国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2010, Vol. 29 ›› Issue (3): 178-181.

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关于发行《世界卫生组织人类精液分析实验室技术手册》（第5版）的评论

FordWCL   

  1. Obstetrics & Gynaecology Unit，Clinical Science at South Bristol，University of Bristol，St Michael’s Hospital，Bristol BS2 8EG，UK
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2010-05-15 发布日期:2010-05-15

Comments on the Release of the Fifth Edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen

FordWCL   

  1. Obstetrics & Gynaecology Unit，Clinical Science at South Bristol，University of Bristol，St Michael’s Hospital，Bristol BS2 8EG，UK
  • Received:1900-01-01 Revised:1900-01-01 Published:2010-05-15 Online:2010-05-15

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摘要： 祝贺各位编撰新版《世界卫生组织人类精液分析实验室技术手册》（简称手册）的作者。手册是推广男科学临床实践的重要工具。然而，手册中叙述的检测方法对预测男性生育力的作用有限，且无法揭示生育力低下的潜在原因。呼吁再次关注男性生育力诊断研究。生育能力应该视为一种连续性状，应放弃人为地将其分为有或没有生育力的做法。应以前瞻性研究数据为基础，开发出可预测生育力低下夫妇一年内妊娠可能性的流程，以指导今后复杂的治疗方案的制定。未来将期待建立检测不育潜在病理机制的方法，以开发个性化治疗手段。诸如氧化应激作用、细胞内调节功能缺陷及正在发展的蛋白质组学等前沿领域，均应进行相应的探索。

关键词: 诊断, 男性不育, 氧化应激, 检测的预测价值, 精子计数

Abstract: The authors of the World Health Organization Semen Analysis Manual are to be
congratulated on producing a new edition; it is an essential tool to disseminate good practice in andrology. However，the tests described have poor prognostic power to predict a man's fertility and show little about the underlying causes of sub-fertility. This commentary urges a revival of research into the diagnosis of male fertility. It suggests that fertility should be regarded as a continuum and that the artificial binary division between fertile and infertile should be abandoned. Models to predict a sub-fertile couple's chance of conception
in a year should be developed on the basis of prospective data. These models would allow for sophisticated decision making about management. The future lies in the identification of tests to detect underlying pathologies open to specific treatment. Leads such as oxidative stress，defects in the intracellular regulation and the developing field of proteomics should be explored.

Key words: Diagnosis, Male infertility, Oxidative stress, Predictive value of tests, Sperm count