泰国少精无精不育男性中Y染色体微缺失和染色体异常的发病率

Aim:To investigate the possible causes of oligozoospermia and azoospermia in infertile Thai men, and to find the frequencies of Y chromosome microdeletions and cytogenetic abnormalities in this group. Methods: From June 2003 to November 2005, 50 azoospermic and 80 oligozoospermic men were enrolled in the study. A detailed history was taken for each man, followed by general and genital examinations. Y chromosome microdeletions were detected by multiplex polymerase chain reaction (PCR) using 11 gene-specific primers that covered all three regions of the azoospermic factor (AZFa, AZFb and AZFc). Fifty men with normal semen analysis were also studied. Karyotyping was done with the standard G- and Q-banding. Serum concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and testosterone were measured by electrochemiluminescence immunoassays (ECLIA). Results: Azoospermia and oligozoospermia could be explained by previous orchitis in 22.3%, former bilateral cryptorchidism in 19.2%, abnormal karyotypes in 4.6% and Y chromosome microdeletions in 3.8% of the subjects. The most frequent deletions were in the AZFc region (50%), followed by AZFb (33%) and AZFbc (17%).No significant difference was detected in hormonal profiles of infertile men, with or without microdeletions.Conclusion: The frequencies of Y chromosome microdeletions and cytogenetic abnormalities in oligozoospermic and azoospermic Thai men are comparable with similarly infertile men from other Asian and Western countries.

正常生育和不育男性的精浆中层粘连蛋白的评价

Aim:To assess laminin levels in the seminal plasma of infertile and fertile men, and to analyze the correlation of laminin levels with sperm count, age, sperm motility and semen volume. Methods: One hundred and twenty-five recruited men were equally divided into five groups according to their sperm concentration and clinical examination: fertile normozoospermia, oligoasthenozoospermia, non-obstructive azoospermia (NOA), obstructive azoospermia (OA) and congenital bilateral absent vas deferens (CBAVD). The patients' medical history was investigated and patients underwent clinical examination, conventional semen analysis and estimation of seminal plasma laminin by radioimmunoassay. Results: Seminal plasma laminin levels of successive groups were: 2.82 ± 0.62, 2.49 ± 0.44,1.77 ± 0.56, 1.72 ± 0.76, 1.35 ± 0.63 U/mL, respectively. The fertile normozoospermic group showed the highest concentration compared to all infertile groups with significant differences compared to azoospermic groups (P＜0.05). Testicular contribution was estimated to be approximately one-third of the seminal laminin. Seminal plasma laminin demonstrated significant correlation with sperm concentration (r = 0.460, P ＜ 0.001) and nonsignificant correlation with age (r = 0.021, P = 0.940), sperm motility percentage (r = 0.142, P = 0.615) and semen volume (r = 0.035, P = 0.087). Conclusion: Seminal plasma laminin is derived mostly from prostatic and testicular portions and minimally from the seminal vesicle and vas deferens. Estimating seminal laminin alone is not conclusive in diagnosing different cases of male infertility.

种族划分是否会影响男性激素避孕的功效?

睾丸"图谱"对非梗阻性无精子症男性的价值

Various methods are currently under investigation to preserve fertility in males treated with high?dose chemotherapy and radiation for malignant and nonmalignant disorders. Human umbilical cord mesenchymal stem cells(HUC?MSCs), which possess potent immunosuppressive function and secrete various cytokines and growth factors, have the potential clinical applications. As a potential alternative, we investigate whether injection of HUC?MSCs into the interstitial compartment of the testes to promote spermatogenic regeneration efifciently. HUC?MSCs were isolated from different sources of umbilical cords and injected into the interstitial space of one testis from 10 busulfan?treated mice(saline and HEK293cells injections were performed in a separate set of mice) and the other testis remained uninjected. Three weeks after MSCs injection, Relative quantitative reverse transcription polymerase chain reaction was used to identify the expression of 10 of germ cell associated, which are all related to meiosis, demonstrated higher levels of spermatogenic gene expression(2–8 fold) in HUC?MSCs injected testes compared to the contralateral uninjected testes(ifve mice). Protein levels for germ cell?speciifc genes,miwi, vasa and synaptonemal complex protein (Scp3)were also higher in MSC?treated testes compared to injected controls 3weeks after treatment. However, no different expression was detected in saline water and HEK293cells injection control group. We have demonstrated HUC?MSCs could affect mouse germ cell?speciifc genes expression. The results also provide a possibility that the transplanted HUC?MSCs may promote the recovery of spermatogenesis. This study provides further evidence for preclinical therapeutic effects of HUC?MSCs, and explores a new approach to the treatment of azoospermia.

