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中華民國泌尿科醫學會雜誌

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篇名 Evaluation of the Sperm Quality of Electroejaculate
卷期 4:3
並列篇名 電激取精後之精蟲品質評估
作者 陳冠州江漢聲吳建志陳慧敏王顏和
頁次 1165-1170
關鍵字 elecdtroejaculationretarded ejaculationviabilitysperm cultureTSCI
出刊日期 199309

中文摘要

對於無法射精的病人,我們通常用經肛門電棒之電激射精來達成獲精液的目的。從1990年8月到1992年8月,總共有27名這類的病人接受我們的治療,其中有五位病人患有心理性(遲滯性)的射精不能,而其他的22位則是脊椎骨受傷的病患。我們所使用的電刺激儀是Seagar Model 12電動取精器。在接連的電索激停止之後,往前射和往膀胱內射精的精液分別被收集,而且我們利用了一些儀器來分析精液的特性,其中包括以針筒來測量精液的量,以試紙來測精液的酸鹼度,以電腦輔助精蟲分析儀來測精蟲的濃度和活動力,並且在光學顯微鏡下觀察精蟲的形態。對於五個從遲滯性射精病人身上所穫得的標本,我們特別做了簡單的精蟲處理和人工授孕來解決他們所共同面對的問題-不孕。對於22位脊椎損傷病人所做的精蟲分析顯示其有高的平均精蟲濃度,但在精蟲活動力方面,特別是直線前進的精蟲,卻是很低的。在五位遲滯性射精病人身上所穫得的原始標本中,精蟲數目從每毫有5x10的6次方到123x10的6次方,而活動力則2%到40%。在經過四十分鐘的”上游”處理之後,有四個標本其精蟲數目變成每毫升12x10的6次方到36x10的6次方;而活動力變成10%到25%。為了要詳估在電激取精之後其精蟲的存活力,我們對電激取精之後的精蟲做了精蟲培養來觀察他們的存活時間,並且與正常的控制組做比較。我們發現無論在存活力和活動力方面,電激取精之後的精蟲都比正常的精蟲來得遜色許多,這點也許是利用電激取精後之精蟲來做人工授精而通常無法穫得滿意授孕率的主要原因。

英文摘要

Rectal probe electroejaculation has been routinely used as a semen recovery technique in 27 patients with anejaculatory problem from August 1990 to August 1992. Five had retarded (psychogenic) ejaculation; the remaining 22 subjects were men with spinal cord injury. The stimulator used was a Seagar Model 12 electroejaculator. After cessation of electrical stimulation, antegrade and retrograde semen specimens were collected. The evaluation of their characteristics included procedures to determine volume (graduated cyclinder), pH (Multiistix strip), sperm concentration and motility (using Computerized Assisted semen Analyzer (CASA)) and spermmorphology (light microscopy). Especially for the five samples obtained from patients with retarded ejaculation, simple sperm processing and assisted reproductive technology were done to solve their problems of long-term infertility. The result of the raw semen analysis of 22 patients with spinal cord injury revealed that the average sperm concentration was high and the sperm motility, especially forward progression, was essentilally low. In the original semen samples of the five patients with retarded ejaculation, the sperm count ranged from 5x1000000 to 123x1000000 /ml, with 2 t 40% motility. After a 40-minute swim-up procedure, the sperm count became 12x1000000 to 36x1000000 /ml in four samples, and the motility of sperm became 10 to 25%. To evaluate the viability of the sperm collected from electorejaculation, sperm culture was performed to observe the survival time (lifespan) of the sperm after ejaculation, in comparison with a normal control group. Both the viability and motility of the sperm in the electroejaculate group were much worse than those in the normal group. This might result in the poor conception rate when electroejaculate is used to do artificial reproductive technology.

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