Mahmud Nusrat, Sharmin Eshita, Mamun Md Arif, Shamayeen Zayan, Rivadeneira Natalie, Rochat Roger, Mehta Akanksha
Department of Obstetrics and Gynaecology, Centre for Assisted Reproduction, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh.
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Indian J Urol. 2018 Jan-Mar;34(1):28-33. doi: 10.4103/iju.IJU_30_17.
The objective of this study was to analyze longitudinal changes in sperm parameters of Bangladeshi men. We hypothesized that semen parameters declined for this population.
We retrospectively analyzed semen data from men aged 18-64 years who sought care for general sperm quality or updates on fertility status at an infertility clinic in Dhaka, Bangladesh, from January 2000 to June 2016 ( = 13,953). Samples with incomplete data were excluded ( = 143). The WHO normal criteria and semen analysis procedures were used to evaluate parameters of the remaining 13,810 specimens. Samples with missing values on sperm concentration ( = 6187) were excluded from concentration analyses. Age and duration of abstinence at testing were recorded and adjusted for. Data were imported into SAS 9.4 statistical software. Temporal significance was investigated using one-way ANOVA for motility parameters and Chi-square test for raw concentration. Logistic regression analyzed the effects of confounders on azoospermia and raw concentration, while median regression modeling adjusted confounders for concentration, total motility, and rapid linear (RL) motility.
Age distribution was significantly correlated with annual parameter changes (concentration, total motility, and RL motility [ < 0.0001]). Adjusted total motility and RL motility declined by 20% from their maximum values to end of the study ( < 0.0001). Raw concentration lacked clear trends and was unaffected by adjustment. Azoospermia increased by 18% between the 2000-2010 and 2011-2016 participants (odds ratio = 0.16 [0.14-0.16]).
In agreement with the hypothesis, Bangladeshi males attending this clinic have experienced decline in semen parameters (total motility and RL motility) and increased frequency of azoospermia.
本研究的目的是分析孟加拉国男性精子参数的纵向变化。我们假设该人群的精液参数会下降。
我们回顾性分析了2000年1月至2016年6月在孟加拉国达卡一家不孕不育诊所寻求一般精子质量检查或生育状况更新的18 - 64岁男性的精液数据（n = 13,953）。数据不完整的样本被排除（n = 143）。采用世界卫生组织的正常标准和精液分析程序来评估其余13,810份标本的参数。精子浓度有缺失值的样本（n = 6187）被排除在浓度分析之外。记录并调整了检测时的年龄和禁欲时间。数据导入SAS 9.4统计软件。使用单因素方差分析研究活力参数的时间显著性，使用卡方检验研究原始浓度的时间显著性。逻辑回归分析混杂因素对无精子症和原始浓度的影响，而中位数回归模型调整混杂因素对浓度、总活力和快速直线（RL）活力的影响。
年龄分布与年度参数变化（浓度、总活力和RL活力[P < 0.0001]）显著相关。调整后的总活力和RL活力从最大值到研究结束下降了20%（P < 0.0001）。原始浓度缺乏明确趋势且不受调整影响。2000 - 2010年和2011 - 2016年参与者之间无精子症增加了18%（优势比 = 0.16 [0.14 - 0.16]）。
与假设一致，在这家诊所就诊的孟加拉国男性精液参数（总活力和RL活力）出现下降，无精子症频率增加。
