<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">NS</journal-id><journal-title-group><journal-title>Natural Science</journal-title></journal-title-group><issn pub-type="epub">2150-4091</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/ns.2022.1412048</article-id><article-id pub-id-type="publisher-id">NS-121898</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Biomedical&amp;Life Sciences</subject><subject> Chemistry&amp;Materials Science</subject><subject> Earth&amp;Environmental Sciences</subject><subject> Medicine&amp;Healthcare</subject><subject> Physics&amp;Mathematics</subject></subj-group></article-categories><title-group><article-title>
 
 
  Study on the Diagnostic Value of Combined Detection of Sperm Quality, Sex Hormone and Ovulation in Infertility
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Jianhong</surname><given-names>Nong</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Dinggan</surname><given-names>Mo<sup>#</sup></given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Yisi</surname><given-names>Ou</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Jing</surname><given-names>Wen</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Mengying</surname><given-names>Lu</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib></contrib-group><aff id="aff1"><addr-line>Laboratory Department of Reproductive Hospital of Guangxi Zhuang Autonomous Region, Nanning, China</addr-line></aff><pub-date pub-type="epub"><day>12</day><month>12</month><year>2022</year></pub-date><volume>14</volume><issue>12</issue><fpage>532</fpage><lpage>537</lpage><history><date date-type="received"><day>26,</day>	<month>October</month>	<year>2022</year></date><date date-type="rev-recd"><day>19,</day>	<month>December</month>	<year>2022</year>	</date><date date-type="accepted"><day>22,</day>	<month>December</month>	<year>2022</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  Objective: To analyze the application value of combined detection of sperm quality, sex hormone and ovulation in the diagnosis of infertility. Methods: The study was conducted from June 2021 to June 2022. Sixty infertile couples who received IVF cycle treatment in our hospital during this period were selected as the observation group, and 60 couples with good sperm quality and follicle number ≥ 5 who conceived naturally after gynecological disease treatment were selected as the control group during the same period. The sperm quality, sex hormones and ovulation of the two groups were observed, and the change of positive rate was detected by the combined detection method. Results: Compared with the control group, the observation group had less semen (2.82 &#177; 0.12) ml, lower concentration (69.17 &#177; 1.28) &#215; 106/ml, normal sperm morphology rate (2.92% &#177; 0.11%), lower survival rate (70.25% &#177; 1.16%), higher deformed sperm index (1.39 &#177; 0.11), and significant differences between groups (P &lt; 0.05); The levels of FSH (7.15 &#177; 1.33) U/L, LH (5.13 &#177; 0.53) mU/ml, E2 (72.34 &#177; 5.11) ng/L, AMH (3.87 &#177; 0.67) ng/ml and AFC (7.15 &#177; 0.76) in the control group were significantly better than those in the observation group (P &lt; 0.05). Compared with the single detection method of the three groups, the positive detection rate of the combined diagnosis method was higher, and the difference between the groups was significant (P &lt; 0.05). Conclusion: For the diagnosis of infertility, the combined detection method of sperm quality, sex hormone and ovulation can effectively clarify the problems existing in the couple, significantly improve the detection rate of the cause of the patient, and is more conducive to guiding clinical symptomatic treatment, which is worthy of promotion and reference.
