目的 探讨高浓度精液标本用全自动精子质量分析仪检测时对精子浓度及前向运动精子百分率(PR)、非前向运动精子百分率(NP)和不动精子百分率(IM)等结果的影响.方法 选取2023年2月至5月于本院生殖门诊就诊患者,精液标本采用全自动精子质量分析仪检测.分析初检精子浓度≥ 100×106/mL,且精液量≥1.5 mL的精液标本155例,设定为高浓度精液原液组(A组);自身精浆稀释组(B组)和37 ℃生理盐水稀释组(C组)分别以自身精浆和37℃生理盐水为稀释液,均按1∶2稀释比例稀释;手工法计数精液原液精子浓度为对照组.分别测定各组精子浓度和精子活力参数.观察A、B、C各组间精子浓度、PR、NP以及IM的差异,以及精子浓度与PR、NP、IM之间的相关性.结果 高浓度精液原液组(A组)的精子浓度显著低于手工法对照组、自身精浆稀释组(B组)和37 ℃生理盐水稀释组(C组)(P均<0.05);B、C两组与对照组之间精子浓度差异无统计学意义(P>0.05);C组的PR显著低于A组和B组(P均<0.05),A组和B组的PR差异无统计学意义(P>0.05);A组的NP显著高于B、C两组(P均<0.05),而B、C两组之间差异无统计学意义(P>0.05);A组的IM显著低于B、C组(P均<0.05),而B、C两组间差异无统计学意义(P>0.05).结论 高浓度精液标本未稀释直接检测可能会引起精子浓度偏低、NP增高和IM降低;建议稀释后检测以提高结果准确性;37 ℃生理盐水稀释可导致PR降低,建议以自身精浆作为高浓度精液标本的首选稀释液.
Objective To investigate the effects of high concentration of semen samples in detection by fully automated sperm quality analyzer for sperm concentration,progressive motility(PR),non-progressive motility(NP)and percentage of immotile sperm(IM).Methods The semen samples from the patients who visited the reproductive clinic in our hospital from February 2023 to May 2023 were analyzed using the fully automated sperm quality analyzer.A total of 155 semen samples with initial sperm concentration ≥100× 106/mL and semen volume ≥1.5 mL were set as the high concentration semen group(group A).The semen samples with self seminal plasma dilution group(group B)and 37 ℃ normal saline dilution group(group C)were prepared with their own seminal plasma and normal saline at 1∶2 dilution ratio respectively.The sperm concentration of group A was detected by the manual method as the control.The sperm concentration and motility parameters of each group were detected.The differences of sperm concentration and the values of PR,NP and IM among the group A,B and C were analyzed.The correlations between sperm concentration and PR,NP and IM were also assessed.Results The sperm concentration of group A was significantly lower than that of the control group and groups B and C(all P<0.05).There was no statistically significant difference for the results between group B and group C(P>0.05).The PR in group C was significantly lower than that in groups A and B(all P<0.05),and there was no significant difference of PR between group A and group B(P>0.05).The values of NP in group A was significantly higher than that in groups B and C(all P<0.05),and there was no significant difference in NP between group B and group C(P>0.05).The IM in group A was significantly lower than that in groups B and C(all P<0.05),and there was no statistical difference of IM values between group B ang group C(P>0.05).Conclusion The direct analysis of undiluted semen samples with high sperm concentration may lead to lower results of sperm concentration,increased percentage of NP sperm and decreased percentage of IM sperm.The dilution of semen samples may improve the accuracy of the detec-tion results.The dilution with 37 ℃ normal saline can lead to decrease of the percentage of PR sperm.The self seminal plasma should be recommended as the first choice of diluent for the semen samples with high sperm concentration.