PDF(Pubmed)
Abstract：
Background and Objectives: Ankylosing spondylitis (AS) is a condition that affects 0.1% to 0.5% of the adult population. The aim of this case report was to investigate the possible effects of the drugs taken for treatment of AS as well as mRNA vaccination for COVID-19 on semen quality by performing a highly detailed analysis. Materials and Methods: Sperm characteristics were examined by light microscopy, DNA fragmentation (DFI) was analysed by flow cytometry and morphology was evaluated by transmission electron microscopy (TEM). Results: Semen analysis under therapy with (1) celecoxib and sulphasalazine showed: concentration 47 million/mL, 53% progressive motility, 7% normal morphology and 9.6% DFI, (2) Golimumab and before mRNA Vaccination showed: concentration 108 million/mL, 82% progressive motility, 1% normal morphology and 7.6% DFI, and (3) Golimumab and after 3 doses of mRNA Vaccination showed: concentration 142 million/mL, 85% progressive motility, 1% normal morphology and 6.8% DFI. TEM revealed head, neck and tail abnormalities, as well as the presence of cells with incomplete spermiogenesis white cells and phagocytes in the sample under therapy with celecoxib and sulphasalazine. Golimumab treatment lead to an increased incidence of elongated heads but in general reduced inflammation as no white cells were evident in TEM. Conclusion: The anti-inflamatory drugs celecoxib and sulphasalazine had no adverse effect on sperm quality as all parameters were within normal limits and the patient achieved under that treatment 2 pregnancies following natural conception that lead to the birth of a healthy boy and girl respectively. Anti-TNFa treatment with Golimumab exerted a negative effect on morphology but not on concentration, motility and DFI. After 3 doses of mRNA Vaccination, sperm concentration increased while motility, morphology and DFI remained similar to the values before vaccination suggesting no negative effect of the mRNA vaccine for COVID-19 on sperm quality.
摘要：
背景和目的：强直性脊柱炎（AS）是一种影响成年人口0.1％至0.5％的疾病。本病例报告的目的是通过进行非常详细的分析，研究用于治疗AS的药物以及COVID-19的mRNA疫苗接种对精液质量的可能影响。材料和方法：通过光学显微镜检查精子特征，通过流式细胞术分析DNA片段(DFI),并通过透射电子显微镜(TEM)评估形态。结果：（1）塞来昔布和柳氮磺吡啶治疗下的精液分析显示：浓度为47百万/mL，53%的渐进性运动，7％正常形态和9.6％DFI，（2）戈利木单抗和mRNA疫苗接种前显示：浓度为1.08亿/mL，82%的渐进性运动，1%正常形态和7.6%DFI,和（3）戈利木单抗和3剂量的mRNA疫苗接种后显示：浓度为142百万/mL，85%的渐进性运动，1%正常形态和6.8%DFI。透射电镜显示头部，颈部和尾部异常，以及在接受塞来昔布和柳氮磺吡啶治疗的样品中存在精子生成不完全的白细胞和吞噬细胞。戈利木单抗治疗导致延长头部的发生率增加,但通常减少炎症,因为在TEM中没有明显的白细胞。结论：抗炎药物塞来昔布和柳氮磺胺吡啶对精子质量无不良影响，因为所有参数均在正常范围内，患者在自然受孕后获得2次妊娠，分别导致健康男孩和女孩出生。使用Golimumab的抗TNFa治疗对形态学有负面影响，但对浓度没有影响。运动性和DFI。3剂mRNA疫苗接种后，精子浓度增加而运动，形态学和DFI与疫苗接种前的值相似，表明COVID-19mRNA疫苗对精子质量没有负面影响。
