孕酮对正常生育和不明原因不育男性精子-仓鼠卵穿透试验的作用

目的　比较正常生育男性和不明原因男性不育症患者精子的受精能力及其对孕酮 (P)的反应性。方法　选择10例不明原因男性不育症患者和 10例正常生育男性 ,在上游后精子悬液中加入P 10 μmol·L -1,并体外获能 2h。采用超排卵法制备仓鼠卵细胞 ,将精子与卵子体外受精 3h后观察卵子受精率 (FR)与受精指数 (FI)。结果　上游后精子与P孵育能显著提高生育组的FR(P <0 .0 1) ,但不能增加不育组的FR ;生育组FR显著高于不育组FR(P <0 .0 0 1)。P能显著提高生育组的FI (P <0 .0 1) ,但不能增加不育组的FI;生育组FI显著高于不育组FI (P <0 .0 1)。结论　P能增强正常生育男性精子的受精能力 ;精子对孕酮的反应性降低可能是不明原因男性不育症的病因之一

Effect of progesterone on sperm-hamster egg penetration assay in normal fertile men and in patients with unexplained infertility

Objective To compare the fertilizing capacity and the responsiveness to progesterone (P) of sperm in normal fertile men and in patients with unexplained infertility. Methods Ten patients with unexplained infertility and ten normal fertile men were selected. After a swim-up, sperms were exposed to P 10 μmol·L -1 and incubated in capacitating medium for 2 hours. Fertilization rate (FR) and fertilization index (FI) were assessed after the hamster eggs were prepared with hyperovulation and the gametes were coincubated for 3 hours. Results P added to postswim-up sperm in fertile men caused a significant elevation of FR (P< 0.01), but it had no effect on FR in the patients. FR was significantly higher in the fertile group than in the infertile group (P< 0.001). P also caused a significant enhancement of FI in fertile men (P<0.01), but it had no effect on FI in the patients. FI was significantly higher in the fertile group than in the infertile group(P<0.01). Conclusion Progesterone can enhance sperm fertilizing capacity in normal fertile men. The reduced responsiveness of sperm to progesterone may be one of the etiologic factors of unexplained infertility.