Preliminary exploration on sperm mitochondrial membrane potential as a comprehensive evaluation of male fertility
Objective:To explore the association between sperm mitochondrial membrane potential(MMP)and semen parameters,sperm morphology,and sperm DNA fragmentation index(DFI),as well as the clinical value of MMP for evaluation and prediction of male fertility.Methods:The study focused on semen samples of male clients seeking for preconception health assessments,fertility counseling,and treatment of infertility at the Andrology Department of Jiangsu Provincial Hospital of Traditional Chinese Medicine from April 2023 to July 2023.The 5th edition WHO standards for routine semen analysis and sperm morphology was followed.Additionally,the sperm DFI and MMP were assessed with flow cytometry.Based on semen quality,participants were divided into two groups:the normal semen quality group(n=57)and the abnormal semen quality group(n=67).The former exhibited all parameters within normal ranges,namely semen volume＞2 ml,pH 7.2-7.8,sperm concentration ≥15 X 106/ml,progressive motility(PR)≥32％,normal sperm morphology rate ≥4％,and DFI＜30％.The latter demonstrated parameters below the normal thresholds:PR＜32％,normal sperm morphology rate＜4％,and DFI ≥30％.Various parameters of semen quality between the two groups were compared.The Spearman rank correlation analysis was employed to examine the relationship between MMP and the sperm concentration,PR,the normal rate of sperm morphology,and DFI.The receiver operating characteristic(ROC)curves were generated to evaluate the clinical value of MMP in assessing male fertility.Results:There were no significant differences in the average age and semen volume between the two groups(P＞0.05).In the normal semen quality group,sperm concentration,PR,normal sperm morphology rate,and MMP were significantly higher than those in the abnormal semen quality group,whereas DFI was significantly lower(P＜0.05).The Spearman rank correlation analysis demonstrated that MMP had no correlation with semen volume(r=-0.065,P=0.475),while showed significant positive correlations with sperm concentration(r=0.396,P＜0.001),PR(r=0.471,P＜0.001),normal sperm morphology rate(r=0.468,P＜0.001),and displayed a significant negative correlation with DFI(r=-0.701,P＜0.001).The ROC analysis results indicated that for the prediction of overall semen quality,the area under the ROC curve(AUC)for MMP was 0.891,with the sensitivity of 87.5％,the specificity of 83.3％,and the MMP cutoff value was 53.69％.For predicting normal sperm concentration,the AUC was 0.787,with the sensitivity of 82.0％,the specificity of 69.2％,and the cutoff value was 43.97％.For the prediction of normal PR,the AUC was 0.741,with the sensitivity of 65.7％,the specificity of 84.2％,and the cutoff value was 56.33％.When predicting the normal sperm morphology rate,the AUC was 0.733,with the sensitivity of 71.1％,the specificity of 69.1％,and the cutoff value was 56.63％.Lastly,for predicting normal DFI,the AUC was 0.809,with the sensitivity of 89.5％,the specificity of 72.1％,and the cutoff value was 54.78％.Conclusions:Sperm MMP exhibits significant positive correlations with the sperm concentration,PR,and the normal sperm morphology rate,while showing a significant negative correlation with DFI.In comparison to other semen parameters,MMP provides a more comprehensive reflection of sperm energy metabolism and apoptosis.It is recommended to consider a threshold of 54％for MMP as the lower reference limit for the comprehensive assessment and prediction of male fertility.
Male infertilitySperm mitochondrial membrane potentialFertilityReference values
万方数据
维普
