A data-driven search for semen-related phenotypes in conception delay.
A data-driven search for semen-related phenotypes in conception delay.
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DOI：
10.1111/andr.12288
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发表时间：
2017-01
期刊：
影响因子：
4.5
通讯作者：
Buck Louis GM
中科院分区：
文献类型：
--
作者：
Patel CJ;Sundaram R;Buck Louis GM
据报道，精子数量、形态和活力可以预测怀孕，尽管其基础不明确，促使一些作者质疑精液分析的预后价值。为了评估精液质量数据在预测受孕延迟或需要超过 6 个周期才能怀孕（称为受孕延迟）方面的效用，我们在受孕前队列中使用了新颖的数据驱动分析技术，对怀孕时间进行了前瞻性随访。研究队列由 402 名 (80%) 男性伴侣组成，他们提供了精液样本并掌握了怀孕时间信息。女性伴侣使用家庭妊娠测试并将结果记录在每日日记中。对 40 个精液质量表型（包括 35 个精液质量终点和 5 个密切相关的生育力决定因素（体重指数、避孕时间、血脂、可替宁和精液白细胞））估计了受孕延迟（怀孕时间 > 6 个周期）的比值比 (OR)、错误发现率和 95% 置信区间 (CI)。传统和严格的精子表型测量均与较低的受孕延迟几率相关。具体来说，对于使用传统方法增加形态正常精子的百分比，我们观察到受孕延迟减少了 40%（OR = 0.6，95% CI = 0.50、0.81；p = 0.0003）。同样，随着严格标准的增加，我们观察到受孕延迟的几率降低了 30%（OR = 0.7，95% CI = 0.52、0.83；p = 0.001）。另一方面，卷尾精子百分比的增加与受孕延迟几率增加 40% 相关（OR = 1.4，95% CI = 1.12、1.75；p = 0.003）。然而，我们的研究结果表明，精液表型对受孕延迟的预测价值不大（曲线下面积为 73%）。在包含显着精液因素和传统风险因素（即年龄、体重指数、可替宁和曾经怀孕）的多变量模型中，受孕延迟的预测略有改善（曲线下面积增加 16%，p < 0.0002）。
Sperm count, morphology, and motility have been reported to be predictive of pregnancy, although with equivocal basis prompting some authors to question the prognostic value of semen analysis. To assess the utility of including semen quality data in predicting conception delay or requiring >6 cycles to become pregnant (referred to as conception delay), we utilized novel data‐driven analytic techniques in a pre‐conception cohort of couples prospectively followed up for time‐to‐pregnancy. The study cohort comprised 402 (80%) male partners who provided semen samples and had time‐to‐pregnancy information. Female partners used home pregnancy tests and recorded results in daily journals. Odds ratios (OR), false discovery rates, and 95% confidence intervals (CIs) for conception delay (time‐to‐pregnancy > 6 cycles) were estimated for 40 semen quality phenotypes comprising 35 semen quality endpoints and 5 closely related fecundity determinants (body mass index, time of contraception, lipids, cotinine and seminal white blood cells). Both traditional and strict sperm phenotype measures were associated with lower odds of conception delay. Specifically, for an increase in percent morphologically normal spermatozoa using traditional methods, we observed a 40% decrease in conception delay (OR = 0.6, 95% CI = 0.50, 0.81; p = 0.0003). Similarly, for an increase in strict criteria, we observed a 30% decrease in odds for conception delay (OR = 0.7, 95% CI = 0.52, 0.83; p = 0.001). On the other hand, an increase in percent coiled tail spermatozoa was associated with a 40% increase in the odds for conception delay (OR = 1.4, 95% CI = 1.12, 1.75; p = 0.003). However, our findings suggest that semen phenotypes have little predictive value of conception delay (area under the curve of 73%). In a multivariate model containing significant semen factors and traditional risk factors (i.e. age, body mass index, cotinine and ever having fathered a pregnancy), there was a modest improvement in prediction of conception delay (16% increase in area under the curve, p < 0.0002).
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影响因子：
2.8
作者：
Buck Louis GM;Yeung E;Sundaram R;Laughon SK;Zhang C
通讯作者：
Zhang C
影响因子：
3.7
作者：
Patel CJ;Bhattacharya J;Butte AJ
通讯作者：
Butte AJ
影响因子：
3.3
作者：
Bonde, JPE;Hjollund, NHI;Olsen, J
通讯作者：
Olsen, J
影响因子：
13.3
作者：
Cooper, Trevor G.;Noonan, Elizabeth;Vogelsong, Kirsten M.
通讯作者：
Vogelsong, Kirsten M.
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y