WHO第5版精液参考值标准的临床应用对IUI适应证谱的影响  

Influence of the reference values for semen analysis proposed in the 5th edition of WHO Laboratory Manual on the indication spectrum for intrauterine insemination

作　　者：张云山[1] 韦冰[1] 陈碧[1] 许丽华[1] 唐棣[1] 彭彩玲[1] 柳建军[2] 

机构地区：[1]广东医学院附属医院,生殖中心,广东湛江524001 [2]广东医学院附属医院,泌尿外科,广东湛江524001

出　　处：《中华男科学杂志》2014年第3期253-256,共4页National Journal of Andrology

摘　　要：目的：探讨WHO第5版精液参考值标准的调整对夫精宫腔内人工授精（IUI）适应证谱的影响。方法：回顾性分析我院生殖中心2012年1-7月采用WHO第4版标准111个周期IUI的临床资料（A组），和2013年1-7月采用WHO第5五版标准84个周期IUI的临床资料（B组），统计各种适应证所占百分率。结果：两组适应证比较，弱精子症差异有统计学意义[97个周期（87．4％）／3547个周期（55．9％），P〈0．05]。少精子症（0W0）、畸形精子症[57个周期（51．4％） vs 30个周期（35．7％）]、液化异常[1个周期（0．9％） vs 0]、性功能障碍及生殖器畸形[0V．53个周期（3．6％）]、免疫性不育[1个周期（0．9％） vs 0]和不明原因不育[4个周期（3．6％）V．52个周期（2．4％）]差异无统计学意义（P均〉0．05）。结论：WHO第5版精液参考值标准的临床应用对IUI适应证谱有较大影响，造成因为男方因素行IUI的病例大幅度减少，可能会使部分患者治疗周期加长，女方诊治过度，进一步加重其经济负担和身心压力。Objective： To study the influence of the reference values for semen analysis proposed in the 5th edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen on the indication spectrum for intrauterine insemination （IUI）. Methods ： We retrospectively analyzed the clinical data of 111 cycles of IUI by the reference values for semen analysis in the 4th edi- tion of the WHO Laboratory Manual （group A） and 84 cycles by the 5th edition （group B）. We recorded and compared the percen- tages of various indications for IUI between the two groups. Results ： The complications for IUI in groups A and B were as follows ： as- thenospermia （87.4% [97/111 ] vs 55.9% [47/84], P 〈 0.05）, oligospermia （0 vs 0）, teratospermia （51.4% [57/111 ] vs 35.7% [30/84] ）, abnormal liquefaction （0.9% [ 1/lll ] vs 0）, sexual dysfunction and genital malformation （0 vs 3.6% [3/84], immune infertility （0.9% ~ 1/111 ] vs 0）, and unexplained infertility （3.6% [4/111 ] vs 2.4% [2/84] ）. There were no significant differences between the two groups in the percentages of all the indications except that of asthenospermia. Conclusion ： The reference values for semen analysis proposed in the 5th edition of the WHO Laboratory Manual for the Examination and Processing of Human Se- men have an evident influence on the indication spectrum for IUI by largely reducing the cases of IUI for male factors, prolonging thecycles of some patients, causing excessive diagnosis and treatment for females, and increasing their mental and economic burdens. Natl J Androl, 2014, 20 （3）： 253-2S6

关 键 词：精液参数 参考值 适应证 宫腔内人工授精 

分 类 号：R697[医药卫生—泌尿科学]