The Effects of Comprehensive Sexual and Reproductive Health/Family Planning Intervention Based on Knowledge, Attitudes, and Practices Among the Domestic Migrant Population of Reproductive Age in China: A Randomized Community Study.

Background: Domestic migrant populations are highly mobilized at a sexually active age, and often fail to meet their needs for contraception. Moreover, they assume sexual and reproductive health (SRH) risks and utilize fewer family planning services. Method: A quasi-experimental trial (community intervention) was adopted. Two-stage stratified cluster sampling was applied to recruit participants in Beijing and Chongqing. A comprehensive SRH/family planning intervention was implemented from August 4 2014 to August 3 2015. Propensity score matching (PSM) and multivariate probit models were adopted. Results: In total, 2100 and 2024 eligible participants were involved, and 815 and 629 pairs were matched by PSM in Beijing and Chongqing, respectively. The knowledge and attitudes of the participants regarding SRH and contraception were significantly improved through the comprehensive intervention. Reversible contraceptive methods were the most prevalent; couples largely decided to utilize condoms and family planning services. Conclusions: The comprehensive intervention had positive effects on knowledge, attitudes, and practices (KAP) for SRH/family planning among the domestic migrant population. The results acquired can be extrapolated to some extent, and the pattern of this intervention is well geared toward other similar settings in China.

[Prevalence of urogenital tract infections with Ureaplasma urealyticum or HPV among men of reproductive age and the associated factors].

OBJECTIVE: To investigate the prevalence of urogenital tract infections with Ureaplasma urealyticum (UU) and human papilloma virus (HPV) in males of reproductive age and the associated factors. METHODS: Using the multi-stage cluster sampling method and a structured questionnaire, we conducted an investigation among 18－50 years old males in Songjiang District, Shanghai, from August 2016 to July 2018. We collected secretory specimens from the urogenital tract of the subjects and detected the infections of UU and HPV by laboratory examination. RESULTS: Among the 621 males included in this study, 279 (44.93%) were found infected with UU, 18 (2.90%) with HPV, and 15 (2.42%) with both UU and HPV. Univariate analysis showed that smokers had a higher rate of UU infection (50.54% ［140/277］) than non-smokers (40.41 ［139/344］), and those with senior high school or secondary technical school education had a higher rate of HPV infection (4.84% ［12/248］) than others (1.61% ［6/373］). Binary stepwise logistic regression analysis revealed a higher risk of UU infection in the subjects with junior high school or lower education than in others (OR = 0.61, 95% CI: 0.39－0.96) as well as in smokers than in non-smokers (OR = 1.46, 95% CI: 1.01－2.01). CONCLUSIONS: The prevalence of UU infection is high, while that of HPV is low among men of reproductive age in Songjiang, Shanghai. The screening of UU infection should be enhanced among men of reproductive age, especially among smokers and those with lower education.

Association between factors related to family planning/sexual and reproductive health and contraceptive use as well as consistent condom use among internal migrant population of reproductive ages in three cities in China, based on Heckprobit selection models.

OBJECTIVE: With the increased population mobility and the transition in population policy, scholars are quite concerned about family planning/sexual and reproductive health (SRH) and related factors among internal migrant population of reproductive age. Therefore, the proposed study was designed to explore the association between factors related to family planning/SRH and contraceptive use as well as consistent condom use among the above-described population in China. DESIGN: Cross-sectional study. SETTING: Three municipalities in China, namely Beijing, Shanghai and Chongqing. PARTICIPANTS: Among the 6545 participants, 2099, 2414 and 2031 subjects came from Beijing, Shanghai and Chongqing, respectively. RESULTS: A total of 6545 eligible participants were included as the full sample, 6188 of whom who had intercourse in the last 3 months were selected as the subsample. Among the subsample, 80.88% (5005/6188) adopted any form of contraceptive methods and 49.14% (3041/6188) consistently used condom in the last three sexual intercourses. Meanwhile, the involved participants had a better mastery of knowledge on SRH than on contraception (p<0.0001). The results of the Heckprobit models revealed that the factors associated with both contraceptive use and consistent condom use were relationship with the first intercourse partner, communication frequency with spouse/sexual partners on sex, actual number of children and knowledge on SRH, while knowledge on contraception and age at first intercourse were associated with contraceptive use and consistent condom use, respectively (p<0.05). CONCLUSIONS: In the current study, we revealed a high-level contraceptive prevalence, a relatively low-level consistent condom use and a poor mastery of knowledge on contraception and SRH. The Heckprobit selection model specified the existence of selection bias, providing evidence on the association between the factors on family planning/SRH and contraceptive use as well as consistent condom use, respectively. Our findings indicated that health institutions should offer appropriate technology and high-quality family planning/SRH services for the internal migrant population in China.

