男性不育患者精液质量及其影响因素分析

doi:10.13481/j.1671-587X.20220225

Abstract

Abstract: Objective

To analyze the semen quality of male infertility patients， and to discuss the general situation and trend of semen quality of the male infertility patients in recent years.

Methods

A total of 4 190 male infertility patients who were treated in Reproduction Medicine Center of 73rd Army Hospital of the People’s Liberation Army and Reproductive Medicine Center of the First Affiliated Hospital of Xiamen University were selected and their total semen parameters were analyzed. The patients were grouped according to age， testing year， abstinence days and testing season， and the routine parameters of semen and the percentage of normal sperm were analyzed and compared between groups.Multiple linear regression analysis was conducted to analyze the effects of age， testing year， abstinence days and testing season on the semen parameters.

Results

The mean age of the patients was （31.81±5.55） years old；the medians of semen volume serum， pH value semen， sperm concentration， total number of sperm，total motility rate， forward motility sperm（PR） and percentage of normal sperm of patients were 3.0 mL， 7.3， 47×10⁶mL^－1， 139.3×10⁶/each ejaculation， 75%， 53% and 3.4%，respectively.There were statistically significant differences in the semen parameters between testing year groups （P<0.05），and the total motility rate， PR and the percentage of normal sperm of patients showed a decreasing trend from 2017—2019.Among age groups， there were significant differences in the total activity rates and percentages of normal sperm of patients among various groups（P<0.05）. In abstinence groups day， there were statistically significant differences in the sperm concentrations， total number of sperm， total motility rates of sperm and PR of patients among various groups （P<0.05）. In the seasonal groups， there were statistically significant differences in the sperm concentrations， total motility rate of sperm， PR and percentages of normal sperm of patients among various groups（P<0.05）.The results of multiple linear regression analysis showed that there was no significant differences in the semen parameters between different age groups；the abstinence days was related to sperm concentration， total number of sperm， total motility rate of sperm and PR of patients， and the seasonal variation was related to the total sperm， total motility rate of sperm and PR of patients.

Conclusion

The total motility rate， PR and percentage of normal sperm in 4 190 male infertility patients show a decreasing trend from 2017—2019， and abstinence days and testing season can affect some semen parameters of the patients.

Key words: Male infertility, Semen quality, Abstinence time, Age, Season

CLC Number:

R698.2

Qiaobin LIU,Ling CHENG,Yuanyuan YE,Ming SUN,Youzhu LI. Analysis on semen quality and its influencing factors in male infertility patients[J].Journal of Jilin University(Medicine Edition), 2022, 48(2): 470-477.

Figures/Tables 7

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References 22

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Semen parameter	Mean value (standard deviation)	Median	5% percentile	25% percentile	75% percentile	95% percentile
Semen volume(V/mL)	3.2(1.4)	3.0	1.2	2.2	4.0	5.6
Sperm concentration(×10⁶ mL^－1)	56.0 (41.0)	47.0	5.0	25.0	74.0	136.0
Sperm total number (×10⁶time^－1)	172.1(136.2)	139.3	17.5	72.4	233.3	445.3
(PR+NP)(η/%)	71.0（16.0）	75.0	42.0	62.0	83.0	89.0
PR(η/%)	52.0（18.0）	53.0	18.0	40.0	65.0	81.0
Percentage of normal sperm(η/%)	4.1（3.7）	3.4	0	1.0	6.3	11.2
pH value	7.3(0.2)	7.3	7.2	7.3	7.4	7.6

Group		Semen parameters
Group	n	Sperm concentration (×10⁶mL^－1)	Total number of sperm (×10⁶)	PR+NP(η/%)	PR(η/%)	Percentage of normal sperm(η/%)
Year
2017	917	59(31－83)	154.2(81.7－261.8)	81(72－86)	64(50－76)	4.9(2.7－7.7)
2018	1 317	56(30－89)	163.2(88.2－268.8)	74(58－83)	51(40－66)	3.8(1.5－6.3)
2019	1 956	41(23－63)	121.9(64.0－204.0)	71(61－79)	50(39－59)	2.6(0.9－5.6)
P		<0.01	<0.01	<0.01	<0.01	<0.01
Age(year)
≤25	346	48(30－72)	143.2(82.5－229.8)	75(64－84)	54(41－66)	2.8(1.0－5.6)
26－30	1 659	47(26－74)	144.0(79.1－236.9)	75(62－83)	54(40－66)	3.5(1.0－6.5)
31－35	1 250	50(27－76)	141.1(73.8－237.6)	75(62－83)	53(40－65)	3.5(1.0－6.3)
36－40	583	51(24－79)	133.0(69.0－230.4)	74(62－81)	51(40－61)	3.5(1.0－6.3)
≥41	352	50(28－75)	125.4(62.9－216.6)	70(54－82)	51(36－61)	3.8(1.4－6.9)
P		0.46	0.09	<0.01	0.10	0.02
Abstinence day（t/d）
2－3	1 539	43(24－69)	119.7(61.5－207.4)	75(63－83)	55(40－67)	3.5(1.0－6.5)
4－5	1 782	51(28－77)	151.2(80.6－241.8)	75(62－83)	53(40－65)	3.4(1.0－6.2)
6－7	869	53(30－83)	159.9(88.2－278.8)	73(59－81)	50(38－62)	3.4(1.0－6.4)
P		<0.01	<0.01	<0.01	<0.01	0.41
Season
Spring	997	51(25－82)	145.18(72.63－243.90)	77(66－85)	57(41－68)	3.7(1.0－6.5)
Summer	1 037	45(28－69)	132.60(76.41－225.90)	71(61－81)	52(40－63)	3.5(1.0－6.3)
Autumn	1 057	49(25－73)	140.50(68.80－229.58)	75(60－83)	52(39－64)	3.0(1.0－6.0)
Winter	1 099	51(28－74)	142.80(76.80－245.90)	74(61－82)	52(39－65)	3.5(1.2－6.6)
P		0.03	0.32	<0.01	<0.01	0.01