 
</p></abstract><kwd-group><kwd>Infertility</kwd><kwd> Sperm Quality</kwd><kwd> Sex Hormones</kwd><kwd> Ovulation</kwd><kwd> Combined Test</kwd><kwd> Positive Rate</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>1. INTRODUCTION</title><p>In the face of the current domestic family planning policy of China’s comprehensive opening, the number of pregnant people has increased significantly. Infertility is a relatively common disease of the reproductive system, which tends to occur in couples of childbearing age. In recent years, the incidence of this disease has gradually increased due to the influence of lifestyle, living environment and eating habits [<xref ref-type="bibr" rid="scirp.121898-ref1">1</xref>]. Infertility is related to many factors, such as ovulation disorder, fallopian tube obstruction and low sperm quality, which seriously affect the quality of life and family happiness. At the same time, it will also bring different degrees of negative impact on the population growth of China. Therefore, early diagnosis and timely treatment has become the focus of research [<xref ref-type="bibr" rid="scirp.121898-ref2">2</xref>]. In this study, 60 infertile couples who came to our hospital for diagnosis and treatment from June 2021 to June 2022 were selected for analysis, and the application value of the combined detection method of sperm quality, sex hormone and ovulation was discussed. The details are as follows.</p></sec><sec id="s2"><title>2. DATA AND METHODS</title><sec id="s2_1"><title>2.1. General Information</title><p>The study was conducted from June 2021 to June 2022. 60 infertile couples who were treated in our hospital during this period were selected as the observation group, and 60 normal pregnant couples with good sperm quality and follicle number ≥ 5 during the same period were selected as the control group. In the control group, the average age of couples was (30.25 &#177; 1.27) years (range, 22 - 37 years); The average body mass index was (24.36 &#177; 1.22) kg/m<sup>2</sup> (range, 22 - 27 kg/m<sup>2</sup>). The average age of couples in the observation group was (30.27 &#177; 1.25) years (range, 22 - 39 years); The average body mass index was (24.34 &#177; 1.25) kg/m<sup>2</sup> (range, 22 - 27 kg/m<sup>2</sup>). The course of infertility was 1 - 7 years, with an average of (3.74 &#177; 0.11) years. There was no significant difference between the two groups (P &gt; 0.05).</p></sec><sec id="s2_2"><title>2.2. Methods</title><p>According to the fifth edition of WHO Laboratory Manual for Human Semen Examination and Processing [<xref ref-type="bibr" rid="scirp.121898-ref3">3</xref>], semen samples were collected from all male testers, the computer semen analysis system was used to observe the changes of semen volume, sperm concentration, sperm survival rate and other indicators.</p><p>For the two groups of women, in the morning of the third day of the menstrual cycle, 5 ml of venous blood was drawn on an empty stomach, centrifuged at 3000 r/min for 10 min, and then the changes of follicle estrogen (FSH), luteinizing hormone (LH), estradiol (E2), sex hormone and anti Mullerian hormone (AMH) were measured with Roche Cobas e601 automatic immune analyzer, and vaginal color Doppler ultrasound was performed. Before the examination, empty the bladder, put the condom probe into the cervix, observe the morphological changes of the fallopian tube, calculate the number of bilateral sinus follicles (AFC) and observe the size of the ovary.</p><p>Joint test: Combine the above indicators.</p></sec><sec id="s2_3"><title>2.3. Observation Indicators</title><p>1) Sperm quality: Male sperm quality change was observed in the two groups, including semen volume, concentration and survival rate.</p><p>2) Sex hormone and B ultrasound examination results: observe the change of sex hormone indicators in the two groups, including LH, FSH, and observe the number of follicles and the change of ovarian size.</p><p>3) Infertility detection rate: The positive rate of infertility detected by single sperm quality, sex hormone, ovulation and the above combined indicators was analyzed and compared.