对寻求受孕夫妇男性伴侣进行生活方式改善促进及生殖/全身健康检查的结果。
Results of lifestyle modification promotion and reproductive/general health check for male partners of couples seeking conception.
作者信息
Komiya Akira, Kato Mayuko, Shibata Hiroki, Imamura Yusuke, Sazuka Tomokazu, Sakamoto Shinichi, Uchida Nozomi, Takayanagi Yuko, Nako Yurie, Tajima Makiko, Hiraoka Kenichiro, Ichikawa Tomohiko, Kawai Kiyotaka
机构信息
Department of Urology, Chiba University Graduate School of Medicine, Japan.
Department of Reproductive Medicine, Kameda IVF Clinic Makuhari, Japan.
出版信息
Heliyon. 2023 Apr 5;9(4):e15203. doi: 10.1016/j.heliyon.2023.e15203. eCollection 2023 Apr.
PURPOSE
Male infertility is partially caused by an inappropriate lifestyle and comorbidities. In this study, we analyzed the prevalence of these factors and the effects of lifestyle modifications as part of male preconception care.
METHODS
Four hundred and two male partners of couples seeking conception with abnormal parameters upon the first semen analysis were enrolled. They were advised to modify their inappropriate lifestyle as male preconception care. Afterward, their general and male reproductive health was examined. Semen quality was compared before and after the promotion.
RESULTS
Smoking, chronic alcohol use, and genital heat stress were found in 22.6%, 47.0%, and 75.1% of patients, respectively. Palpable varicoceles, hypogonadism, obesity (body mass index ≧30 kg/m), hypertension, zinc deficiency, hyperlipidemia, liver dysfunction, and diabetes mellitus were found in 25.9%, 17.0%, 7.0%, 14.9%, 16.2%, 37.0%, 26.9% and 3.4% of the participants, respectively; 98.8% of the patients had at least one factor. After the promotion, semen parameters and sperm DNA fragmentation were improved significantly. Improvement was found in those with palpable varicocele or hypogonadism but not in those with night work shift, abstinence (>3 days), erectile dysfunction, hypertension, obesity, zinc deficiency, or diabetes mellitus.
CONCLUSIONS
Comorbidities and inappropriate lifestyle choices were common among men with infertility. The promotion of lifestyle modifications as part of male preconception care could improve semen quality without urologic intervention.
目的
男性不育部分是由不适当的生活方式和合并症引起的。在本研究中，我们分析了这些因素的患病率以及作为男性孕前保健一部分的生活方式改变的影响。
方法
招募了402名首次精液分析参数异常的备孕夫妇的男性伴侣。建议他们作为男性孕前保健改变不适当的生活方式。之后，对他们的一般健康和男性生殖健康进行检查。比较了宣教前后的精液质量。
结果
分别在22.6%、47.0%和75.1%的患者中发现吸烟、长期饮酒和生殖器热应激。分别在25.9%、17.0%、7.0%、14.9%、16.2%、37.0%、26.9%和3.4%的参与者中发现可触及的精索静脉曲张、性腺功能减退、肥胖（体重指数≧30kg/m）、高血压、锌缺乏、高脂血症、肝功能障碍和糖尿病；98.8%的患者至少有一个因素。宣教后，精液参数和精子DNA碎片率显著改善。可触及精索静脉曲张或性腺功能减退的患者有改善，但夜班、禁欲（>3天）、勃起功能障碍、高血压、肥胖、锌缺乏或糖尿病患者无改善。
结论
合并症和不适当的生活方式选择在不育男性中很常见。作为男性孕前保健一部分的生活方式改变的宣教可在无泌尿外科干预的情况下改善精液质量。
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