Kamkar Narges, Ramezanali Fariba, Sabbaghian Marjan
Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O. Box: 16635-148, Tehran, Iran.
Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education Culture and Research, Tehran, Iran.
Reprod Biol. 2018 Dec;18(4):330-335. doi: 10.1016/j.repbio.2018.11.002. Epub 2018 Nov 14.
More than two consecutive miscarriages in less than 20 weeks of gestation is defined as recurrent spontaneous miscarriage. Various causes such as uterine anatomical anomalies, genetic factors, and infectious and endocrine disorders have been reported for RPL. However, approximately 50% of the causes are unknown, which can be due to male factors. Several studies have been done on semen parameters to determine the unknown causes and risk factors for miscarriages, however, only studying common semen parameters have not been sufficient. In this study, the relationship between sperm DNA fragmentation, the amount of free radicals, and total antioxidant capacity (TAC) in semen have been considered as a risk factor for spontaneous miscarriage. Semen samples were collected from 42 men whose partners had a history of spontaneous miscarriage and 42 fertile men as the control group. Volume, pH, viscosity, concentration, and motility of semen, as well as sperm morphology were measured. Sperm DNA fragmentation was analyzed by the sperm chromatin structure assay (SCSA) and TUNEL methods, the amount of sperm free radicals was measured by the luminescence method and the total amount of semen antioxidant was measured using the TAC kit. The results have shown that sperm motility in the experimental group was significantly less than the control group (P = 0.001). The percentage of sperm DNA fragmentation and the amount of free radicals in the experimental group were significantly higher than the control group (P < 0.001). The total amount of antioxidant was lower in the experimental group compared to the control. Spouses of men with lower sperm motility and higher DNA fragmentation had a higher chance of spontaneous miscarriage when compared to the control group. The results of this study support the hypothesis that sperm DNA fragmentation is a major contributor to spontaneous miscarriage. The relationship between SDF, ROS and TAC with RPL.
妊娠20周内连续发生两次以上流产被定义为复发性自然流产。复发性流产（RPL）有多种原因，如子宫解剖结构异常、遗传因素、感染及内分泌紊乱等。然而，约50%的病因尚不清楚，这可能与男性因素有关。已有多项关于精液参数的研究来确定流产的未知病因和危险因素，但仅研究常见精液参数并不足够。在本研究中，精液中精子DNA碎片、自由基含量与总抗氧化能力（TAC）之间的关系被视为自然流产的一个危险因素。从42名配偶有自然流产史的男性和42名生育能力正常的男性（作为对照组）收集精液样本。测量精液的体积、pH值、粘度、浓度、活力以及精子形态。采用精子染色质结构分析（SCSA）和TUNEL方法分析精子DNA碎片，用发光法测量精子自由基含量，并用TAC试剂盒测量精液抗氧化剂总量。结果显示，实验组精子活力显著低于对照组（P = 0.001）。实验组精子DNA碎片百分比和自由基含量显著高于对照组（P < 0.001）。实验组抗氧化剂总量低于对照组。与对照组相比，精子活力较低且DNA碎片率较高的男性配偶自然流产的几率更高。本研究结果支持精子DNA碎片是自然流产主要因素的假说。精子DNA碎片（SDF）、活性氧（ROS）和总抗氧化能力（TAC）与复发性流产（RPL）之间的关系。
