Study On The Relationship Between The Expression Of Vitamin D Metabolic Enzyme CYP24A1 In Spermatozoa And Sperm Quality

Part one: the expression and clinical significance of vitamin D metabolizing enzyme CYP24A1 in spermatozoaObjective: The purpose of this study was to explore the correlation between the localization and expression of CYP24A1(Cytochrome P450 family 24 subfamily A member,CYP24A1)in spermatozoa and sperm quality and its significance in male semen quality.Early identification of patients with impaired semen quality to find new therapeutic targets for improving male fertility.Methods: 1.A total of 151 male patients who visited the reproductive center of our hospital from November 2019 to August 2020 were selected according to the input and excretion criteria.The patients who met the criteria were analyzed by semen routine analysis and sperm morphology analysis.The concentration of vitamin D metabolizing enzyme CYP24A1 in spermatozoa was determined by enzyme-linked immunosorbent assay(ELISA),and the correlation between semen parameters and CYP24A1 concentration was analyzed.2.According to the results of semen routine and sperm morphology,the patients were divided into two groups: normal sperm quality group(n= 32)and impaired sperm quality group(n = 119).The localization and expression of CYP24A1 in spermatozoa of 32 patients with normal sperm quality and 40 patients with impaired sperm quality were analyzed by immunocytochemical(Immuno cytochemistry,ICC).To analyze the difference of CYP24A1 expression between patients with normal sperm quality and patients with impaired sperm quality.3.The diagnostic value of CYP24A1 concentration and expression in male sperm quality was evaluated by ROC curve.Results: 1.CYP24A1 was mainly expressed in the neck of spermatozoa and a little in the head and tail of spermatozoa.2.The concentration of CYP24A1 in sperm was positively correlated with sperm concentration,total sperm count,forward motility and normal sperm shape,but not with abstinence time,semen p H,semen volume and liquefaction time.3.The expression of CYP24A1 in patients with normal sperm quality(17.5%)was significantly higher than that in patients with impaired sperm quality(1.5%).4.The prediction value of CYP24A1 concentration in sperm is low,the area under ROC curve is 55.4%,the sensitivity is 65.6%,the specificity is 52.1%,when the expression of CYP24A1 in sperm neck is 2%,it has good predictive value for sperm quality,the area under ROC curve is 72.0%,the sensitivity is 71.9%,and the specificity is 65.0%.Conclusions: 1.The expression of CYP24A1 in sperm neck and the concentration of CYP24A1 in sperm were positively correlated with sperm quality.2.The expression of CYP24A1 can be used as an index to measure the quality of male semen.Part two: the effect of vitamin D supplementation on the pregnancy rate of intrauterine inseminationObjective: The purpose of this study was to investigate whether vitamin D supplementation can improve semen quality and improve the clinical pregnancy rate of intrauterine insemination((Intrauterine insemination,IUI))in patients with impaired sperm quality.Methods: 1.119 patients with impaired sperm quality in the reproductive center of our hospital from November 2019 to August 2020 were randomly divided into experimental group(n = 60)and control group(n = 59).The experimental group was given oral vitamin D 1400IU/ once a day for 3 months,while the control group was not given vitamin D supplementation.After treatment,semen routine,sperm morphology analysis and CYP24A1 concentration determination were performed in the two groups,and the differences between the two groups were compared.2.After treatment,according to the inclusion and exclusion criteria,the clinical pregnancy rate was compared between the control group(n = 30)and the experimental group(n = 30)by IUI.Results: 1.After 3 months of vitamin D supplementation in patients with impaired sperm quality,the total sperm count,sperm concentration,forward motility and CYP24A1 concentration in the experimental group were significantly higher than those in the control group.2.There was no significant difference in semen p H,semen volume,abstinence time and normal sperm morphology between the two groups.3.After intrauterine insemination after vitamin D supplementation,the clinical pregnancy rate in the experimental group(16.7%)was significantly higher than that in the control group(10%),but there was no statistical difference(p > 0.05).Conclusions: 1.Vitamin D supplementation for patients with impaired sperm quality is helpful to improve semen quality.2.After vitamin D supplementation for patients with impaired sperm quality,intrauterine insemination can improve the pregnancy rate.