吸烟、饮酒、冷冻对精子顶体完整率的影响
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摘要
当前,男性不育是困扰许多育龄夫妇的一个世界性问题。临床上,育龄夫妇中10～15%患有不育不孕症,其中男性原因引起的不育约占不育夫妇的一半。很多因素,包括内部因素和外部因素都影响男性生育力。
常规精液分析的方法有精子计数、精子正常形态比例。但这些方法对全面了解生育力尚嫌不足,精子顶体内的酶参与精子受孕过程,精子顶体内的酶含量降低会引起精子生育力下降。精子顶体的完整性能直接反映精子顶体内酶含量的多少,因顶体不完整的精子顶体内酶会漏出,影响精子和卵子的受精。
国内外对于顶体完整与受精能力的关系的报道较多,然而国内外对顶体不完整机理研究还很不深入。顶体的不完整究竟是发生在什么部位,是睾丸生成时,还是在附睾中成熟中抑或是在女性生殖道中出现的问题,尚且不得而知,而且究竟是什么外界因素(pH值、温度,及其它小分子和大分子等等)导致了顶体不完整,什么遗传因素导致了顶体出现问题还没有一个令大多数人信服的观点。
本文目的是探讨顶体完整率与男性不育关系,通过对488例不育男性精液标本检测,分析常规精液参数与顶体完整率的关系到吸烟、饮酒对顶体完整率的影响,还探讨了辅助生殖技术中优选和冷冻对顶体完整率的影响。采用计算机自动检测系统下人工修正方法进行精子形态分析。患者自愿填写问卷,对吸烟、饮酒因素进行调查分析。结果如下:
①精子形态异常组精子顶体完整率低于精子形态正常组,两组比较有显著性差异(P<0.05)。②精液pH值异常组顶体完整率明显低于精液pH值正常组,两组比较有显著性差异(P <0.05)。③精液量正常组和精液量异常组精子顶体完整率进行分析,两组之间比较无显著差异(P >0.05)。④液化时间正常组与液化时间异常组的顶体完整率进行分析,两组之间比较无显著差异(P >0.05)。⑤与生育组比较,吸烟组顶体完整率低于生育组的顶体完整率,两组比较有显著性差异(P <0.01);与不吸烟组比较,吸烟组顶体完整率低于生育组的顶体完整率,两组比较有显著性差异(P <0.05)。⑥与生育组比较,饮酒组顶体完整率低于不吸烟组的顶体完整率,两组比较有显著性差异(P <0.05);与不饮酒组比较,饮酒组的顶体完整率与不饮酒组的顶体完整率没有显著性差异(P >0.05)。⑦与优选前比较,优选后的顶体完整率高于优选前,两组比较有极显著性差异(P <0.001)。⑧与冷冻前比较,快速冷冻和慢速冷冻后顶体完整率与冷冻前比较均没有显著性差异(P >0.05),快速冷冻与慢速冷冻后,两组之间比较亦没有显著性差异(P >0.05)。
通过比较研究,得到以下结论:形态正常精子百分率高的精子顶体完整率也高,精子顶体完整率与精子形态具有一致性。精液pH值异常的精子顶体完整率较低,提示pH值影响精子顶体完整率。精液量不影响精子顶体完整率;精液液化时间不影响精子顶体完整率。吸烟能导致顶体完整率降低;饮酒在一定程度上能使精子顶体完整率下降。上游法优选能较好地提高精子顶体完整率。在甘油作为保护剂的情况下,快速冷冻和慢速冷冻都不影响精子顶体完整率。
Currently, male infertility has been a world matter. In clinical practice, infertility affects approximately 15 % of couples trying to conceive and a male cause is believed to be a sole or contributing factor in approximately half of these cases. Many factors are responsible for male infertility, including inner factor and exoteric factors.
The analysis of semen parameters included sperm count, the percentage of normal morphology sperm. But it’s not enough for evaluation of male infertility. Enzymes are important for fecundation of sperm and egg. Therefore, if acrosomal integrity were lower, it would influence the binding of sperm and egg.
