The Analysis Of Semen Quality And Influencing Factors Of Men With Fertility Intention In Local Area Under The New Two-child Policy

Objective:The characteristics and influencing factors of semen in the men with fertility intention in local area were preliminarily investigated,with a view to providing fertility guidelines for all men with fertility intention in local area under the new two-child policy,and improving their semen quality and reproductive health.Methods:The men who came to the Department of Urologic Surgery or the Andrology Clinic in our hospital for semen test prior to pregnancy from January 2017 to December 2018 and complied with the inclusion and exclusion criteria were collected assamples.Questionnairesweredistributedtocollecttheirgeneral socio-demographic features,such as age,height,weight,occupation,living habits,education background,the planned parity and sexual life satisfaction.Their total testosterone in serum and semen quality were also determined.SPSS19.0 was applied for descriptive statistics on the general socio-demographic features and various indicators of semen quality.Single-factor analysis and multiple linear regression were then conducted to define the relationship of semen quality with the socio-demographic features and total testosterone in serum.Results:A total of 228 subjects who met the inclusion and exclusion criteria and passed the questionnaire were collected in this study.⑴General situation:the median age（quartile age）ofsubjects was 29（27-36）years old;Their occupation regarded staff as principle was 36.8%;The sleeping time as sleep for 6-8 hours was 43.9%;BMI18.5²3.9 accounted for 62.3%,24.0²7.9for 31.1%;Smokers accounted for 60.5%;The subjects drinking alcohol was 41.7%;The educational levels regarded college education was 46.1%,and high school the nest in order was 39.0%;66.7%of male who planned to have their first child;The sexual satisfaction was"very satisfied"accounted for 42.1%;Serum total testosterone level>11.5nmol/L accounted for 87.7%.⑵The analysis of semen quality:the semen volume M(P₂₅-P₇₅)of 228 cases was 3.0（2.2-3.8）ml,and 9 cases（4.0%）were abnormal;The sperm density M(P₂₅-P₇₅)was 93.8（58.7-128.9）×10⁶/ml,and 11 cases（4.8%）were abnormal;The total number of sperm M(P₂₅-P₇₅)was 271.9（146.0-428.2）×10⁶/ml,and 12 cases（5.3%）were abnormal;The progressive（PR）of sperm x±s was 69.0±13.9%,and 21 cases（9.2%）were abnormal;The survival rate of sperm x±s was 52.3±14.6%,45 cases（19.7%）were abnormal.⑶The single factor analysis:The difference in sperm density,sperm count,sperm progressive（PR）and sperm survival rate of 228 subjects in different factors of BMI groups,smoking groups,drinking alcohol groups and serum total testosterone levels was statistically significant（all P<0.05）;The difference in sperm progressive（PR）and sperm survival rate were statistically significant differences between the groups with different levels of education and sexual satisfaction（all P<0.05）;The difference of sperm progressive（PR）between different birth order groups was statistically significant（P=0.036）;There were significant differences in semen volume and sperm count between different age groups（all P<0.05）.There was no significant difference in semen parameters between sleep times and occupational groups（all P>0.05）.⑷Multivariate linear regression analysis:The age of study subjects was significantly correlated with semen volume（t=4.856,P<0.001）;BMI was significantly correlated with PR（t=2.301,P=0.022）and sperm survival rate（t=2.928,P=0.004）;Smoking was significantly correlated with sperm density（t=3.805,P<0.001）,sperm count（t=3.278,P=0.001）,PR（t=8.760,P<0.001）and sperm survival rate（t=7.184,P<0.001）;Drinking alcohol was significantly correlated with sperm density（t=2.321,P=0.021）,PR（t=4.152,P<0.001）and survival rate（t=4.314,P<0.001）;Sexual satisfaction was significantly correlated with sperm survival rate（t=2.588,P<0.010）;The testosterone level was significantly correlated with sperm survival rate（t=2.079,P<0.039）;However,there was no significant correlation among the parameters of education level,birth order and sperm quality（all P>0.05）.Conclusion:The men with fertility intention in local area were relatively old,because of a high proportion of them intended to have a second child or more since the release of the new two-child policy.A high proportion of men with fertility intention had abnormal sperm motility and progressive（PR）.The age above 40 years,obesity,smoking,drinking,sexual life dissatisfaction,and low testosterone level may be independent-risk factors for semen quality.