Objective: To study the influence of povidone-iodine (PI) versus that of the benzethonium chloride wipe (BCW) on semen collection and semen quality of sperm donors undergoing penile skin disinfection and provide some evidence for the selection of disinfection methods for semen collection.
Methods: We used PI from August to December 2015 and BCWs from January to July 2016 for penile skin disinfection before semen collection, with two samples from each donor, one collected with and the other without penis skin disinfection (the blank control group). After semen collection, we conducted a questionnaire investigation on the influence of the two disinfection methods on semen collection and compared the semen parameters between the two groups of sperm donors.
Results: Totally, 185 sperm donors were included in this study, of whom 63 underwent penile skin disinfection with PI and the other 122 with BCWs before semen collection. Statistically significant differences were found between the PI and BCW groups in the adaptability to the disinfectant and rigid disinfection procedures (P <0.05), but not in the other items of the questionnaire (P >0.05). Compared with the sperm donors of the blank control group, those of the PI group showed statistically significant difference in the percentage of progressively motile sperm (PMS) (［63.02 ± 3.18］% vs ［61.45 ± 4.78］%, P<0.05), but not in the abstinence time (［4.97 ± 1.79］ vs ［4.7 ± 0.94］ d, P >0.05), semen volume (［4.11 ± 1.54］ vs ［4.15 ± 1.61］ ml, P >0.05), sperm concentration (［110 ± 29.6］ vs ［107.5 ± 31.79］ ×10⁶/ml, P >0.05), or total sperm count (［439.10 ± 170.13］ vs ［434.02 ± 186.91］ ×106/ejaculate, P >0.05), while those of the BCW group exhibited no remarkable difference in any of the above parameters (P >0.05). Among the samples with abnormal semen quality, significantly fewer were found with abnormal PMS in the BCW than in the PI group (1.64% ［2/122］ vs 9.68% ［6/62］, P <0.05). However, there were no significant differences between the PI and BCW groups in the abnormal semen volume, abnormal sperm concentration, or the rate of semen bacterial contamination (P >0.05).
Conclusions: Before semen collection from donors, penile skin disinfection with povidone-iodine may affect both the semen collection process and the quality of donor sperm, while the benzethonium chloride wipe can reduce the influence on the semen collection process and does not affect the semen parameters.
目的： 比较碘复合物消毒液和季铵盐类消毒湿巾两种消毒方式对捐精志愿者取精过程及精液质量影响，为辅助生殖技术过程中需无菌采集精液选取较为理想的消毒方法提供参考依据。方法： 研究对象采用未消毒(对照组)和两种消毒方式各采集1份精液样本，阴茎消毒2015年8~12月采用碘复合物消毒液(碘剂组,n=63)，2016年1~7月采用湿巾消毒(湿巾组,n=122)。精液采集完成后填写《阴茎消毒对采集精液过程影响调查问卷》。结果： 碘剂组1例疑似消毒液污染，其余全部完成试验。消毒对采精过程影响方面，两组志愿者对消毒后是否存在不适感及后期对消毒操作程序认真态度2个选项之间有统计学差异 (P均＜0.05)，其他选项无显著差异（P均＞0.05）。精液质量方面，碘剂组与其对照组比较，前向运动精子百分率 ［(63.02±3.18)% vs (61.45±4.78)%］存在显著差异（P＜0.05），而禁欲时间［(4.97±1.79) d vs (4.7±0.94) d］、精液体积［(4.11±1.54) ml vs (4.15±1.61) ml］、精子浓度［(110±29.6)×10⁶/ml vs (107.5±31.79) ×10⁶/ml］、精子总数［(439.10±170.13) ×10⁶/ vs (434.02±186.91) ×10⁶/］均无显著差异（P均＞0.05）；湿巾组与其对照组比较，禁欲时间、精液体积、精子浓度、前向运动精子百分率、精子总数均无显著差异（P＞0.05）。另外，获得的精液异常质量样本中，碘剂组中精液前向运动精子百分率异常比例［9.68% (6/62)］与湿巾组［1.64% (2/122)］相比，差异有显著性（P＜0.05），而精液体积异常比例、精子浓度异常比例、精液细菌污染率在两种消毒方式间均无显著性差异（P均＞0.05）。结论： 碘伏消毒剂对捐精者取精过程和精液质量有一定影响，而湿巾消毒方式可以减少对捐精者取精过程影响, 不影响精液参数。
Keywords: benzethonium chloride wipe; penile skin disinfection; povidone-iodine; semen collection process; semen quality; human sperm bank.