Single or double semen samples: the dilemma in epidemiological studies on semen quality.

STUDY QUESTION: Is it necessary to collect more than one semen sample from each individual in epidemiological studies? SUMMARY ANSWER: Single semen samples can be used in model construction as long as the model adjusts for major relevant covariates. WHAT IS KNOWN ALREADY: If a series of semen samples are taken from one individual at different times, significant intra-individual variation may exist. STUDY DESIGN, SIZE, DURATION: A population-based cross-sectional study was conducted from 1 December 2000 to 20 November 2002. A total of 1010 volunteers, aged between 20 and 60 years old, were recruited. PARTICIPANTS/MATERIALS, SETTING, METHODS: A total of 998 subjects were included for statistical analysis. Of these, 332 men provided single semen samples (group 1) and 666 men provided two samples (group 2). Semen parameters, including semen volume, sperm concentration, total sperm number, progressive motility, vitality, and sperm morphology, were analyzed with standardized methods according to the World Health Organization (WHO) laboratory manual for the examination of human semen and sperm-cervical mucus interaction (3rd edition). MAIN RESULTS AND THE ROLE OF CHANCE: Rapidly progressive motility of semen from group 1 was lower than that of group 2, but other parameters were not significantly different. The differences in mean values between the double samples were small on all semen parameters. The correlations between the two ejaculates were high, but the agreements were poor except for sperm vitality and normal morphology. Model selection and validation analysis supported the premise that the regression model from the first samples was applicable for the second samples. The large sample size with extensive quality control provides robust parameter estimation and promises good applicability for model selection and validation. LIMITATIONS, REASONS FOR CAUTION: The results are valid for healthy men in China, not for subfertile or infertile men. WIDER IMPLICATIONS OF THE FINDINGS: The overall semen quality of a given group of healthy men will not vary significantly in the short term. Single semen samples can be used in model building as long as major relevant covariates are considered. Utilizing multiple semen donations may actually cause the samples to be less representative. STUDY FUNDING/COMPETING INTERESTS: This research was supported by a grant from Shanghai Science and Technical Committee (02DJ14053) and a grant from Ministry of Science and Technology, China (9902). All authors have no competing interests.

Induced abortion and breast cancer: results from a population-based case control study in China.

AIM: To determine whether induced abortion (IA) increases breast cancer (BC) risk. MATERIALS AND METHODS: A population-based case-control study was performed from Dec, 2000 to November, 2004 in Shanghai, China, where IA could be verified through the family planning network and client medical records. Structured questionnaires were completed by 1,517 cases with primary invasive epithelial breast cancer and 1,573 controls frequency- matched to cases for age group. The information was supplemented and verified by the family planning records. Statistical analysis was conducted with SAS 9.0. RESULTS: After adjusting for potential confounders, induced abortions were not found to be associated with breast cancer with OR=0.94 (95%CI= 0.79-1.11). Compared to parous women without induced abortion, parous women with 3 or more times induced abortion (OR=0.66, 95%CI=0.46 to 0.95) and women with 3 or more times induced abortion after the first live birth (OR=0.66, 95%CI =0.45 to 0.97) showed a lower risk of breast cancer, after adjustment for age, level of education, annual income per capita, age at menarche, menopause, parity times, spontaneous abortion, age at first live birth, breast-feeding, oral contraceptives, hormones drug, breast disease, BMI, drinking alcohol, drinking tea, taking vitamin/calcium tablet, physical activity, vocation, history of breast cancer, eating the bean. CONCLUSIONS: The results suggest that a history of induced abortions may not increase the risk of breast cancer.

Efficacy of a combined contraceptive regimen consisting of condoms and emergency contraception pills.

