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目的:探讨原发不育症与继发不育症患者精液参数的异同,以期为临床治疗男性不育症患者提供指导。方法:对2013年5月—2014年5月就诊于我中心77例男性不育患者,分为原发不育症组52例,继发不育症组25例,进行精液分析,并对精子密度、活力及畸形率进行对比分析。结果:原发不育症组52例患者中精子参数正常16例,少精子症10例,弱精子症9例,少弱精子症4例,畸形精子症4例,无精子症9例;继发不育症组25例患者中精子参数正常20例,少精子症2例,弱精子症2例,少弱精子症1例。两组病因构成差异有统计学意义(P=0.002);原发不育症组精子密度为(60.65±81.30)×106/m L,精子活力(A+B)(35.86±24.81)%,精子畸形率为(73.5±34.29)%;继发不育症组精子密度为(120.51±93.31)×106/m L,精子活力(56.14±16.14)%,精子畸形率为(87.48±4.42)%。继发不育症组的精子密度、精子活力(前项运动精子比率)及正常形态精子比率明显优于原发不育组,差异有统计学意义。结论:继发不育症的治疗应重点在于治疗后使其自然妊娠,而对于原发不育症患者应在药物治疗一段时间(一般3个月~6个月)后,精子质量改善不明显可考虑及早行人类辅助生殖技术(ART)助孕。
Objective: To explore the similarities and differences between semen parameters of primary infertility and secondary infertility so as to provide guidance for clinical treatment of male infertility. Methods: From May 2013 to May 2014, 77 male infertility patients in our center were divided into primary infertility group (52 cases) and secondary infertility group (25 cases), and semen analysis was performed. Density, vitality and deformity rate comparative analysis. Results: Among 52 cases of primary infertility group, sperm parameters were normal in 16 cases, oligozoospermia in 10 cases, asthenospermia in 9 cases, oligozoospermia in 4 cases, deformity spermosis in 4 cases and azoospermia in 9 cases. In 25 infertility patients, 20 normal sperm parameters, 2 oligozoospermia, 2 asthenospermia and 1 oligozoospermia were found. There were significant differences in etiology between the two groups (P = 0.002). The sperm density in the primary infertility group was (60.65 ± 81.30) × 106 / m L and the sperm motility (A + B) was 35.86 ± 24.81% The sperm deformity rate was (73.5 ± 34.29)%. The sperm density was (120.51 ± 93.31) × 106 / m L, the sperm motility was 56.14 ± 16.14% and the sperm deformity rate was (87.48 ± 4.42)%. Secondary infertility group sperm density, sperm motility (motile sperm ratio in the preceding paragraph) and normal morphology sperm ratio was significantly better than the primary sterile group, the difference was statistically significant. Conclusion: The treatment of secondary infertility should focus on the natural pregnancy after treatment, but for patients with primary infertility should be in the drug treatment for a period of time (usually 3 months to 6 months), no significant improvement in sperm quality Early ART assisted pregnancy may be considered.