常。
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