轻度子宫内膜异位症患者的腹腔液对精子运动及超微结构的影响  

The Effect of Peritoneal Fluid of Infertile Patients with Minimal or Mild Endometriosis on Human Sperm Motility and Sperm Uitrastructure

作　　者：闫彩平[1] 祝育德[2] 朱伟杰[3] 李素春[1] 郭祖文[3] 

机构地区：[1]广东省计划生育科学技术研究所,广东广州510600 [2]暨南大学第三附属医院,广东珠海519000 [3]暨南大学医学院,广东广州510632

出　　处：《实用妇产科杂志》2006年第2期111-113,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:观察轻度子宫内膜异位症(EM)不孕患者的腹腔液对精子运动及超微结构的影响。方法:经过处理的精子在体外分别和轻度EM不孕患者、正常妇女的腹腔液及精子培养液孵育5小时,观察其运动参数及超微结构的变化;酶联免疫法测量EM腹腔液肿瘤坏死因子α(TNF-α)的含量。结果:EM组腹腔液TNF-α含量高于正常妇女(P<0.05);EM组精子平均直线速度(VSL)、平均曲线速度(VCL)、平均路径速度(VAP)、快速直线运动精子活率(MOT)4项运动指标均低于正常组和培养液组(P<0.05),与TNF-α含量呈负相关(P<0.05),EM组精子头部、顶体及尾部主段胞质肿胀、胞膜破损,而孵育前及孵育后另外两组精子结构无改变。结论:轻度EM不孕患者腹腔液TNF-α值升高,经体外观察腹腔液对精子运动及精子形态学均有损害作用,推测这些可能是EM患者不孕的原因之一。Objective：To observe the effect of peritoneal fluid of infertile patients with minimal or mild （EM） on human sperm motility and ultrastructure. Methods： Women with minimal or mild EM underwent laparoscopy for infertility served as cases （ n = 20）. Normal women undergoing tubal ligation served as controls Ⅰ （ n = 15）. HTF culture served as controls Ⅱ （n = 5）. Perito Ⅰ fluid was aspirated from women dudng laperoscopy. Sperm motility, motion characteristics and ultrastructure were assessed following incubation 5 hours in vitro by means of CASA and electron microscope. The levels of TNF-α in peritoneal fluid of cases and controls Ⅰ were measured also. Results：The levels of TNF-α in peritoneal fluid of EM were higher than that of normal women （ P 〈 0.05）. Spen＇n motility and motion characteristics （VSL, VCL, VAP, MOT） in EM group significantly differed between cases and controls after 5 hours of incubation with the peritoneal fluid （P〈0.05） .The levels of TNF-α in perltoneal fluld of EM had negative correlation with the sperm motility and motion characteristics respectively after 5 hours＇ incubation （P〈0.05）. After incubated 5 hours with peritoneal fluid of EM, the membrane of sperm caput, acrosome, and main segment of empennage were damaged with swelling cytoplasm. No obvious change of sperm ultrastructure was found in controls Ⅰ and controls Ⅱ. Conclusions： The level of TNF-α in peritoneal fluid of minimal or mild EM is higher than normal person. The peritoneal fluid of EM maybe is one of the infertile reasons that contribute to infertility by damaging the sperm motility and ultrastructure.

关 键 词：不孕 子宫内膜异位症 腹腔液 精子运动 超微结构 

分 类 号：R711.71[医药卫生—妇产科学]