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弱精子症患者禁欲天数与精液质量及精子功能指标的相关性分析
李耀宣1,刘海芳1,陈良师2,张小慧2,黄悦悦2,施 文2,韦娉嫔2,李政达2,毛献宝2,王世凯2,薛林涛1,2
1.桂林医学院,桂林 541001;2.广西壮族自治区人民医院(广西医学科学院)生殖医学与遗传中心,南宁 530021
摘要:
[摘要] 目的 分析弱精子症患者禁欲天数与精液质量及精子功能指标的相关性。方法 招募2022年10月28日至2023年6月15日广西壮族自治区人民医院生殖医学与遗传中心收治的弱精子症患者192例,根据取精前禁欲天数分为三组:A组(禁欲天数≤2 d,41例)、B组(禁欲天数为3~4 d,114例)和C组(禁欲天数≥5 d,37例)。手淫法收集新鲜精液,并采用密度梯度离心法结合上游法进行优化处理。比较三组优化处理前后的精液质量、精子形态和精子DNA碎片率(SDF),分析禁欲天数与精液相关指标的相关性。结果 在精液优化处理前,三组间精液体积、精子总数、前向运动精子总数及SDF比较差异有统计学意义(P<0.05),A组精液体积、精子总数、前向运动精子总数及SDF均显著低于B组和C组(P<0.05),B组SDF显著低于C组(P<0.05)。在精液优化处理后,三组SDF比较差异有统计学意义(P<0.05),A组SDF显著低于B组和C组(P<0.05)。在精液优化处理前,禁欲天数与精液体积(r=0.225,P=0.002)、精子总数(r=0.200,P=0.016)及SDF呈正相关(r=0.226,P=0.006),与精液浓度、精子总活率、前向运动百分率、前向运动精子总数、正常形态精子百分率的相关性不显著(P>0.05)。在精液优化处理后,禁欲天数与SDF呈正相关(r=0.171,P=0.036),与其余精液相关指标相关性不显著(P>0.05)。结论 弱精症患者禁欲天数与精液体积、精子总数及SDF呈正相关,缩短禁欲天数有助于降低不育男性的SDF。
关键词:  男性不育  禁欲天数  精液分析  精子DNA碎片率
DOI:10.3969/j.issn.1674-3806.2025.01.11
分类号:R 446
基金项目:广西自然科学基金面上项目(编号:2023GXNSFAA026011);广西卫生健康委自筹课题(编号:Z20210112)
Analysis on the correlation of days of sexual abstinence with semen quality and sperm function indicators in patients with asthenozoospermia
LI Yaoxuan1, LIU Haifang1, CHEN Liangshi2, ZHANG Xiaohui2, HUANG Yueyue2, SHI Wen2, WEI Pingpin2, LI Zhengda2, MAO Xianbao2, WANG Shikai2, XUE Lintao1,2
1.Guilin Medical University, Guilin 541001, China; 2. Reproductive Medicine and Genetic Center, the People′s Hospital of Guangxi Zhuang Autonomous Region(Guangxi Academy of Medical Sciences), Nanning 530021, China
Abstract:
[Abstract] Objective To analyze the correlation of days of sexual abstinence with semen quality and sperm function indicators in patients with asthenozoospermia. Methods A total of 192 patients with asthenozoospermia who were admitted to Reproductive Medicine and Genetic Center, the People′s Hospital of Guangxi Zhuang Autonomous Region from October 28, 2022 to June 15, 2023 were recruited and divided into three groups according to the days of sexual abstinence before semen collection: group A(days of sexual abstinence ≤2 days, 41 cases), group B(days of sexual abstinence of 3-4 days, 114 cases) and group C(days of sexual abstinence ≥5 days, 37 cases). Fresh semen samples were collected via masturbation and were optimized using density gradient centrifugation method combined with swim-up method. The semen quality, sperm morphology and sperm DNA fragmentation rate(SDF) were compared among the three groups before and after optimization of the fresh semen samples. The correlation between the days of sexual abstinence and the indicators related to semen was analyzed. Results Before semen optimization, there were significant differences among the three groups in terms of semen volume, total sperm count, total progressively motile sperm count and SDF(P<0.05), and group A had significantly lower semen volume, total sperm count, total progressively motile sperm count and SDF than group B and group C(P<0.05), and group B had significantly lower SDF than group C(P<0.05). After semen optimization, there was significant difference in SDF among the three groups(P<0.05), and group A had significantly lower SDF than group B and group C(P<0.05). Before semen optimization, days of sexual abstinence were positively correlated with semen volume(r=0.225, P=0.002), total sperm count(r=0.200, P=0.016) and SDF(r=0.226, P=0.006), and were not significantly correlated with sperm concentration, total sperm motility rate, progressive motility percentage, total progressively motile sperm count and the percentage of normal sperm morphology(P>0.05). After semen optimization, days of sexual abstinence were positively correlated with SDF(r=0.171, P=0.036), and were not significantly correlated with the other indicators related to semen(P>0.05). Conclusion Days of sexual abstinence in the asthenozoospermia patients are positively correlated with semen volume, total sperm count and SDF. Shortening the days of sexual abstinence in the infertile men can help to reduce their SDF.
Key words:  Male infertility  Days of sexual abstinence  Semen analysis  Sperm DNA fragmentation rate(SDF)