Group	Semen parameters
	Sperm concentration		Total number of sperm		PR+NP		PR		Percentage of normal sperm
	z	P	z	P	z	P	z	P	z	P
2019 vs 2018	10.238	<0.01	5.802	<0.01	4.229	<0.01	4.913	<0.01	6.850	<0.01
2019 vs 2017	9.655	<0.01	9.182	<0.01	17.075	<0.01	17.549	<0.01	13.063	<0.01
2018 vs 2017	0.500	0.62	－2.272	0.069	12.384	<0.01	12.258	<0.01	6.476	<0.01

Group	Semen parameter
	PR+NP		Percentage of normal sperm
	z	P	z	P
≥41 years vs 36－40 years	2.087	0.369	0.989	0.323
≥41 years vs 31－35 years ≥41 years vs 26－30 years ≥41 years vs ≤25 years 36－40 years vs 31－35 years 36－40 years vs 26－30 years	3.200	0.014	2.352	0.187
	3.778	0.002	2.974	0.029
	3.922	0.001	2.718	0.066
	1.044	0.297	1.502	0.133
	1.685	0.920	2.243	0.249
36－40 years vs ≤25 years 31－35 years vs 26－30 years 31－35 years vs ≤25 years	2.303	0.213	2.051	0.403
	0.770	0.442	0.874	0.382
	1.712	0.869	1.053	0.292
26－30 years vs ≤25 years	1.272	0.203	0.529	0.597

Group	Semen parameter
Group	Sperm concentration		Total number of sperm		PR+NP		PR
	z	P	z	P	z	P	z	P
6－7 d vs 4－5 d	－2.781	0.016	－3.204	0.004	2.399	0.049	3.451	0.002
6－7 d vs 2－3 d	－5.573	<0.001	－8.153	<0.001	3.600	0.001	4.971	<0.001
4－5 d vs 2－3 d	－3.504	<0.001	－6.157	<0.001	1.543	0.368	1.967	0.147

Analysis on semen quality and its influencing factors in male infertility patients

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Variable	Sperm concentration (×10⁶ mL^－1)	Total number of sperm (×10⁶)	(PR+NP)(η/%)	PR(η/%)	Percentage of normal sperm(η/%)
Age(year)
≤25	Reference	Reference	Reference	Reference	Reference
26—30	0.98(0.88—1.10)	1.00(0.89—1.13)	0.97(0.93—1.01)	0.97(0.92—1.03)	1.10(0.98—1.24)
31—35	1.05(0.93—1.18)	1.00(0.89—1.13)	0.96(0.92—1.00)	0.96(0.90—1.02)	1.08(0.96—1.22)
36—40	1.01(0.89—1.16)	0.95(0.83—1.08)	0.96(0.92—1.01)	0.94(0.88—1.01)	1.11(0.97—1.27)
≥41	1.06(0.92—1.23)	0.87(0.75—1.01)	0.88(0.83—0.92)^**	0.85(0.78—0.92)^**	1.17(1.01—1.36)^*
Abstinence day(t/d)
2—3	Reference	Reference	Reference	Reference	Reference
4—5	1.10(1.03—1.17)^**	1.21(1.13—1.30)^**	1.00(0.97—1.02)	0.99(0.96—1.03)	0.96(0.90—1.03)
6—7	1.23(1.13—1.33)^**	1.38(1.27—1.51)^**	0.96(0.93—0.99)^**	0.93(0.89—0.97)^**	0.94(0.86—1.02)
Season
Spring	Reference	Reference	Reference	Reference	Reference
Summer	0.95(0.88—1.04)	0.85(0.78—0.93)^**	0.94(0.91—0.96)^**	0.88(0.84—0.92)^**	0.85(0.78—0.93)^**
Autumn	0.75(0.69—0.82)^**	0.75(0.69—0.82^**	0.94(0.91—0.97)^**	0.87(0.83—0.91)^**	0.83(0.76—0.90)^**
Winter	1.03(0.95—1.12)	0.91(0.84—1.00)^*	0.97(0.94—1.00)^*	0.91(0.87—0.95)^**	0.94(0.86—1.03)

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Group	Semen parameter
Group	Sperm concentration		PR+NP		PR		Percentage of normal sperm
	z	P	z	P	z	P	z	P
Antumn vs summer	2.351	0.112	－3.073	0.013	0.039	0.969	1.930	0.322
Antumn vs winter	－5.389	<0.001	－3.160	0.009	－2.204	0.165	－4.479	<0.001
Antumn vs spring	5.692	<0.001	9.309	<0.001	7.954	<0.001	4.512	<0.001
Summer vs winter	－3.032	0.015	－0.009	0.993	－2.203	0.166	－2.544	0.066
Summer vs spring	3.406	0.004	6.166	<0.001	8.046	<0.001	2.635	0.051
Winter vs spring	0.471	0.638	6.304	<0.001	5.962	<0.001	0.169	0.866