禁欲时间对少精子症和弱精子症精液参数的影响  

Effect of sexual abstinence on semen analysis parameters in oligospermia and asthenozoospermia

作　　者：贾烨菻 李福平 Jia Yelin;Li Fuping(West China Second University Hospital Human Sperm Bank/Department of Andrology,Chengdu 610061,China;Key Laboratory of the Ministry of Education for Birth Defects and Related Diseases of Women and Children,Chengdu 610041,China)

机构地区：[1]四川大学华西第二医院人类精子库/生殖男科,成都610061 [2]西部妇幼研究院出生缺陷与相关妇儿疾病教育部重点实验室,成都610041

出　　处：《中华生殖与避孕杂志》2022年第7期696-702,共7页Chinese Journal of Reproduction and Contraception

基　　金：四川省科技厅重点研发项目(2021YFS0026)。

摘　　要：目的研究禁欲时间对少精子症和弱精子症患者精液参数的影响。方法采用回顾性队列研究,收集2018年1月至2019年12月期间就诊于四川大学华西第二医院生殖男科的正常育前检查、少精子症和弱精子症人群的临床资料。比较不同禁欲时间(分别为禁欲2 d、3 d、4 d、5 d、6 d、7 d)对少精子症(n=5127)、弱精子症(n=4003)和正常对照男性(n=4529)精液参数的影响,观察不同组别男性的精子浓度、前向精子百分比、活动精子总数(total motile sperm count,TMSC)等参数随禁欲时间的变化。结果正常育前检查组随禁欲时间延长,精液体积从(3.3±1.2)mL升至(4.1±1.3)mL(r=0.167,P<0.001),精子浓度从(89.0±60.9)×10^(6)/mL升至(125.2±82.3)×10^(6)/mL(r=0.181,P<0.001),精子总数从(273.2±169.8)×10^(6)/次升至(473.5±193.7)×10^(6)/次(r=0.310,P<0.001),前向精子百分比从62.1%±13.0%降至59.5%±13.3%(r=-0.057,P<0.001),存活率从80.6%±8.5%降至79.0%±9.1%(r=-0.048,P<0.001)。少精子症组随禁欲时间延长,精液体积从(3.1±1.4)mL升至(3.9±1.6)mL(r=0.171,P<0.001),精子浓度从(10.3±5.5)×10^(6)/mL降至(8.7±4.3)×10^(6)/mL(r=-0.043,P<0.001),精子总数从(29.0±17.1)×10^(6)/次升至(38.6±19.8)×10^(6)/次(r=0.285,P<0.001),前向精子百分比从41.1%±17.0%降至35.1%±17.3%(r=-0.141,P<0.001),存活率从71.1%±12.3%降至63.1%±16.6%(r=-0.225,P<0.001),禁欲2 d时精子浓度和前向精子百分比达峰值。弱精子症组随禁欲时间延长,精液体积从(3.1±1.4)mL升至(3.8±1.9)mL(r=0.197,P<0.001),精子浓度从(35.1±30.5)×10^(6)/mL升至(49.7±31.9)×10^(6)/mL(r=0.071,P<0.001),精子总数从(109.1±82.3)×10^(6)/次升至(170.1±99.3)×10^(6)/次(r=0.394,P<0.001),存活率从59.6%±16.4%降至54.0%±16.4%(r=-0.081,P<0.001),前向精子百分比、圆细胞浓度与禁欲时间均无相关性(均P>0.05),TMSC(r=0.119,P<0.001)随禁欲时间延长而增高。结论延长禁欲时间可不同程度地增加少精子症患者、弱精子症患者Objective To investigate the impact of sexual abstinence(SA)on semen parameters in oligospermia and asthenozoospermia.Methods This retrospective cohort study was conducted for the clinical data from oligospermia(n=5127),asthenozoospermia(n=4003)and normozoospermia(n=4529)with different SAs(2 d,3 d,4 d,5 d,6 d,7 d)who were treated in Andrology Department of West China Second University Hospital during January 2018 to December 2019.The correlation between semen parameters(sperm concentration,motility,total motile sperm count etc.)and SA were observed.Results In normozoospermia,as the SA was getting longer,the semen volume was increased from(3.3±1.2)mL to(4.1±1.3)mL(r=0.167,P<0.001),the sperm concentration was increased from(89.0±60.9)×10^(6)/mL to(125.2±82.3)×10^(6)/mL(r=0.181,P<0.001),the total sperm count was increased from(273.2±169.8)×10^(6)/ejaculate to(473.5±193.7)×10^(6)/ejaculate(r=0.310,P<0.001).The progressive motility was decreased from 62.1%±13.0%to 59.5%±13.3%(r=-0.057,P<0.001).The viability was decreased from 80.6%±8.5%to 79.0%±9.1%(r=-0.048,P<0.001).In oligospermia,the semen volume was increased from(3.1±1.4)mL to(3.9±1.6)mL(r=0.171,P<0.001)and the sperm concentration was decreased from(10.3±5.5)×10^(6)/mL to(8.7±4.3)×10^(6)/mL(r=-0.043,P<0.001),the total sperm count was increased from(29.0±17.1)×10^(6)/ejaculate to(38.6±19.8)×10^(6)/ejaculate(r=0.285,P<0.001).The progressive motility was decreased from 41.1%±17.0%to 35.1%±17.3%(r=-0.141,P<0.001).The viability was decreased from 71.1%±12.3%to 63.1%±16.6%(r=-0.225,P<0.001).The peak value of sperm concentration and motility were observed on day 2.In asthenozoospermia,the semen volume was increased from(3.1±1.4)mL to(3.8±1.9)mL(r=0.197,P<0.001)and the sperm concentration was increased from(35.1±30.5)×10^(6)/mL to(49.7±31.9)×10^(6)/mL(r=0.071,P<0.001),the total sperm count was increased from(109.1±82.3)×10^(6)/ejaculate to(170.1±99.3)×10^(6)/ejaculate(r=0.394,P<0.001).The viability was decreased from 59.6%±16.4%to 5

关 键 词：禁欲时间 精液分析 弱精子症 少精子症 精液参数 

分 类 号：R698.2[医药卫生—泌尿科学]