Irvine D S, Macleod I C, Templeton A A, Masterton A, Taylor A
Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, Foresterhill, Scotland, UK.
Hum Reprod. 1994 Dec;9(12):2324-34. doi: 10.1093/oxfordjournals.humrep.a138446.
The objective of this study was to examine the clinical predictive value for the achievement of pregnancy in vivo of the assessment of human semen quality by computer-assisted semen analysis using the Hamilton-Thorn Motility Analyser (HTM-S), alongside classic World Health Organization (WHO) techniques. A prospective follow-up study of 303 couples attending a regional infertility clinic providing tertiary level services to the population of a single geographical region was undertaken. Couples attending the infertility clinic, in whom the female partner was normal on conventional investigations (history, examination, evidence of ovulation, laparoscopy), were studied. After initial assessment, couples were followed for a median of 15 months and treatment-independent pregnancies observed and related to the results of semen assessment. During the period of follow-up, the treatment-independent pregnancy rate was 52%. Several measures of semen quality, determined both manually and by the HTM-S, were found to be predictive of the achievement of pregnancy and were related to the time taken to conceive. Couples who conceived had higher sperm concentrations and motilities, determined both manually and by the HTM-S, as well as differences in sperm head morphometry and sperm velocity determined by the HTM-S. Using multiple logistic regression, the prognostic accuracy of the HTM-S alone was similar to manual techniques, although data from the computer assisted sperm analysis system were preferred. Using proportional hazards regression, several variables were related to the achievement of pregnancy, particularly morphometry and motility. It was concluded that a strong case can be made for the introduction of automated assessment of human semen in routine service andrology laboratories.
本研究的目的是通过使用汉密尔顿-桑恩运动分析仪（HTM-S）的计算机辅助精液分析，结合经典的世界卫生组织（WHO）技术，来检验评估人类精液质量对体内受孕的临床预测价值。对一家为单一地理区域人群提供三级服务的地区不孕不育诊所的303对夫妇进行了一项前瞻性随访研究。研究对象为前往该不孕不育诊所就诊的夫妇，其中女性伴侣在常规检查（病史、体格检查、排卵证据、腹腔镜检查）中均正常。经过初步评估后，对夫妇进行了为期15个月的中位数随访，观察了与精液评估结果相关的自然受孕情况。在随访期间，自然受孕率为52%。通过手工和HTM-S测定的多项精液质量指标被发现可预测受孕情况，并与受孕所需时间相关。受孕夫妇的精子浓度和活力更高，这是通过手工和HTM-S测定得出的结果，此外，HTM-S测定的精子头部形态学和精子速度也存在差异。使用多元逻辑回归分析，单独使用HTM-S的预后准确性与手工技术相似，尽管计算机辅助精子分析系统的数据更受青睐。使用比例风险回归分析，多个变量与受孕情况相关，尤其是形态学和活力。研究得出结论，有充分理由在常规男科实验室引入人类精液的自动化评估。
