Study On The Relationship Between Varicocele And Epididymis In The Occurrence Of Teratozoospermia

The normal morphology and structure of sperm is an important factor to ensure the completion of normal fertilization process.Many researchers regard sperm morphology as an important index to evaluate male fertility,and the success of intrauterine artificial insemination and in vitro fertilization-embryo transfer.More and more studies have confirmed that teratozoospermia has become one of the important factors affecting male infertility.The causes of abnormal sperm are varicocele,urinary tract infection,genetic disorders,endocrine metabolic disorder,physical and chemical and lifestyle,systemic disease and so on.Varicocele is one of important and common factor.Varicocele refers to the abnormal expansion,elongation and tortuosity of spermatic vein plexus caused by the obstruction of venous reflux or valve failure and blood reflux,The incidence rate is about 5%-20%in the normal population,and is higher in male infertility patients,accounting for 30%-40%[1].Varicocele tends to occur on the left side,accounting for 78%-93%,and can also occur on the right or both sides[2].At present,it is believed that varicocele can cause male fertility decline,leading to subclinical infertility and even infertility.The influence of varicocele on fertility function is mainly caused by abnormal semen parameters,which mainly include oligospermia,asthenospermia,teratozoospermia,etc.Teratozoospermia is one of the common semen parameter abnormalities.In the past,fertility decline caused b y varicocele mainly focused on the influence of testis.It is believed that varicocele can damage the structure and function of testis and affect the spermatogenesis.Epididymis is also an important part of the male reproductive system,which plays an important role in sperm maturation and protection.In mammals,the blood supply of testis and epididymis mainly comes from the testicular artery,so varicocele may affect both testis and epididymis at the same time,causing pathophysiological changes.Free 1-carnitine,glycerophosphate cholinesterase and neutral-glucosidase can all reflect the secretion function of epididymis,but neutral-glucosidase is more sensitive and specific and only comes from the epididymis.There are ready-made kits for the determination of simple and convenient.ObjectiveResearch group measurement into the seminal plasma neutral ? glycosidic enzyme activity and analyze the clinical data,and to explore varicocele in teratozooospermia and epididymal functionMaterials and MethodsFrom April 2018 to April 2019,assisted fertility patients were performed in the reproductive male department of the third affiliated hospital of Zhengzhou university.A total of 95 patients(23-49 years old)who met the inclusion criteria were selected as study subjects and divided into three groups:Group A:Normal group(n=30);Group B:Varicocele with normal sperm(n=30);Group C:varicocele with teratozoospermia group(n=35),?,? degree varicocele were selected into groups,eliminate fever,iatrogenic factors,operation history,urinary tract infections,sexually transmitted diseases,epididymal orchitis and testicular trauma,torsion and fall not congruent sperm deformity caused by history,detection between groups in the seminal plasma neutral alpha glycosidic enzyme activity.Statistical processingUsing SPSS 22.0 software to collate and analyze the data,if the data accord with the normal distribution,the measurement data are expressed as mean± standard deviation((?)),the skewed distribution data is represented by M(P25,P75),normal distribution data of the comparison group use the single factor analysis of variance,the further comparison with LSD method comparison and correlation analysis if two variables are continuous,and obey the normal distribution,use Pearson correlation analysis,otherwise taking the Spearman correlation analysis,inspection level ?=0.05.Result1 General clinical data of the three groups of patients:(1)left testicular volume:left testicular volume in group C(varicocele with teratozoospermia group)was significantly lower than that in group B(normal spermatozoosis group)(P<0.05),and left testicular volume in group B was lower than that in group A(normal group),with no statistically significant difference(P>0.05).(2)there was no significant difference in right testicular volume,age,height or body mass index among the three groups(P>0.05).2 Serum sex hormone levels:(1)serum T level:serum T level in group C(varicocele with teratozoospermia group)was significantly lower than that in group B(varicocele and normal spermatozoa group)(P<0.05),and serum T level in group B was lower than that in group A(normal group),with no statistically significant difference(P>0.05).(2)serum levels of FSH,LH,E2 and PRL:the corresponding serum hormones FSH,LH,E2 and PRL were not statistically significant(P>0.05)among the three groups.3 Seminal plasma neutral ?-glycosidase:The activity of ?-glycosidase in seminal plasma of group C(varicocele with teratozoospermia group)was significantly lower than that of group B(varicoceles with normal spermatozoa group)(P<0.05),and the activity of-glycosidase in seminal plasma of group B was lower than that of group A(normal group),with no statistically significant difference(P>0.05).4 Correlation analysis:(1)The relationship among normal sperm percentage,the seminal plasma neutral alpha glycosidic enzyme activity and serum T in patients of C group(varicocele with teratozoospermia):Normal sperm morphology percent and seminal plasma neutral ? glycosidic enzyme activity were positively correlated(r=0.396,P<0.05),and positive correlation between serum level of T and(r=0.459,P<0.05),serum T level and seminal plasma enzymes were positively correlated(r=0.428,P<0.05).(2)The relationship between serum FSH and left testicular volume in the C group(varicocele with teratozoospermia group):Serum FSH level are negatively correlated with the left testicular volume(r=-0.448,P<0.05).Conclusion1.Varicocele can cause a decrease in neutral alpha-glucosidase activity in the epididymal seminal plasma of malformed spermatozoa;2.Varicocele can cause reduced testosterone levels in malformed sperm disease3.Varicocele can directly or indirectly affect the epididymal function and play an important role in the occurrence of teratozoospermia.