肛殖距、男性因素不孕与妊娠时间。

Anogenital distance, male factor infertility and time to pregnancy.

机构信息

Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

International Center for Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

出版信息

Andrology. 2022 May;10(4):686-693. doi: 10.1111/andr.13161. Epub 2022 Feb 26.

DOI:10.1111/andr.13161

PMID:35178873

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9306635/

Abstract

BACKGROUND

Anogenital distance (AGD), the distance between the anus and genitals, is in rodents a well-established marker of early androgen action and has been suggested to be so in humans as well. Thus, a link between human AGD and semen quality and potentially fecundity may exist.

OBJECTIVE

The aim of this study was to assess the association between AGD and male factor infertility and among proven fertile men also time to pregnancy (TTP).

MATERIAL AND METHODS

All included men were recruited from and examined at Copenhagen University Hospital - Rigshospitalet, Denmark (N = 388). Men with impaired semen quality were included from infertile couples (N = 128), and men with naturally conceived pregnant partners were invited to participate when their partners had their routine second trimester examination (N = 260). All men underwent a physical examination, completed a questionnaire (including TTP for the fertile men), delivered a semen sample and had a blood sample drawn. The primary exposure was AGD measured from the centre of the anus to the posterior base of the scrotum. Associations between AGD and fertility status as well as between AGD and TTP among the fertile men were calculated using multiple logistic regression adjusted for covariates.

RESULTS

AGD did not show a statistically significant association with fertility status. In adjusted logistic regression models, the odds of infertility per 1 cm increase in AGD were 1.02 (95% confidence interval [CI]: 0.88; 1.19). Among fertile men, a 1-cm increase in AGD was associated with an 8% non-statistically significantly reduced odds of having a longer (>3months) TTP (adjusted odds ratio (OR) = 0.92, 95% CI: 0.76-1.11).

CONCLUSION

Our study showed that the clinical application of AGD as a predictor of fertility and fecundity seems to be limited as no associations were observed between AGD and fertility status, nor was the decreased risk of experiencing a longer TTP with longer AGD statistically significant.

摘要

背景

肛生殖器距离（AGD），即肛门和生殖器之间的距离，在啮齿动物中是早期雄激素作用的一个公认标志物，并且在人类中也有这种可能性。因此，人类 AGD 与精液质量和潜在生育力之间可能存在联系。

目的

本研究旨在评估 AGD 与男性因素不孕之间的关系，并在已证实的生育能力正常的男性中评估其与妊娠时间（TTP）之间的关系。

材料和方法

所有纳入的男性均来自丹麦哥本哈根大学医院 - 里格医院（N=388），并在此接受检查。从不孕夫妇中招募精液质量受损的男性（N=128），并在其伴侣进行常规的孕中期检查时邀请生育能力正常的男性伴侣参加（N=260）。所有男性均接受了体格检查、完成了一份问卷（包括生育能力正常男性的 TTP）、提供了精液样本并抽取了血样。主要暴露因素是从肛门中心到阴囊后基底部测量的 AGD。使用多变量逻辑回归模型，调整协变量后，计算 AGD 与生育能力状况之间的关联，以及生育能力正常男性中 AGD 与 TTP 之间的关联。

结果

AGD 与生育能力状况之间无统计学显著关联。在调整后的逻辑回归模型中，AGD 每增加 1cm，不孕的几率为 1.02（95%置信区间 [CI]：0.88；1.19）。在生育能力正常的男性中，AGD 增加 1cm，其 TTP 延长（>3 个月）的几率降低 8%，但无统计学意义（调整后的优势比 [OR] = 0.92，95% CI：0.76-1.11）。