BACKGROUND: To evaluate and compare the effectiveness of the combined regimen (consisting of condoms and emergency contraception pills (ECP)) and using condoms only for the purpose of preventing pregnancy. METHODS: One-thousand-five-hundred-and-sixty-two (1,562) couples as volunteers enrolled at nine centers in Shanghai. Eight-hundred-and-twelve (812) were randomized to use male condoms and ECP (i.e., Levonorgestrel) as a back-up to condoms (the intervention group) and 750 to use male condoms only(the control group), according to their working unit. Participants were visited at admission and at the end of 1, 3, 6, 9, and 12 months. The cumulative life table rates were calculated for pregnancy and other reasons for discontinuation. RESULT: The gross cumulative life table rates showed that the cumulative discontinuation rates for all reasons during the year of follow-up in the condoms plus emergency contraception group and the condoms only group were 7.76 ± 0.94 and 6.61 ± 0.91, respectively, per 100 women (χ2 = 0.41, p = 0.5227). The cumulative gross pregnancy rate of the condoms plus emergency contraception group and the condoms only group were 2.17 ± 0.52 and 1.25 ± 0.41, respectively, per 100 women (χ2 = 1.93, p = 0.1645). The Pearl Index in the condoms plus emergency contraception group and the condoms only group were 2.21% and 1.26%, respectively. CONCLUSION: Male condoms remain a highly effective contraceptive method for a period of one year while consistently and correctly used. In addition, the lowest pregnancy rate followed from perfect use condom.

Male rural-to-urban migrants and risky sexual behavior: a cross-sectional study in Shanghai, China.

This study examined the prevalence and the determinants of risky sexual behavior (defined as having multiple sex partners and paying for sex) among male rural-to-urban migrants in China. An anonymous questionnaire was used to collect information on socio-demographics, knowledge, attitudes, and behavior associated with increased risk of risky sexual behavior from 4,069 subjects. In total 1,132 (27.8%) participants reported two or more sex partners and 802 (19.7%) participants paid for sex. A considerable proportion (29.6%-41.5%) did not use a condom during risky sexual behavior. Logistic regression analysis revealed that unmarried status (OR: 0.62, CI: 0.42-0.85 for married), earlier age at first sexual experience (OR: 0.67, 95% CI: 0.31-0.91 for ≥ 22 years old), poor perception of risk of acquiring HIV/AIDS (OR: 1.51, 95% CI: 1.33-1.96 for unlikely; OR: 2.38, 95% CI: 1.61-3.70 for impossible), frequent exposure to pornography (OR: 0.67, 95% CI: 0.60-0.81 for sometimes; OR: 0.31, 95% CI: 0.11-0.43 for never), attitudes toward legalization of commercial sex (OR: 0.39, 95% CI: 0.21-0.59 for no), peer influence (OR: 0.51, 95% CI: 0.27-0.88 for no), and not knowing someone who had/had died from HIV/AIDS (OR: 0.35, 95% CI: 0.20-0.53 for yes) were all significantly associated with having multiple sex partners. Those who paid for sex showed similar findings.

Unmarried male migrants and sexual risk behavior: a cross-sectional study in Shanghai, China.

BACKGROUND: In China, there is increasing concern because of the rapid increase in HIV infection recorded over recent years. Migrant workers are recognized as one of the groups most affected. In this study, HIV/AIDS-related knowledge, attitudes, and behavior among unmarried migrant workers in Shanghai are investigated, with the aim of providing critical information for policy makers and sex educators to reinforce sexual health services and sex health education targeting the behavior and sexual health of unmarried male migrants. METHODS: A cross-sectional survey was conducted among unmarried male migrant workers in Shanghai, China's largest city and housing the most migrants. A self-administered, anonymous questionnaire was used to collect information on knowledge, attitudes, and behavior associated with increased risk of HIV/AIDS. RESULTS: A total of 2254 subjects were questioned, with a response rate of 91.3%. Among those interviewed, 63.5% reported sexual activities. Misconceptions regarding HIV transmission, poor perception of HIV infection, and low use of condoms were not uncommon. Among those who had sexual intercourse, 73.7% had not used condoms in their last sexual intercourse, and 28.6% reported having engaged in sexual risk behavior (defined as having at least one non-regular partner). Multivariate logistic regression analyses identified several indicators of sexual risk behavior, including younger age at first sexual intercourse (OR: 0.67, 95% CI: 0.31-0.91 for older age at first sexual intercourse), more cities of migration (OR: 2.91, 95% CI: 2.17-3.81 for high level; OR: 1.15, 95% CI: 1.06-1.29 for medium level), poor perception of acquiring HIV/AIDS (OR: 1.52, 95% CI: 1.33-1.96 for unlikely; OR: 2.38, 95% CI: 1.61-3.70 for impossible), frequent exposure to pornography (OR: 0.33, 95% CI: 0.11-0.43 for never; OR: 0.69, 95% CI: 0.60-1.81 for less frequently), not knowing someone who had or had died of HIV/AIDS and related diseases (OR: 2.13, 95% CI: 1.70-2.53 for no), and having peers who engaged in sex with a non-regular sex partner (OR: 4.40, 95% CI: 3.37-5.56 for yes). CONCLUSIONS: Today, it is necessary to reinforce sex health education among unmarried migrants and sexual health services should target vulnerable migrant young people.

