NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences, Central South University, Changsha 410008, China.
Laboratory of Zebrafish Genetics, College of Life Sciences, Hunan Normal University, Changsha 410006, China.
Asian J Androl. 2024 Sep 1;26(5):528-534. doi: 10.4103/aja202422. Epub 2024 Jun 4.
Necrozoospermia is a poorly documented condition with a low incidence, and its definition and clinical significance are unclear. Herein, we provide a reference range for necrozoospermia and discuss its possible etiology and impact on male fertility and assisted reproductive outcomes. We extracted relevant information from 650 Chinese male partners of infertile couples and statistically analyzed sperm vitality. Necrozoospermia was present in 3.4% (22/650) of our study population, and the lower cut-off value for sperm vitality was 75.3%. We compared two methods for assessing sperm vitality (eosin-nigrosin head staining and hypo-osmotic swelling test [HOST]), for which the percentage in the eosin-nigrosin group (mean ± standard deviation [s.d.]: 77.5% ± 10.5%) was significantly higher than that in the HOST group (mean ± s.d.: 58.1% ± 6.7% [5-10 min after incubation] and 55.6% ± 8.2% [25-30 min after incubation]; both P < 0.001). The incidence of necrozoospermia increased with age (odds ratio [OR] = 1.116, 95% confidence interval [CI]: 1.048-1.189, P = 0.001), while the percentage of normal sperm morphology and DNA fragmentation index (DFI) were significantly associated with necrozoospermia, with ORs of 0.691 (95% CI: 0.511-0.935, P = 0.017) and 1.281 (95% CI: 1.180-1.390, P < 0.001), respectively. In the following 6 months, we recruited 166 patients in the nonnecrozoospermia group and 87 patients in the necrozoospermia group to compare intracytoplasmic sperm injection (ICSI) and pregnancy outcomes between the two groups. The necrozoospermia group had a significantly lower normal fertilization rate (74.7% vs 78.2%, P = 0.041; OR = 0.822; 95% CI: 0.682-0.992) than that in the nonnecrozoospermia group. This study presents substantial information on necrozoospermia to establish comprehensive and applicable reference values for sperm vitality for spontaneous conception and artificially assisted reproductive management.
精子坏死症是一种文献记录较少、发病率较低且定义和临床意义尚不明确的病症。在此，我们提供了精子坏死症的参考范围，并讨论了其可能的病因以及对男性生育能力和辅助生殖结局的影响。我们从 650 对不孕夫妇的中国男性伴侣中提取了相关信息，并对精子活力进行了统计学分析。在我们的研究人群中，有 3.4%（22/650）存在精子坏死症，精子活力的下限值为 75.3%。我们比较了两种评估精子活力的方法（伊红-黑染头部染色和低渗肿胀试验[HOST]），伊红-黑染组的百分比（平均值±标准差[s.d.]：77.5%±10.5%）显著高于 HOST 组（5-10 分钟孵育后的 58.1%±6.7%和 25-30 分钟孵育后的 55.6%±8.2%；均 P<0.001）。精子坏死症的发生率随年龄增长而增加（比值比[OR] = 1.116，95%置信区间[CI]：1.048-1.189，P = 0.001），而正常精子形态和 DNA 碎片化指数（DFI）的百分比与精子坏死症显著相关，OR 分别为 0.691（95%CI：0.511-0.935，P = 0.017）和 1.281（95%CI：1.180-1.390，P<0.001）。在接下来的 6 个月中，我们招募了非精子坏死症组的 166 名患者和精子坏死症组的 87 名患者，比较两组的胞浆内单精子注射（ICSI）和妊娠结局。精子坏死症组的正常受精率显著低于非精子坏死症组（74.7% vs 78.2%，P = 0.041；OR = 0.822；95%CI：0.682-0.992）。本研究提供了大量关于精子坏死症的信息，为自然受孕和人工辅助生殖管理建立了全面适用的精子活力参考值。
