在孟加拉国锡尔赫特接受不孕症治疗的不育男性伴侣的精液模式

Laila Nazneen Khan, Nowshafreen Chowdhury, Riffat Rahim, Kamrunnahar Sweety, Razia Begum, Tahera Sultana, Fahmida Naz Mustafa
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引用次数: 0

摘要

背景:不孕症具有重大的公共卫生、经济和社会心理后果,影响约15% - 20%的育龄夫妇。男性不育可能是由于精子产量低、精子功能异常或精子输送受阻造成的。疾病、伤害、慢性健康问题和生活方式都可能导致男性不育。目的:研究在锡尔赫特市某三级医院门诊就诊的不育夫妇的精液特征。方法:本前瞻性纵向研究于2004年6月至2004年12月在SOMCH的OPD中进行。研究人群包括100名不育夫妇的男性伴侣,他们至少尝试了一年。排除标准是做过输精管结扎术的男性。 不育夫妇的每一位男性伴侣都被提供了关于收集精液方法的详细说明。禁欲三天后,受试者被要求在实验室提供的干净、干燥、宽口的容器中通过手淫收集精液。在大多数情况下,精液是在实验室内的精液采集室收集的,但建议那些无法通过手淫产生精液的人在性交中断后尽快将标本带到实验室。严格要求精液在检测时2小时内取出,2小时后取出的样本被拒收。精子浓度用马克勒计数室估计。在光镜下通过精液涂片评估精子形态。精液参数按WHO(1999)精液分析参考值解释为正常或异常。在没有精子的患者中,在宣布无精子症之前,每隔四周重复进行三次精液分析。无精子症和少精子症患者也进行激素检测。 结果:本研究中绝大多数(87%)精液标本在2 ~ 3ml之间。在本研究中,66%的精液样本精子数量超过2000万/ml, 20%为600 - 2000万/ml, 5%为<500万/零&9%的人精液标本中没有精子(无精子症)。100例中,66%的精液标本显示精子浓度正常(> 2000万/ml)。34%显示精子浓度低或没有。在本研究中,大多数(74%)男性伴侣的精液标本中存在脓细胞。本研究中大部分精液标本(96%)在30分钟内液化,95%的精液标本pH值在7.2-7.4之间。在这项研究中,在100个样本中,9个样本(9%)的精子浓度为0。在这91个样本中,20.86%的精液样本中有10-50%的活跃精子,2.18%的精液样本中有10%的活跃精子。91个样本中有21个(23.04%)精子活力低下。这一比例极显著(P=<0.005)。2.18%的精液标本有10%的精子形态正常。正常精子形态下男性伴侣的分布他们的精子数量非常显著(P值<0.001) 结论:无精子症、弱精子症和精液感染是我国男性不育症的重要因素 中华医学杂志[j];6 (1): 16 - 19
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Semen Pattern of Infertile-Male Partners Attending for Infertility Treatment, Sylhet, Bangladesh
Background: Infertility has major public health, economic, and psychosocial consequences, affecting approximately 15% - 20% of couples of reproductive ages. Male infertility can be caused by low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm . Illness, injuries, chronic health problems, life style may contribute to male infertility. Objective: the aim of the study was to find the semen profile of infertile couples who attended the OPD of a tertiary hospital in Sylhet city. Methodology: This prospective longitudinal study was carried out in OPD of SOMCH, from June 2004 to December 2004. The study population was included with the criteria of the 100 male partners of the infertile couples who had tried for at least one year. The Exclusion criteria were men who had undergone a vasectomy. Each of the male partner of the infertile couples were provided-with detailed instructions regarding the method of collection of the semen. After three days of abstinence, the subjects were instructed to collect semen by masturbation in a clean, dry, wide-mouthed container provided by the laboratory. In most of the cases, semen was collected in the semen collection room within the premises of the laboratory, but those were unable to produce semen by masturbation were advised to bring the specimen to the laboratory as soon as possible after collection by coitusinteruptus. It was strictly suggested that the semen was to be brought within 2 hours at the test, sample which was brought after 2 hours was rejected. The sperm concentration was estimated by using the Makler counting chamber. Sperm morphology was assessed under light microscope by making a semen smear. The semen parameters were interpreted as normal or abnormal according to WHO (1999) semen analysis reference values. In patients with absence of sperm, semen analysis was repeated three times at four weeks interval before declaring azoospermia. Those patients with azoospermia and oligospermia also had a hormonal assay. Result: In this study, most (87%) of the semen specimens were between 2-3ml.In this study, 66% of the semen samples had a sperm count of more than 20 million/ml, 20% had 6-20 million/I, 5% had < 5 million/nil & 9 % had no sperm in their semen specimen (azoospermia). Out of 100 cases, 66% of semen specimens showed normal sperm concentration (>20 million/ml) . 34% showed low or no sperm concentration. Statistically, the proportion is highly significant (P=<0.001) In this study, the majority (74%) of male partners had pus cell in their semen specimen. In this study, most of the semen specimens (96%) liquefied within 30 minutes and 95% cases, pH of the semen specimen was between 7.2-7.4. In this study, out of 100 sample, sperm concentrations were found 0 in 9 samples (9%). Out of this 91 samples, 20.86% had 10-50% actively motile sperm, 2.18% had <10% motile sperm in their semen specimen. Out of 91 samples 21(23.04%) showed low sperm motility. The proportion is highly significant (P=<0.005). 2.18% semen specimen had <10% normal sperm morphology. The distribution of male partners according to normal sperm morphology & their sperm count is highly significant (P value<0.001) Conclusion: In conclusion, azoospermia and asthenozoospermia and infection in semen are found to be important factors associated with male infertility in our country Mugda Med Coll J. 2023; 6(1): 16-19
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