Assessment of the magnitude of contextual and individual demographic effects on diabetes mellitus and glucose intolerance in rural Southwest China: a multilevel analysis.

OBJECTIVE: This study aimed to determine the contribution of individual and contextual socioeconomic status (SES) to the prevalence of diabetes mellitus and glucose intolerance in the adult population in rural southwest China. METHODS: A population-based cross-sectional study of diabetes was performed in 4801(2152 men) Chinese adults (≥ 25 years old). Multilevel logistic regression model was used to examine the association between individuals' and townships' variables and the prevalence of diabetes mellitus and glucose intolerance. RESULTS: The age-and gender-standardized prevalence of diabetes mellitus and glucose intolerance were 7.1% (3.6% for undiagnosed) and 8.8% in adults aged ≥ 25 years, respectively, and increasing with age. Females were more likely to develop diabetes than males. The probability of developing diabetes increased with BMI. Both contextual and individual educational level and yearly household income were found to be negatively associated with the prevalence of diabetes. Residence in communities with a higher percentage of ethnic minorities was associated with higher prevalence of diabetes. Smoking had a protective effect for diabetes, drinking had a positive association with diabetes mellitus and glucose intolerance. CONCLUSIONS: Diabetes mellitus and glucose intolerance are common in rural adults of southwest China by international standards. These results indicate that diabetes mellitus has become a major public health problem in rural areas in southwest China, and strategies aimed at the prevention and treatment of diabetes mellitus and glucose intolerance are needed.

[The influence of high birth weight on the blood pressure during childhood - a cohort study].

OBJECTIVE: To explore the effects of high birth weight (HBW) on blood pressure (BP) during childhood. METHODS: A total of 1435 couples with high or normal birth weight were selected from a birth cohort who were born between 1993 and 1995 in Wuxi, China and, followed between 2005 and 2007. A questionnaire survey was conducted, with their height, weight and blood pressure measured. RESULTS: The medians of systolic blood pressure (SBP) and diastolic BP (DBP) of HBW group were 100 mm Hg (Q(1)-Q(3): 90 - 110 mm Hg), 64 mm Hg (Q(1)-Q(3): 60 - 70 mm Hg) in the high birth weight group, respectively, while they were 100 mm Hg (Q(1)-Q(3): 90 - 108 mm Hg), 62 mm Hg (Q(1)-Q(3): 60 - 70 mm Hg) in the normal weight group. No statistical significant difference was found between the exposed and unexposed groups. The proportion of elevated BP, including pre-hypertension and hypertension, in exposed group was 13.66%, a bit higher than that (11.57%) of the unexposed group (P = 0.055). The relative risk (RR) of HBW on elevated BP was 1.06 (0.92 - 1.21), after adjusted the following parameters as BMI in childhood, sex, age during the follow-up period, age of mother at delivery, gestational age, type of feeding at infancy, dietary habit as well as the frequencies of exercise during childhood. CONCLUSION: No statistically significant correlation was found between high birth weight and blood pressure of children.

[The influence of smoking on the routine parameters of semen quality].

