精子畸形男人怕难育 Sperm malformation man afraid of difficult to brood

受访专家/中山大学附属第六医院泌尿外科主任 汪中扬 Interviewed experts/sun yat-sen university affiliated sixth hospital uropoiesis surgical department director WangZhong Yang

　　经历了婚前及婚后的一段浪漫生活，许多小夫妻开始积极计划孕育一个见证两人爱情的新生命。可是，经过一年、两年的“辛勤耕耘”，什么“奥运宝宝”、“龙宝宝”都没有降临，这下子可让小夫妻初尝愁滋味了。众多国内外资料显示不孕不育症约占已婚夫妇的10%，而男方因素约占40%，其中约50%不育男性精子形态异常。目前，精子形态异常的机制尚未完全明晰，这使部分畸形精子症患者得不到有效治疗。

Experienced before marriage and after marriage a romantic life，Many small couples began to actively plan conceived a witness two people love new life。but，After a year、Two years of“Hard work”，what“Olympic baby”、“Dragon baby”Didn't come，It can let a little at the beginning of the husband and wife sorrow taste the taste。Many domestic and foreign data display infertility accounted for about 10% of married couples，And the man factors about 40%，About 50% of infertile men abnormal sperm forms。At present，The mechanism of abnormal sperm morphology has not yet completely clear，This makes part of sperm abnormalities disease patients did not receive effective treatment。

正常精子低于15%受孕难 Normal sperm less than 15% conception difficult

　　中山大学附属第六医院泌尿外科主任汪中扬表示，畸形精子过多症，是指异常形态的精子比例过多的一种病症。畸形精子不具备正常的活动能力和受孕能力，是导致男性不育的主要原因之一。正常精液内，除正常精子外，还含有一定比例的畸形精子，在最新的WHO手册中规定人类精子正常形态的参考范围最低限是4%，然而相关来自辅助生殖技术项目的资料表明，如果正常形态精子低于15%，体外受精率低。

Sun yat-sen university affiliated sixth hospital uropoiesis surgical department director WangZhong Yang said，Sperm malformation too much disease，Refers to the abnormal morphology sperm proportion too much a disease。Sperm malformation do not have the normal activity ability and ability to conception，In one of the main causes of male infertility。Within normal semen，In addition to normal sperm outside，Also contains a percentage of sperm deformity，In the latest WHO manual human sperm stipulated in the normal form of the reference range minimums is 4%，However from the assisted reproductive technology projects related data show that，If normal morphology sperm less than 15%，In vitro fertilization rate low。

　　在常规精液分析中，精子形态学测定对预测精子受精能力最有价值，但精子形态学评估则是较不容易做准确和稳定的，因为人类精子本身存在着形态多样性的情况存在，且形态学检测受检测者的主观影响偏倚较大。畸形精子的检测和计数应当按WHO的标准中推荐的染色方法和计数方法进行，并且要严格掌握正常精子形态的标准以及畸形精子的分类标准。

In a routine semen analysis，Sperm morphology test to predict ability of sperm to fertilise the most value，But sperm morphology evaluation is less likely to do accurate and stable，Because human sperm itself exists the morphological diversity condition exists，And morphological detection by detection of the subjective influence large bias。Sperm malformation test and count should be arranged according to the WHO standards recommended dyeing method and counting method，And it must be strictly to grasp the normal sperm morphology and sperm deformity of the standard of classification standard。

畸形精子逐个数 Sperm malformation number one

　　精子畸形有多种情况，首当其冲的是精子头部异常。精子头部主要结构为浓缩的细胞核和顶体。在染色质成熟过程异常可导致位于头部的精子核空泡样缺陷即精子核异常发生几率较高。汪中扬表示，其中还有较为少见的圆头精子综合征，表现为精子头部外观呈圆形，顶体缺无、过小或脱离，无顶体后致密带，而且发生呈现家族性。

Sperm malformation has a variety of conditions，The sperm head is abnormal。Sperm head main structure for concentrated the nucleus and cone。In the chromatin mature process anomaly can lead to located at head sperm nucleus cavity sample defect that sperm nucleus abnormal high risk。WangZhong Yang said，With a relatively rare round head sperm syndrome，For the performance of the sperm head appearance assumes the circular，Top body lack no、Is too small or from，No top body dense zone，And happen present familial。

　　另一种是精子颈部和中段异常。头尾分离是常见的精子连接段畸形，这种畸形也被称为断头精子。有研究显示，大多数断头精子尾部结构正常；小部分这类精子，尾部有残留的连接段并被胞质团包绕，或呈现中段缺失；另有部分精子，尾部有规则的连接段和中段，或者残留的连接段与主段相连。汪中扬认为，过多残余胞质可导致精子功能下降。

