Effects Of Diabetes On Sperm Morphology And Semen Quality And Related Mechanisms

Objective:To investigate the effect of DM on male sperm morphology and sperm quality by comparing the sperm morphology and sperm quality(including semen volume, pH, liquefaction time, sperm concentration, total sperm count, total motility and forward motility, etc.) of healthy adult males and patients with diabetes(DM). To clarify the mechanisms involving the effects of DM on sperm quality by detecting and analyzing the serum glucose, glycated hemoglobin, follicle stimulating hormone(FSH), luteinizing hormone(LH), prolactin(PRL), testosterone(T) and anti-sperm antibodies.To find effective measures for preventing or treating the fertility decline and infertility of male DM patients. Methods:1. Study selection and grouping objects: 100 cases of samples are from 2014-2015 in Assisted reproductive center of Jiangxi Maternal and Child Health Hospital for treatment, of which 50 cases of male patients with diabetes, 50 cases of healthy adult males. Study inclusion criteria:(1) 22-45 year old adult male(2)DM group has been diagnosed with diabetes endocrine specialist. Study Exclusion criteria:(1) can not be the object masturbation semen specimens;(2) the impact of semen quality associated with other diseases such as varicocele, etc;(3) a history of the epididymis testicular trauma history, the history of reproductive system and reproductive system surgery infection;(4) alcohol, tobacco;(5) the impact of semen quality in high-risk occupations.2. Specimen collection and preservation2.1 Semen specimen collection: Abstinence 2-7d,by masturbation method to obtain semen, semen specimen placed all specified sterile container, while patient is asked to write down the exact time of the acquisition, inspection immediately after liquefaction.2.2 Venous blood specimen collection: The day of patients obtain semen, take the fasting venous blood 2 tubes, one of the tube 3ml, placed in the serum tube, room temperature static 1 hours and then centrifugal separation by 3000 r/min,serum reserve;another tube 2ml, placed in EDTA-k2 anticoagulant tube.3. Using the computer-assisted semen analysis system combined with manual counting, comparative analysis of DM patients with semen quality, including: semen volume, pH, liquefaction time, sperm concentration, total sperm count, total motility(PR + NP,%) and forward motility( PR,%) and the like.[ Referring to WHO of human semen and Processing Laboratory Manual(fifth edition) standard]4. By using the thin film technique combined with modified PAP staining to detect the abnormal condition of the sperm of DM patients. [ Referring to WHO of human semen and Processing Laboratory Manual(fifth edition) standard]5. Mixed antiglobulin reaction test(MAR test), comparative analysis of DM patients with anti-sperm antibodies positive rate.6. The determination of serum glucose by hexokinase method, turbidimetric determination of glycosylated hemoglobin in blood value.7. Methods to measure the serum levels of FSH, LH, prolactin and testosterone in DM patients with chemoluminescence technique. Results:1.Through comparative analysis of the indicators DM and control groups semen found DM significantly lower in patients with sperm concentration, total sperm count and total motility. DM Group semen sperm concentration mean(35.36 ± 22.09) × 106 / ml, the mean concentration of sperm in semen control group(63.31 ± 33.29) × 106 / ml, there is a statistically significant difference(P= 0.001). The total number of sperm in semen DM group mean(74.97 ± 49.53) × 106 / ejaculation, the total number of sperm in semen control group mean(147.81 ± 86.72) × 106 / ejaculation, there is a statistically significant difference(P = 0.001). DM Group semen sperm total motility(PR + NP,%) a mean of(53.86 ± 22.21), group semen sperm total motility(PR + NP,%) a mean of(62.54 ± 20.21), there is a statistically difference(P = 0.044).2.The study found DM group and control group, abnormal sperm azoospermia and anti-antibody-positive rate was no significant difference, but separately abnormal azoospermia azoospermia group and non-group abnormal blood glucose and glycated hemoglobin concentration contrast, found that abnormal blood glucose azoospermia value [(7.1 ± 4.06) mmol / L] than non-distortion azoospermia group [(5.46 ± 2.77) mmol / L](P = 0.038). glycated hemoglobin concentration [(7.69 ± 2.61)] is higher than the non-abnormal azoospermia group [(6.61 ± 1.98)](P = 0.048)?3.DM group compared to the control group T was significantly decreased, while FSH, LH, PRL did not change significantly. DM group's T mean(354.14 ± 144.15) ng / dL,Control group's T mean(490.72 ± 253.08) ng / dL, there is a statistically significant difference(P = 0.001). Conclusions:DM can cut men with sperm concentration, total sperm count and total motility, but had no significant effect on sperm morphology, suggesting that DM mainly through inhibition affect sperm production or sperm motility causing male reproductive dysfunction. Clinical research suggests that in clinical practice for fertility counseling to male patients, need to pay attention to screening for diabetes or impaired glucose tolerance is found have been diagnosed with diabetes should consult their timely and targeted therapies, control blood sugar, blocking long-term hyperglycemia on the male reproductive system damage. DM male patients after treatment, if blood sugar has been controlled, it should be recommended early childbearing.