OBJECTIVE: To explore the effect and heaviness of smoking on the routine parameters of semen quality. METHODS: A total of 727 eligible subjects including 421 smokers and 306 nonsmokers were selected in 2004 - 2006 in Hebei, Shanxi, Guizhou, Zhejiang and Shandong provinces. Data on background information, general demographic characteristics, exposure to smoking and related confounding factors were obtained through a questionnaire survey. Semen samples of all the subjects were collected during the period of study. Parameters of semen were examined according to the manual recommended by WHO. RESULTS: Four models from the multiple logistic regression regarding the semen routine parameters were used as the dependent variables to be fitted in descending order respectively, while six confounders including area, age, abstinence time, education level, history of alcohol intake and the exposure to pesticides etc., were adjusted. RESULTS: showed that smoking could affect the sperm viability, with significantly higher proportion of abnormal sperm viability seen in the smoking group (OR = 1.77, 95% CI: 1.12 - 2.80). Proportions regarding the abnormal mobility and morphology of sperms in the smoking group were also significantly higher than in the control group, with OR values as 1.51 (95%CI: 1.00 - 2.27) and 2.55 (95%CI: 1.68 - 3. 88) respectively. The density of sperms was significantly decreased in the smoking groups who smoked more than 20 cigarettes per day (OR = 1.70, 95%CI: 1.05 - 2.76) or the total numbers of cigarette consumption exceeding 150 000 (OR = 1.84, 95% CI: 1.03 - 3.29). CONCLUSION: Smoking showed adverse effects on the quality of semen, especially for heavy or long-term smokers.

Does high load of oxidants in human semen contribute to male factor infertility?

Basal generation of reactive oxygen species (ROS) was essential for male reproductive function, whereas high ROS levels may be linked to low quality of sperm and male infertility. We examined the associations between ROS levels in whole ejaculates and sperm quality among 1092 male factor infertility (MFI) patients and 50 donors with normal semen characteristics. ROS levels were significantly positively correlated with abnormal morphology rate, head defect, and sperm deformity index. Further, we investigated whether seminal plasma from MFI patients with high ROS levels affects sperm motility from donors with normal semen characteristics. After cross-culturing fresh human sperm from donors possessing normal semen characteristics with seminal plasma from infertitle men, sperm motility was measured at different ROS levels. Seminal plasma from MFI patients significantly reduced motility of sperm and the reduction rate increased with increasing ROS levels in seminal plasma. On the other hand, we found MFI patients with the ROS levels in the lowest 25th percentile had similar ROS levels to donors with normal semen characteristics. Collectively, our observations lead to the hypothesis that oxidative stress plays a critical role in the development of MFI among those with high ROS levels, but not those with low ROS levels.

Turning point of age for semen quality: a population-based study in Chinese men.

OBJECTIVE: To explore the relationship between age and semen quality in Chinese men. DESIGN: Population-based cross-sectional study. SETTING: The Department of Reproductive Epidemiology and Social Science, Shanghai Institute of Planned Parenthood Research, People's Republic of China. PATIENT(S): Healthy 20- to 60-year-old men. INTERVENTION(S): Standard World Health Organization procedures (3rd ed.) for semen analysis. MAIN OUTCOME MEASURE(S): Semen volume, sperm concentration, total sperm number, progressive motility, vitality, and sperm morphology. RESULT(S): Statistical analysis results of 998 subjects showed that age was negatively correlated with progressive motility, vitality, and percentage of normal sperm. No declining trend was found between age and parameters semen volume, sperm concentration, or total sperm number. Rapidly progressive motility and percentage of normal sperm began to decrease slowly at age 30 years, and progressive motility began to decrease at age 40 years. Compared with the 20- to 29-year age group, the values of the latter three parameters showed significant differences in men aged ≥35, ≥45, and ≥40 years. CONCLUSION(S): Increasing age mainly influences sperm motility, vitality, and normal morphology, but these parameters have turning points at different ages. Because of the large sample size, this information can be used to provide standard values for Chinese men, particularly in the age range 30-50 years. Further research would enroll a large sample of healthy 40- to 70-year olds to examine declining semen parameters in these age groups.

Selection and use of contraceptive methods among internal migrant workers in three large Chinese cities: a workplace-based survey.