Now, many reports paid attention to the relation between acrosomal integrity and ability of impregnation. There was no clarity for influencing factors of acrosomal integrity, its mechanism, idiographic area, and so on.
In the current study, several comparative studies were carried out to clarify whether inner and outer factors influence on acrosomal integrity or not. The sperm morphology analysis using semiautomated sperm morphology analyzer (ASMA) was performed. Patients voluntarily filled out a questionnaire in order to analyze exoteric factors, cigarette and alcohol consumption. Results:
①Acrosomal integrity of abnormal morphology sperm group was significantly lower than that of normal morphology sperm group (P<0.05).②Acrosomal integrity of abnormal semen pH group was significantly lower than that of normal semen pH group (P<0.05).③Acrosomal integrity of abnormal semen volume group was no statistics difference in comparison with normal semen volume group (P>0.05).④Acrosomal integrity of abnormal liquefaction time of semen group was no statistics difference in comparison with normal liquefaction time of semen group (P>0.05).⑤Acrosomal integrity of smoking group was significantly lower than that of fertile group (P<0.01). Acrosomal integrity of smoking group was significantly lower than that of nonsmoking group (P<0.05).⑥Acrosomal integrity of drinking group was significantly lower than that of fertile group (P<0.05). Acrosomal integrity of drinking group was no statistics difference in comparison with non-drinking group (P>0.05).⑦After selecting, acrosomal integrity was significantly higher than that of before selecting (P<0.001).⑧After freezing and thawing, acrosomal integrity of rapid and slow freezing methods were no statistics difference in comparison with before freezing (P>0.05). Acrosomal integrity of rapid freezing method was no statistics difference in comparison with slow freezing method (P>0.05).
All results showed that some factors influence acrosomal integrity. Acrosomal integrity was consistent with the percentage of normal morphology sperm. Semen pH could make acrosomal integrity decreased. Semen volume and liquefaction time didn’t influence acrosomal integrity. Acrosomal integrity is relevant to smoking, drinking. Semen selection of swimming could make acrosomal integrity increased. When glycerol was cryoprotectant, rapid and slow freezing didn’t influence acrosomal integrity.
常规精液分析的方法有精子计数、精子正常形态比例。但这些方法对全面了解生育力尚嫌不足,精子顶体内的酶参与精子受孕过程,精子顶体内的酶含量降低会引起精子生育力下降。精子顶体的完整性能直接反映精子顶体内酶含量的多少,因顶体不完整的精子顶体内酶会漏出,影响精子和卵子的受精。
国内外对于顶体完整与受精能力的关系的报道较多,然而国内外对顶体不完整机理研究还很不深入。顶体的不完整究竟是发生在什么部位,是睾丸生成时,还是在附睾中成熟中抑或是在女性生殖道中出现的问题,尚且不得而知,而且究竟是什么外界因素(pH值、温度,及其它小分子和大分子等等)导致了顶体不完整,什么遗传因素导致了顶体出现问题还没有一个令大多数人信服的观点。
本文目的是探讨顶体完整率与男性不育关系,通过对488例不育男性精液标本检测,分析常规精液参数与顶体完整率的关系到吸烟、饮酒对顶体完整率的影响,还探讨了辅助生殖技术中优选和冷冻对顶体完整率的影响。采用计算机自动检测系统下人工修正方法进行精子形态分析。患者自愿填写问卷,对吸烟、饮酒因素进行调查分析。结果如下:
①精子形态异常组精子顶体完整率低于精子形态正常组,两组比较有显著性差异(P<0.05)。②精液pH值异常组顶体完整率明显低于精液pH值正常组,两组比较有显著性差异(P <0.05)。③精液量正常组和精液量异常组精子顶体完整率进行分析,两组之间比较无显著差异(P >0.05)。④液化时间正常组与液化时间异常组的顶体完整率进行分析,两组之间比较无显著差异(P >0.05)。⑤与生育组比较,吸烟组顶体完整率低于生育组的顶体完整率,两组比较有显著性差异(P <0.01);与不吸烟组比较,吸烟组顶体完整率低于生育组的顶体完整率,两组比较有显著性差异(P <0.05)。⑥与生育组比较,饮酒组顶体完整率低于不吸烟组的顶体完整率,两组比较有显著性差异(P <0.05);与不饮酒组比较,饮酒组的顶体完整率与不饮酒组的顶体完整率没有显著性差异(P >0.05)。⑦与优选前比较,优选后的顶体完整率高于优选前,两组比较有极显著性差异(P <0.001)。⑧与冷冻前比较,快速冷冻和慢速冷冻后顶体完整率与冷冻前比较均没有显著性差异(P >0.05),快速冷冻与慢速冷冻后,两组之间比较亦没有显著性差异(P >0.05)。
