Reduced Testicular Steroidogenesis and Increased Semen Oxidative Stress in Male Partners as Novel Markers of Recurrent Miscarriage
Reduced Testicular Steroidogenesis and Increased Semen Oxidative Stress in Male Partners as Novel Markers of Recurrent Miscarriage
复制标题
DOI：
10.1373/clinchem.2018.289348
复制
发表时间：
2019-01-01
影响因子：
9.3
通讯作者：
Dhillo, Waljit S.
中科院分区：
文献类型：
--
作者：
Jayasena, Channa N.;Radia, Utsav K.;Dhillo, Waljit S.
背景：复发性妊娠丢失(RPL)影响1%-2%的夫妇，定义为妊娠20周前连续3次妊娠丢失。患有RPL的女性通常会进行病因筛查，但目前不建议对男性伴侣进行常规筛查。最近有人提出，患有RPL的女性的男性伴侣的精子质量会降低，但这种质量降低的原因尚不清楚。我们假设这些男性可能存在潜在的生殖内分泌和代谢功能障碍，导致精子质量下降。方法：经过伦理学批准，比较了健康对照组和患有RPL的女性的男性伴侣的生殖参数。用室内化学发光法测定精液中的ROS。结果：与对照组相比，RPL组的总精子活力、前进精子活力和正常形态精子活力均降低。RPL组晨间平均+/-SE血清睾酮(nmoL/L)较对照组低15%(对照组，19.0+/-1.0；RPL，16.0+/-0.8；P<；0.05)。RPL组平均+/-SE血清雌二醇(PmoUL)水平较对照组低16%(对照组，103.1+/-5.7；RPL，86.5+/-3.4；P<；血清黄体生成素和卵泡刺激素组间差异无统计学意义。RPL组平均+/-SE ROS(RLU/s/10(6)精子)是对照组的4倍(对照组，2.0+/-0.6；RPL，9.1+/-4.1；P<；0.01)。RPL组平均+/-SE精子DNA片段率(%)是对照组的2倍(对照组，7.3+/-1.0；RPL，16.4+/-1.5；P<；0.0001)。结论：RPL女性男性伴侣的生殖内分泌功能受损，精液ROS水平升高，精子DNA片段化。对男性伴侣进行常规生殖评估可能对RPL有益。(C)2018年美国临床化学协会
BACKGROUND: Recurrent pregnancy loss, (RPL) affecting 1%-2% of couples, is defined as >= 3 consecutive pregnancy losses before 20-week' gestation. Women with RPL are routinely screened for etiological factors, but routine screening of male partners is not currently recommended. Recently it has been suggested that sperm quality is reduced in male partners of women with RPL, but the reasons underlying this lower quality are unclear. We hypothesized that these men may have underlying impairments of reproductive endocrine and metabolic function that cause reductions in sperm quality.METHODS: After ethical approval, reproductive parameters were compared between healthy controls and male partners of women with RPL. Semen reactive oxygen species (ROS) were measured with a validated in house chemiluminescent assay. DNA fragmentation was measured with the validated Halosperm method.RESULTS: Total sperm motility, progressive sperm motility, and normal morphology were all reduced in the RPL group vs controls. Mean +/- SE morning serum testosterone (nmol/L) was 15% lower in RPL than in controls (controls, 19.0 +/- 1.0; RPL, 16.0 +/- 0.8; P< 0.05). Mean +/- SE serum estradiol (pmoUL) was 16% lower in RPL than in controls (controls, 103.1 +/- 5.7; RPL, 86.5 +/- 3.4; P< 0.01). Serum luteinizing hormone and follicle-stimulating hormone were similar between groups. Mean +/- SE ROS (RLU/sec/10(6) sperm) were 4-fold higher in RPL than in controls (controls, 2.0 +/- 0.6; RPL, 9.1 +/- 4.1; P < 0.01). Mean +/- SE sperm DNA fragmentation (%) was 2-fold higher in RPL than in controls (controls, 7.3 +/- 1.0; RPL, 16.4 +/- 1.5; P < 0.0001).CONCLUSIONS: Our data suggest that male partners of women with RPL have impaired reproductive endocrine function, increased levels of semen ROS, and sperm DNA fragmentation. Routine reproductive assessment of the male partners may be beneficial in RPL. (C) 2018 American Association for Clinical Chemistry