OBJECTIVES: To describe the current status of the decision-making process with regard to the use of contraceptive methods among internal migrant workers in three large Chinese cities. METHODS: A total of 4313 sexually active internal migrant workers were recruited in Beijing, Shanghai, and Chengdu. Information on contraceptive use was collected by means of questionnaires. RESULTS: Contraceptive prevalence was 86% among unmarried sexually active migrant workers and 91% among married workers. The main contraceptive methods used by married migrants were the intrauterine device (51%), condoms (25%) and female/male sterilisation (17%); the main methods resorted to by unmarried, sexually active migrants were condoms (74%) and oral contraceptives (11%). The contraceptive method applied by 20% of married respondents had been selected by other people, without they themselves having their share in an informed choice. Adopting the contraceptive decisions made by others was associated with being a married migrant, a construction or service worker, a rural-urban migrant, a migrant living in collective or rented rooms, or a migrant with more children. CONCLUSIONS: Many internal migrants in these large cities did not choose their contraceptive method on their own. Efforts enabling and encouraging migrants to make informed choices are needed.

[Effect of acupoint-catgut-embedment on mammary gland hyperplasia].

OBJECTIVE: To evaluate the clinical therapeutic effect of acupoint-catgut-embedment therapy in the treatment of mammary gland hyperplasia (MGH). METHODS: Eighty MGH patients were equally randomized into acupoint-catgut-embedment (ACE) group and medication (Rupixiao, a herbal patent drug for relieving MGH) group according to odd-numbered days or even-numbered days of visiting. Subcutaneous catgut-embedment was performed in Wuyi (ST 15), Rugen (ST 18), Tanzhong (CV 17), Xuehai (SP 10), Zusanli (ST 36) and Yanglingquan (GB 34), once every 15 days for 3 months. Patients of the medication group were treated by oral administration of Rupixiao (3 tablets, 3 times per day, 3 months altogether). The degree of breast pain and the size of the hyperplastic lump were observed before and after the treatment. Serum estrodiol, progesterone and prolactin contents on day 1 to day 3 of menstruation were detected by using an automation chemiluminescence immune analysator. RESULTS: After the treatment, of the two 40 MGH patients in the ACE and medication groups, 16 (40. 0%) and 5 (12. 5%) were cured basically, 8 (20. 0%) and 8 were improved markedly in their symptoms and signs, 16 (40. 0%) and 22 (55. 0%) were effective, and 0 and 5 (12. 5%) failed in the treatment, with the effective rates being 100% and 87.5%, respectively. The therapeutic effect of the ACE group was significantly better than that of the medication group (P<0. 05). In comparison with the pretreatment, the pain grades and the size of the hyperplastic lump in both ACE and medication groups decreased significantly after immediate termination of the treatment and 6 months after the treatment (P<0.01), and the therapeutic effects of the ACE group were significantly superior to those of the medication group in reducing pain grade and hyperplastic lump size (P<0. 01). After the treatment, serum estrodiol and progesterone contents were decreased evidently in both ACE and medication groups (P<0. 01, P<0. 05). Type-B ultrasonic examination showed that of the two 40 MGH patients in the ACE and medication groups, 16 and 5 cases turned to normal in their mammary glands, and the cure rate of the ACE group was evidently higher than that of the medication group (P<0. 01). CONCLUSION: Acupoint-catgut-embedment is effective in relieving MGH, and its therapeutic effect is apparently superior to that of medication (oral administration of Rupixiao).

[Association between age and quality of semen in Chinese males with normal fertility].

OBJECTIVE: To explore the association between age and variables of semen in Chinese males with normal fertility. METHODS: The population size under study would consist of 946 fertile male volunteers from 6 provinces of China, aged between 20 and 59. Semen quality was analyzed by hand on site and background information was obtained through structured questionnaire. Trend chi-square test and multiple linear regression methods were used and 95%CI were calculated to serve as reference value of semen variables of different age group. RESULTS: The normal percent of motility and living sperm declined significantly while the ascending of age, they were 55.7% and 97.3% in age < 30 group when compared to 21.9% and 90.3% in the age 50 - 59 group respectively. Under control of confounding factors as for center and abstinence time, all semen variables except semen volume were significantly different among the age groups. Sperm concentration, percentage of sperm motility and normal morphology sperm decreased significantly after age 40 while percentage of living sperm decreased after age 50 - 59 group. Sperm concentration among the 50 - 59 year-old group appeared to be lower than the 40 - year-old group. CONCLUSION: The influence of age must be taken into account when evaluating the quality of semen.

Reference values of semen parameters for healthy Chinese men.

