Sperm morphology, motility, and concentration in fertile and infertile men.
Sperm morphology, motility, and concentration in fertile and infertile men.
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DOI：
10.1056/nejmoa003005
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发表时间：
2001-11-08
影响因子：
158.5
通讯作者：
Natl Cooperative Reprod Med Network
中科院分区：
文献类型：
--
作者：
Guzick, DS;Overstreet, JW;Natl Cooperative Reprod Med Network
背景：虽然精液分析通常被用来评估不育夫妇中的男性伴侣，但区分生育和不育男性的精子测量还没有很好的定义。方法：我们评估了9个地点的765对不育夫妇和696对生育夫妇的每个男性伴侣的精液样本。不孕症夫妇中的女性伴侣的生育能力评估结果正常。在这些地点测定精子密度和活动率；在这些地点进行精液涂片染色，并运往中心实验室，使用严格的标准评估精子的形态特征。我们使用分类和回归树分析来估计与精子密度、活动率和形态相关的次生育和生育阈值。结果：不育男性的精子密度低于13.5×10(Sup 6)/毫升，活动率低于32%，形态特征正常者低于9%。可育范围是每毫升超过48.0×10(Sup 6)的浓度，超过63%的活力，超过12%的正常形态特征。介于这些范围之间的值表明生育率不确定。在所有三项测量中，有生育能力的人和不能生育的人在低生育能力和可生育能力的范围内都有广泛的重叠。尽管每一项精子测量都有助于区分生育能力和不育男性，但没有一项是强有力的鉴别器。结论：精子密度、精子活力和精子形态的阈值可以用来将男性分为低生育能力、不确定生育能力和生育能力。然而，这些措施都不能诊断为不孕不育。
Background: Although semen analysis is routinely used to evaluate the male partner in infertile couples, sperm measurements that discriminate between fertile and infertile men are not well defined.Methods: We evaluated two semen specimens from each of the male partners in 765 infertile couples and 696 fertile couples at nine sites. The female partners in the infertile couples had normal results on fertility evaluation. The sperm concentration and motility were determined at the sites; semen smears were stained at the sites and shipped to a central laboratory for an assessment of morphologic features of sperm with the use of strict criteria. We used classification-and-regression-tree analysis to estimate threshold values for subfertility and fertility with respect to the sperm concentration, motility, and morphology. We also used an analysis of receiver-operating-characteristic curves to assess the relative value of these sperm measurements in discriminating between fertile and infertile men.Results: The subfertile ranges were a sperm concentration of less than 13.5 x 10(sup 6) per milliliter, less than 32 percent of sperm with motility, and less than 9 percent with normal morphologic features. The fertile ranges were a concentration of more than 48.0 x 10(sup 6) per milliliter, greater than 63 percent motility, and greater than 12 percent normal morphologic features. Values between these ranges indicated indeterminate fertility. There was extensive overlap between the fertile and the infertile men within both the subfertile and the fertile ranges for all three measurements. Although each of the sperm measurements helped to distinguish between fertile and infertile men, none was a powerful discriminator. The percentage of sperm with normal morphologic features had the greatest discriminatory power.Conclusions: Threshold values for sperm concentration, motility, and morphology can be used to classify men as subfertile, of indeterminate fertility, or fertile. None of the measures, however, are diagnostic of infertility.