Childhood inguinal herniorrhaphy is one common cause of seminal tract obstruction. Vasovasostomy(VV) can reconstruct seminal deferens and result in appearance of sperm and natural pregnancy in some patients. Secondary epididymal obstruction caused by a relatively long?term vasal obstruction is a common cause of lower patency compared with VV due to vasectomy in adults. From July 2007 to June 2012, a total of 62patients, with history of childhood inguinal herniorrhaphy and diagnosed as obstructive azoospermia were treated in our center. The overall patency rate and natural pregnancy rate were 56.5%(35/62) and 25.8%(16/62), respectively. 48.4%(30/62) of the patients underwent bilateral VV in the inguinal region, with a patency rate of 76.7%(23/30) and a natural pregnancy rate of 36.7%(11/30), respectively. 30.6%(19/62) of the patients underwent bilateral VV and unilateral or bilateral vasoepididymostomies due to ipsilateral epididymal obstruction with the patency and natural pregnancy rate decreasing to 63.2%(12/19) and 26.3%(5/19). 21.0%(13/62) of the patients merely underwent vasal exploration without reconstruction due to failure to ifnd distal vasal stump,etc. Our study indicate that microsurgical reanastomosis is an effective treatment for some patients with seminal tract obstruction caused by childhood inguinal herniorrhaphy.

精液血浆抗苗勒管激素水平与精液参数相关但不能预测睾丸切开取精术是否成功

Eighty-four male cases were studied and divided into four groups: fertile normozoospermia (n = 16), oligoasthenoteratozoospermia (n = 15), obstructive azoospermia (OA) (n = 13) and non-obstructive azoospermia (NOA) (n = 40).Conventional semen analysis was done for all cases. Testicular biopsy was done with histopathology and fresh tissue examination for testicular sperm extraction (TESE) in NOA cases. NOA group was subdivided according to TESE results into unsuccessful TESE (n = 19) and successful TESE (n = 21). Seminal plasma AMH was estimated by enzyme linked immunosorbent assay (ELISA) and serum follicular stimulating hormone (FSH) was estimated in NOA cases only by radioimmunoassay (RIA). Results: Mean seminal AMH was signifcantly higher in fertile group than in oligoasthenoteratozoospermia with significance (41.5 ± 10.9 pmol/L vs. 30.5 ± 10.3 pmol/L, P ＜ 0.05). Seminal AMH was not detected in any OA patients. Seminal AMH was correlated positively with testicular volume (r = 0.329, P = 0.005),sperm count (r = 0.483, P = 0.007), sperm motility percent (r = 0.419, P = 0.021) and negatively with sperm abnormal forms percent (r = -0.413, p = 0.023). Nonsignificant correlation was evident with age (r = -0.155, P = 0.414)and plasma FSH ( r = -0.014, P = 0.943). In NOA cases, seminal AMH was detectable in 23/40 cases, 14 of them were successful TESE (57.5%) and was undetectable in 17/40 cases, 10 of them were unsuccessful TESE (58.2%).Conclusion: Seminal plasma AMH is an absolute testicular marker being absent in all OA cases. However, seminal AMH has a poor predictability for successful testicular sperm retrieval in NOA cases.

参数正常和无精子症精液游离DNA的快速提取与一般特征:遗传研究及诊断的无创性途径