AIMS: To establish reference values of semen parameters in a residential, geographic, and age representative sample of healthy Chinese men. METHODS: From a national study of 1,191 healthy Chinese men, semen samples were analyzed from 105 subjects whose wives or partners were pregnant within the 12 months prior to the date when the semen sample was taken. RESULTS: The means, fifth percentiles, and percentages lower than the WHO criteria for semen parameters were, respectively: 75.8 x 10(6)/ml, 17.8 x 10(6)/ml, and 6.7% for sperm concentration; 206.9 x 10(6)/ejection, 26.3 x 10(6)/ejection, and 6.7% for total sperm count; 18.9, 3.0, and 79.1% for rapid progressive motility; 49.1, 25.3, and 52.4% for sperm progressive motility; 73.8, 49.3, and 45.7% for sperm viability, and 49.5, 25.2, and 9.5% for normal morphology. CONCLUSION: The values of semen parameters for Chinese men are lower than the WHO criteria, especially for rapid progressive motility, progressive motility, and sperm viability, and a different standard for Chinese may be needed.

Do reproductive hormones explain the association between body mass index and semen quality?

AIM: To examine whether reproductive hormones play a role in the association between body mass index (BMI) and semen quality. METHODS: Semen quality and testosterone (T), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and estradiol (E(2)) were evaluated in 990 fertile males with age 38.9 +/- 9.7 (mean +/- SD) years recruited from the Chinese general population in 2001 and 2002. RESULTS: Semen quality was reduced among underweight (BMI < 18.5) compared with normal (BMI 18.5-24.9) and overweight (BMI 25.0-29.9), but the associations were independent of reproductive hormones. After adjustment for the potential confounders, underweight men had reductions in sperm concentration (22.4 X 10(6)/mL), total sperm count (52.9 X 10(6)) and percentage of normal sperm forms (6.9%) compared with men with normal BMI. Being underweight may be a risk factor for low sperm concentration (OR: 4.68, 95% confidence intervals [CI]: 2.01-10.91). Otherwise, being overweight may be a protected factor for low sperm concentration (OR: 0.25; 95% CI: 0.08-0.83) and low total sperm count (OR: 0.37, 95% CI: 0.15-0.87). CONCLUSION: Low BMI was associated with reduced semen quality. The associations between BMI and semen quality were found statistically significant even after adjustment for reproductive hormones. Reproductive hormones cannot explain the association between BMI and semen quality.

Do Ureaplasma urealyticum infections in the genital tract affect semen quality?

UNLABELLED: To investigate the relationship between Ureaplasma urealyticum (UU) infection and semen quality. METHODS: From 2001 to 2003, 346 eligible patients aged 20-45 years were invited from two hospitals in Shanghai, China, to participate in an investigation which included questionnaires about general and reproductive health, an external genital tract examination, UU culture and semen analysis. Multiple linear regression models were used to examine whether UU had a significant effect on semen quality after adjustment for confounding factors. RESULTS: Findings suggested that UU infection was associated with higher semen viscosity and lower semen pH value. Sperm concentration was lower in UU positive subjects than that in UU negative subjects (54.04 X 10(6)/mL vs.70.58 X 10(6)/mL). However, UU did not significantly affect other semen quality indexes. CONCLUSION: UU infection of the male genital tract could negatively influence semen quality.

Does exposure to computers affect the routine parameters of semen quality?

AIM: To assess whether exposure to computers harms the semen quality of healthy young men. METHODS: A total of 178 subjects were recruited from two maternity and children healthcare centers in Shanghai, 91 with a history of exposure to computers (i.e., exposure for 20 h or more per week in the last 2 years) and 87 persons to act as control (no or little exposure to computers). Data on the history of exposure to computers and other characteristics were obtained by means of a structured questionnaire interview. Semen samples were collected by masturbation in the place where the semen samples were analyzed. RESULTS: No differences in the distribution of the semen parameters (semen volume, sperm density, percentage of progressive sperm, sperm viability and percentage of normal form sperm) were found between the exposed group and the control group. Exposure to computers was not found to be a risk factor for inferior semen quality after adjusting for potential confounders, including abstinence days, testicle size, occupation, history of exposure to toxic substances. CONCLUSION: The present study did not find that healthy men exposed to computers had inferior semen quality.