| Objective:It is one of the worldwide problem that male reproductive health is declining. The effects of Environmental estrogen compound Bisphenol A on reproductive system has been the research hotspot. There were in vitro and in vivo researches have confirmed the reproductive toxicity of BPA, our previous study about occupational population revealed that BPA affect male reproductive system. however, there is no report about the effects of daily exposure level on reproductive system. This study aims to analyze the relationship between the BPA level with sperm quality and sexual function in general population based on the men from infertility clinic, which provides further theoretical basis for the reproductive toxicity of BPA, and improve population quality.Methods:Participating men were partners in infertile couples seeking treatment from Shan Xi MCH hospital during September 2014- April 2015. All subjects were investigated with the same structured questionnaire. The structured questionnaire included general characteristics, general lifestyle habits, sexual lifestyle, history of disease and contacting with harmful materials. The fasting morning of venous blood and semen samples from all the objects were collected. The levels of serum BPA were measured by high-performance liquid chromatography(HPLC). The sperm counts and sperm vitality were analyzed by the Computer Assisted Sperm Analysis system, the sperm morphology was analyzed by improved pap staining. Data analysis was performed by SPSS 21.0 software. The main statistical methods included t test, analysis of variance, chi-square test, trend chi-square test, Spearman rank correlation, multiple linear regression analysis, multiple Logisticanalysis.Results:1.The general characteristics: The range of the age of objects was 23 to 52 years old,with an average age of 33±5.44. The subjects at the age of 23 to 30 years old accounted for 39.1%, subjects from 31-40 years old accounted for 52.1%, and subjects from 41-52 years old accounted for 8.8%. There was no significant difference in address distribution( 49% of city and 51% of town); Subjects were mainly with secondary or advanced educational background(53%); Subjects were mainly in enterprises and institutions(28.3%); Subjects were mainly with income between 3000-4999(54.4%); Subjects were mainly with BMI 24-35.92%(61.8%).2.The sperm quality and influencing factors analysis: Based on the《WHO laboratory manual for the Examination and processing of human semen》(5th, 2010), the abnormal sperm accounted for 55.4%; The average level of semen volume was 3.5 ml, the abnormal semen volume accounted for 3.40%; the average level of sperm density was 109.0 ×106/ml, the abnormal sperm density accounted for 11.60%; the average level of total number of sperm was 431.0 ×106/per ejaculation, the abnormal total number of sperm accounted for 11.00%; the average level of forward movement sperm was 40.4%, the abnormal forward movement of sperm accounted for 11.60%; the average level of no forward movement sperm was 24.3%, the abnormal no former movement of sperm accounted for 3.10%; the average level of motionless sperm was 35.3%, the inactive sperm accounted for 14.20%; the average level of head deformity was 95.4%, the abnormal head malformation accounted for 46.20%; the average level of neck deformity was 13.3%, the abnormal neck deformity accounted for 52.40%; the average level of tail abnormalities was6.3%, the abnormal tail malformation accounted for 22.40%. The risk factors of sperm quality were age>30, occupation, marriage year >5, smoking, smoking year >5, passive smoking, sauna, electric blanket, use plastic tableware, infection disease and urinary diseases,pesticides, heavy metals.3. Sexual function and influencing factors analysis: According to the Delphi methods,the average total score of sexual function was 6.59, the sexual dysfunction accounted for41.40%; the average libido score was 6.63, the hyposexuality accounted for 47.3%; the average score of erectile function was 3.69, he average score of the low erectile ability accounted for 30%; the average degree of difficulty of erectile is the low score was 0.94,the abnormal score of difficulty of erectile accounted for 39.4%; the average degree of difficulty of ejaculation was 0.72, the abnormal score of difficulty of ejaculation accounted for 29.2%; the average strength of ejaculation was 7.29, the low score of strength of ejaculation accounted for 27.2%; the average score of premature ejaculation was 1.43, the abnormal premature ejaculation accounted for 31.7%; the average score of sex life satisfactory degree was 7.07, the abnormal sex life satisfactory degree accounted for 30.9%;the average score of confidence about sex function is 7.15, the low sex function confidence accounted for 28.3%. The risk factors of sexual function were age>30, marriage year >5,smoking, smoking year >5, sauna, electric blanket, use plastic cup and plastic tableware,infection disease, urinary diseases, chronic disease, BPA, heavy metal, and organic solvent occupational exposure.4.The distribution of the serum levels of BPA :(1) The internal levels of serum BPA:the range of serum BPA concentration was 0.38 to 21.93 ng/ml and the average concentration was 6.83 ng/ml.(2)There were no significant difference in age, address,culture level, occupation, income and the BMI.5.The associations between BPA concentrations and sperm quality: There were dose-response relationships between BPA concentrations with sperm density, sperm count,forward movement sperm, abnormal forward movement sperm, inactive sperm and abnormal head malformation. After adjusting the confounding factors, there were negative relationships between BPA concentrations in serum with sperm density, sperm count,forward movement sperm and abnormal forward movement sperm; while there were positive correlations with inactive sperm, deform rate of sperm head.6.The associations between BPA concentrations and sexual function: There were dose-response relationships between BPA concentrations with total score of sexual function, the average libido score, the strength of ejaculation, premature ejaculation. Afteradjusting the confounding factors, there were negative relationships between BPA concentrations in serum with sexual function score, libido score, strength of ejaculation,while here were positive correlations with premature ejaculation.Conclusions:1.The sperm quality from males attending infertility clinic are low according to WHO criteria, the normal sperm morphology is the main type of abnormal sperm. The declining of sperm quality may be associated with age, marriage year, address, smoking, smoking years, sauna, electric blanket, plastic cup and plastic tableware, infection disease and urinary disease. In order to improve the sperm quality, the bad habits such as smoking,sauna and so on should be corrected, and pay more attention to personal hygiene to avoid infection diseases.2. The sexual function from male attending infertility clinic are low, the weak libido is the main type of sexual dysfunction. The declining of sexual function may be associated with age, marriage year, smoking, smoking year, sauna, electric blanket, plastic cup and cutlery, infection disease, chronic disease and urinary disease, exposure to BPA, heavy metals and organic solvents chemicals. In order to improve the male sexual function, the bad habits such as smoking, sauna and so on should be corrected, and should promote to do more exercises to prevent chronic diseases such as hypertension.3. The serum BPA levels was negative related with the sperm counts, sperm density,forward movement rate, no forward movement rate and the first principal component scores, while positive related with the inactive sperm rate and head abnormalities rate.Although it is low dose BPA exposure in daily living environment, the long-term and low dose BPA may cause effect on sperm quality in the general population.4. The BPA levels was negative correlated with the total score of sexual function,sexual desire score and ejaculation, while positive correlated with the premature ejaculation. Although it is low dose BPA exposure in daily living environment, the long-term and low dose BPA may cause effect on sexual function in the general population. |
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