通过比较研究,得到以下结论:形态正常精子百分率高的精子顶体完整率也高,精子顶体完整率与精子形态具有一致性。精液pH值异常的精子顶体完整率较低,提示pH值影响精子顶体完整率。精液量不影响精子顶体完整率;精液液化时间不影响精子顶体完整率。吸烟能导致顶体完整率降低;饮酒在一定程度上能使精子顶体完整率下降。上游法优选能较好地提高精子顶体完整率。在甘油作为保护剂的情况下,快速冷冻和慢速冷冻都不影响精子顶体完整率。
Currently, male infertility has been a world matter. In clinical practice, infertility affects approximately 15 % of couples trying to conceive and a male cause is believed to be a sole or contributing factor in approximately half of these cases. Many factors are responsible for male infertility, including inner factor and exoteric factors.
The analysis of semen parameters included sperm count, the percentage of normal morphology sperm. But it’s not enough for evaluation of male infertility. Enzymes are important for fecundation of sperm and egg. Therefore, if acrosomal integrity were lower, it would influence the binding of sperm and egg.
Now, many reports paid attention to the relation between acrosomal integrity and ability of impregnation. There was no clarity for influencing factors of acrosomal integrity, its mechanism, idiographic area, and so on.
In the current study, several comparative studies were carried out to clarify whether inner and outer factors influence on acrosomal integrity or not. The sperm morphology analysis using semiautomated sperm morphology analyzer (ASMA) was performed. Patients voluntarily filled out a questionnaire in order to analyze exoteric factors, cigarette and alcohol consumption. Results:
①Acrosomal integrity of abnormal morphology sperm group was significantly lower than that of normal morphology sperm group (P<0.05).②Acrosomal integrity of abnormal semen pH group was significantly lower than that of normal semen pH group (P<0.05).③Acrosomal integrity of abnormal semen volume group was no statistics difference in comparison with normal semen volume group (P>0.05).④Acrosomal integrity of abnormal liquefaction time of semen group was no statistics difference in comparison with normal liquefaction time of semen group (P>0.05).⑤Acrosomal integrity of smoking group was significantly lower than that of fertile group (P<0.01). Acrosomal integrity of smoking group was significantly lower than that of nonsmoking group (P<0.05).⑥Acrosomal integrity of drinking group was significantly lower than that of fertile group (P<0.05). Acrosomal integrity of drinking group was no statistics difference in comparison with non-drinking group (P>0.05).⑦After selecting, acrosomal integrity was significantly higher than that of before selecting (P<0.001).⑧After freezing and thawing, acrosomal integrity of rapid and slow freezing methods were no statistics difference in comparison with before freezing (P>0.05). Acrosomal integrity of rapid freezing method was no statistics difference in comparison with slow freezing method (P>0.05).
All results showed that some factors influence acrosomal integrity. Acrosomal integrity was consistent with the percentage of normal morphology sperm. Semen pH could make acrosomal integrity decreased. Semen volume and liquefaction time didn’t influence acrosomal integrity. Acrosomal integrity is relevant to smoking, drinking. Semen selection of swimming could make acrosomal integrity increased. When glycerol was cryoprotectant, rapid and slow freezing didn’t influence acrosomal integrity.
引文
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