Another kind is sperm neck and middle anomaly。Head to tail separation is a common sperm connection section deformity，This deformity is also called beheaded sperm。Research shows that，Most beheaded sperm tail structure normal；Small this kind of sperm，The rear there are residual connection section and cytoplasmic group around the package，Present or lack of the middle；Another part of the sperm，The rear there are rules of the connection section and the middle，Or residual connection section and main segment connected。WangZhong Yang think，Too much residual cytoplasm can lead to sperm function decline。

　　还有一种是精子鞭毛异常。主要有原发性纤毛运动障碍和纤维鞘发育不良两种表现、前者是一种常染色体隐性遗传疾病。这类患者常表现为支气管扩张、慢性鼻窦炎、内脏逆位和男性不育。纤毛或鞭毛结构不能有力地摆动是其主要致病原因。而后者常见于严重弱精症患者，光学显微镜下可见大部分精子尾部短、僵直、粗或不规则。

Still another kind is a sperm flagellum anomaly。Mainly has primary ciliary dyskinesia and fiber sheath dysplasia two kind of expression、The former is an autosomal recessive genetic disease。These patients often presents with bronchiectasis、Chronic sinusitis、Situs inversus and male sterility。Cilia or flagella structure can't effectively swing is the main cause of the disease。While the latter in serious weak sperm disease patients，Optical microscopy most sperm tail short、rigidity、Coarse or irregular。

多吃大豆山药精子受益多 Eat soybean yam sperm benefit much

　　汪中扬说道，影响精子形态，导致精子畸形的机制尚未完全清楚，但总体而言主要包括微生物因素、理化因素和内分泌因素等几个方面。

WangZhong Yang said，Affect sperm morphology，Cause the mechanism of sperm deformity is not entirely clear，But overall including microbial factors、Physical and chemical factors and endocrine factors and so on several aspects。

　　微生物因素。男性生殖道和射出精液中均可见白细胞。精液中白细胞浓度增高可导致精液质量下降。另外，细菌、支原体、衣原体、病毒等也可致使精液发生感染，可导致精液质量(活力、pH、形态)改变。

Microbial factors。Male genital tract and injection semen are seen white blood cells。In the seminal fluid leukocyte concentration heighten can lead to the decrease of the quality of semen。In addition，bacteria、mycoplasma、chlamydia、Virus can also cause semen an infection，Can lead to sperm quality(vitality、pH、form)change。

　　环境变化包括空气污染、职业接触、生活习惯等可影响精液质量。工作环境对精液质量也有显著影响。各种毒性物质接触史是导致男性生育力降低的重要因素。长期接触农药(如杀虫剂)对精子形态也有显著影响，导致形态正常精子率显著降低。此外，一些药物(如抗生素、抗癌、抗躁狂药)也可导致男性精液中形态异常精子率增高。

Environmental changes including air pollution、Vocational contact、Living habits can affect sperm quality。Work environment on semen quality also has significant effect。All kinds of poisonous substance exposure to reduce is the important factor of male fertility。Long-term contact pesticide(Such as pesticides, insecticides,)On sperm morphology also have significant effect，Lead to form normal sperm rate significantly reduced。In addition，Some drugs(Such as antibiotics、anti-cancer、Anti manic medicine)Can also lead to male semen form abnormal sperm rate increase。

　　内分泌因素。正常男性精浆中，雌激素水平显著高于血清雌激素水平。这既表明雌激素的局部产生，也暗示睾酮/雌激素的平衡对正常男性精子发生起重要作用。

Endocrine factors。Normal men in the seminal plasma，Estrogen level significantly higher serum estrogen level。It was shown that estrogen local produce，Also suggests that testosterone/balance of estrogen to normal male spermatogenesis play an important role。

　　要保护好精子，降低畸形率，汪中扬强调除减少烟酒危害、控制房事次数、保持阴囊适温、防止药物损害、注意劳逸结合、加强身体锻炼外，还应注意生活环境，合理调整饮食，多吃一些含精氨酸类食物，如大豆及其制品、鳝鱼、墨鱼、章鱼、山药、银杏、西瓜、南瓜等。(文/记者 陈辉 通讯员 瞿虎 简文杨)

To protect the good sperm，Reduce deformity rate，WangZhong Yang emphasized in addition to reduce tobacco hazards、Control sexual intercourse frequency、Keep the scrotum optimum temperature、Prevent drug damage、Pay attention to combining exertion and rest、Strengthen exercise outside，Should also pay attention to the living environment，Rationally adjust the diet，Eat more a few contain arginine kind of food，Such as soybeans and soy products、eel、cuttlefish、octopus、yam、Ginkgo biloba、watermelon、pumpkin。(Wen/reporter ChenHui correspondent QuHu JianWen Yang)