Pergialiotis Vasilios, Karampetsou Nikoleta, Perrea Despina N, Konstantopoulos Panagiotis, Daskalakis Georgios
Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Athens, Greece.
First Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.
J Family Reprod Health. 2018 Jun;12(2):73-83.
To evaluate the impact of bacteriospermia on semen parameters. We used the Medline (1966-2017), Scopus (2004-2017), Clinicaltrials.gov (2008-2017), EMBASE, (1980-2017), LILACS (1985-2017) and Cochrane Central Register of Controlled Trials (1999-2017) databases in our primary search along with the reference lists of electronically retrieved full-text papers. Meta-analysis was performed with the RevMan 5.3 software. Eighteen studies were finally included. Men were stratified in two groups, healthy controls (5,797 men) and those suffering from bacteriospermia (3,986 men). Total sperm volume was not affected by the presence of bacteriospermia when all pathogens were analyzed together (MD 0.02 95%CI -0.13,0.17). Both sperm concentration (MD -27.06, 95% CI -36.03, -18.08) and total sperm count (MD -15.12, 95% CI -21.08, -9.16) were significantly affected by bacteriospermia. Decreased rates of normal sperm morphology were also found (MD -5.43%, 95% CI -6.42, -4.44). The percentage of alive sperm was significantly affected by bacteriospermia (MD -4.39 %, 95% CI -8.25, -0.53). Total motility was also affected by bacteriospermia (MD -3.64, 95% CI -6.45, -0.84). In addition to this, progressive motility was significantly affected (MD -12.81, 95% CI -18.09, -7.53). Last but not least, pH was importantly affected (MD 0.03, 95% Cl 0.01, 0.04). Bacteriospermia significantly affects semen parameters and should be taken in mind even when asymptomatic. Further studies should evaluate the impact of antibiotic treatment on semen parameters and provide evidence on fertility outcome.
为评估菌精症对精液参数的影响。我们在初步检索中使用了Medline(1966 - 2017年)、Scopus(2004 - 2017年)、Clinicaltrials.gov(2008 - 2017年)、EMBASE(1980 - 2017年)、LILACS(1985 - 2017年)以及Cochrane对照试验中央注册库(1999 - 2017年)数据库,并结合电子检索到的全文论文的参考文献列表。使用RevMan 5.3软件进行荟萃分析。最终纳入18项研究。男性被分为两组,健康对照组(5797名男性)和患有菌精症的男性(3986名男性)。当对所有病原体一起分析时,菌精症的存在并不影响精液总体积(平均差0.02,95%置信区间 - 0.13,0.17)。菌精症显著影响精子浓度(平均差 - 27.06,95%置信区间 - 36.03, - 18.08)和总精子数(平均差 - 15.12,95%置信区间 - 21.08, - 9.16)。正常精子形态的比例也有所下降(平均差 - 5.43%,95%置信区间 - 6.42, - 4.44)。菌精症显著影响活精子的百分比(平均差 - 4.39%,95%置信区间 - 8.25, - 0.53)。总活力也受菌精症影响(平均差 - 3.64,95%置信区间 - 6.45, - 0.84)。除此之外,前向运动能力受到显著影响(平均差 - 12.81,95%置信区间 - 18.09, - 7.53)。最后但同样重要的是,pH值受到显著影响(平均差0.03,95%置信区间0.01,0.04)。菌精症显著影响精液参数,即使无症状也应予以考虑。进一步的研究应评估抗生素治疗对精液参数的影响,并提供关于生育结局的证据。
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