探究精子DNA完整性检测相对传统的精液常规在男性生育力评价中的辅助预估价值。

采集收集2017年4月至10月共1076例不育男性精液标本，男性患者来源于安徽医科大学第一附属医院妇产科，每份标本分成2份，分别行精液常规及精子DNA完整性检测，根据精子DNA碎片指数（DFI）分为精子DNA完整性良好组（DFI≥30%）、完整性一般组（15%<DFI<30%）及完整性差组（DFI≤15%）。根据患者年龄分为21~30岁、31~40岁及≥41岁；按照精子浓度分为浓度正常（≥15×10⁶/ml）及少精症（<15×10⁶/ml），按照精子前向活动率分为正常（≥32%）及弱精子症（<32%），采用χ²检验分析不同精子DNA完整性组之间的年龄、浓度和前向活动率的差异，采用Pearson相关分析分析患者年龄、精子浓度及前向活动率分别与精子DFI的相关性。

不同精子DNA完整性组间，精子浓度正常与少精症水平差异具有统计学意义（χ²=96.82，P<0.001）、活力正常与弱精子症水平差异均具有统计学意义（χ²=2.06，P<0.001）。年龄与DFI成正相关（r=0.154，P<0.001），精子浓度及前向活动率与DFI成负相关（r=-0.231，P<0.001；r=-0.564，P<0.001）。

精子DFI与精子浓度及活动率呈负相关，与年龄呈正相关，精子DNA完整性检测一定程度上可以弥补精液常规参数分析在评价男性生育能力上的不足，具有重要参考价值。

To evaluate the value of sperm DNA integrity test compared with traditional semen analysis in the supplementary assessment of male fertility.

A total of 1076 semen samples were collected at the Reproductive Medicine Center of the First Affiliated Hospital of Anhui Medical University from April to October 2017. Each specimen was divided into two parts for conventional semen analysis and sperm DNA integrity test. Sperm DNA integrity was assessed to be good (DFI≥30%), fair (15%<DFI<30%), or poor (DFI≤15%) according to sperm DNA fragmentation index (DFI). According to the age of the patients, the specimens were divided into three groups: 21-30 years old, 31-40 years old, and ≥40 years old. According to sperm concentration, the specimens were divided into normal (≥15×10⁶/ml) and oligospermia groups (<15×10⁶/ml). According to sperm forward motility rate, the specimens were divided into normal (≥32%) and asthenospermia groups (<32%). The Chi-square test was used to compare the differences in sperm DNA integrity between different groups. Pearson correlation analysis was used to analyze the correlation of patient age, sperm concentration, and forward motility rate with sperm DFI.

There were significant differences in sperm DNA integrity between the normal and oligospermia groups and between the normal and asthenospermia groups (χ²=96.82, P<0.001; χ²=2.06, P<0.001). Age was positively correlated with DFI (r=0.154, P<0.001), and sperm concentration and forward motility rate were negatively correlated with DFI (r=-0.231, P<0.001). r=-0.564, P<0.001).

Sperm DFI is negatively correlated with sperm concentration and forward motility rate, and positively correlated with age. Sperm DNA integrity test can make up for the deficiency of semen analysis in evaluating male fertility.