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Single semen analysis as a predictor of semen quality： clinical and epidemiological implications

Asian Journal of Andrology 2009年第6期11卷 723-730页

作者： Lars Rylander Boel Wetterstrand Trine B Haugen Gunilla Malm Johan Malm cathrine bjorsvik Trine Henrichsen Thomas Saether Aleksander Giwercman Reproductive Medicine Centre Maltao University Hospital Lund University Maltao SE-20502 Sweden Division of Occupational and Environmental Medicine Lund University Lund SE-22185 Sweden Faculty of Health Sciences Oslo University College Oslo NO-O130 Norway Andrology Laboratory Dept of Gynecology and Obstetrics Rikshospitalet University Hospital Oslo N0-0027 Norway Department of Clinical Chemistry Malmo University Hospital Malmo SE-20502 Sweden Department of Molecular Biosciences University of Oslo Oslo N0-0316 Norway

It is generally thought that a single ejaculate is a bad predictor of semen quality of a subject, because of significant intra-individual variation. Therefore, we investigated the degree to which the results of a first semen analysis differ from that of a second analysis among men from a how the two different semen results mirrored the overall general population in Norway. In addition, we analysed semen quality assessment. A total of 199 volunteers participated in the study and delivered two semen samples with an interval of 6 months. The semen parameters were determined according to the World Health Organization （WHO） 1999 guidelines, which were also used to determine whether semen quality was normal or abnormal. In addition, the DNA fragmentation index （DFI） was determined using the Sperm Chromatin Structure Assay. The two samples from each individual were very similar with regard to standard semen parameters and DFI （rs： 0.67-0.72）, and there were no significant systematic differences between the two samples. The result of the first sample （normal/abnormal） was highly predictive of the overall conclusion based on the two samples （sperm concentration： in 93% of the cases （95% confidence interval [CI]： 89%-96%）; sperm motility： in 85% of the cases （95% CI： 79%-89%）; overall semen quality： in 85% of the cases （95% CI： 80%-90%）. In epidemiological studies, one ejaculate is a sufficient indicator of semen quality in a group of subjects. In a clinical situation, when the question is whether the semen quality is normal or not, the first ejaculate will, in at least 85% of cases, give a correct overall conclusion.

关键词： DNA fragmentation intra-individual semen quality semen volume sperm concentration sperm motility

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