</p></sec><sec id="s2_4"><title>2.4. Statistical Methods</title><p>SPSS25.0 statistical software was used for analysis. Measurement data were expressed in X &#177; s, t-test was performed; n (%) was used to represent count data, and χ<sup>2</sup> was used for data test, and statistical significance was represented as P &lt; 0.05</p></sec></sec><sec id="s3"><title>3. RESULTS</title><sec id="s3_1"><title>3.1. Comparison of Sperm Quality Data between the Two Groups</title><p>Compared with the control group, the amount of semen in the observation group was less (2.82 &#177; 0.12) ml, and the concentration was lower (69.17 &#177; 1.28) &#215; 10<sup>6</sup>/ml; the normal sperm morphology rate and survival rate of the observation group were (2.92% &#177; 0.11%) and (70.25% &#177; 1.16%), and the deformed sperm index was higher (1.39 &#177; 0.11). There were significant differences between groups (P &lt; 0.05). See <xref ref-type="table" rid="table1">Table 1</xref> for details.</p></sec><sec id="s3_2"><title>3.2. Comparison of the Results of Sex Hormones and Ovulation Ultrasound Examination</title><p>The levels of control group FSH (7.15 &#177; 1.33) U/L, LH (5.13 &#177; 0.53) mU/ml, E2 (72.34 &#177; 5.11) ng/L, AFC (7.15 &#177; 0.76) and OV (4.48 &#177; 0.46) cm<sup>3</sup> were significantly higher than those in the observation group (P &lt; 0.05), as shown in <xref ref-type="table" rid="table2">Table 2</xref>.</p></sec><sec id="s3_3"><title>3.3. The Results of Detection Rate of Single Index and Combined Index in Three Groups Were Compared</title><p>Compared with the three groups of single indicators, the detection rate of joint detection method for 60 cases of couples was significantly higher (P &lt; 0.05). See <xref ref-type="table" rid="table3">Table 3</xref> for details.</p><table-wrap id="table1" ><label><xref ref-type="table" rid="table1">Table 1</xref></label><caption><title> Comparison of sperm quality analysis results ( x &#175; &#177; s)</title></caption><table><tbody><thead><tr><th align="center" valign="middle" >Group</th><th align="center" valign="middle" >Cases</th><th align="center" valign="middle" >Semen volume (ml)</th><th align="center" valign="middle" >Concentration (&#215;10<sup>6</sup>/ml)</th><th align="center" valign="middle" >Rate of normal morphology (%)</th><th align="center" valign="middle" >Survival rate (%)</th><th align="center" valign="middle" >Abnormal sperm index</th></tr></thead><tr><td align="center" valign="middle" >Observation group</td><td align="center" valign="middle" >60</td><td align="center" valign="middle" >2.82 &#177; 0.12</td><td align="center" valign="middle" >69.17 &#177; 1.28</td><td align="center" valign="middle" >2.92 &#177; 0.11</td><td align="center" valign="middle" >70.25 &#177; 1.16</td><td align="center" valign="middle" >3.39 &#177; 0.11</td></tr><tr><td align="center" valign="middle" >Control group</td><td align="center" valign="middle" >60</td><td align="center" valign="middle" >3.39 &#177; 0.22</td><td align="center" valign="middle" >81.54 &#177; 2.13</td><td align="center" valign="middle" >6.12 &#177; 0.23</td><td align="center" valign="middle" >79.38 &#177; 5.27</td><td align="center" valign="middle" >1.12 &#177; 0.08</td></tr><tr><td align="center" valign="middle" >t</td><td align="center" valign="middle" ></td><td align="center" valign="middle" >5.564</td><td align="center" valign="middle" >38.558</td><td align="center" valign="middle" >97.222</td><td align="center" valign="middle" >13.106</td><td align="center" valign="middle" >15.376</td></tr><tr><td align="center" valign="middle" >P</td><td align="center" valign="middle" ></td><td align="center" valign="middle" >0.000</td><td align="center" valign="middle" >0.000</td><td align="center" valign="middle" >0.000</td><td align="center" valign="middle" >0.000</td><td align="center" valign="middle" >0.000</td></tr></tbody></table></table-wrap><table-wrap id="table2" ><label><xref ref-type="table" rid="table2">Table 2</xref></label><caption><title> The analysis of sex hormone and ovulation data ( x &#175; &#177; s)</title></caption><table><tbody><thead><tr><th align="center" valign="middle" >Group</th><th align="center" valign="middle" >Cases</th><th align="center" valign="middle" >FSH (U/L)</th><th align="center" valign="middle" >LH (mU/ml)</th><th align="center" valign="middle" >E2 (ng/L)</th><th align="center" valign="middle" >AMH (ng/ml)</th><th align="center" valign="middle" >AFC (number)</th></tr></thead><tr><td align="center" valign="middle" >Observation group</td><td align="center" valign="middle" >60</td><td align="center" valign="middle" >36.25 &#177; 4.28</td><td align="center" valign="middle" >4.08 &#177; 0.17</td><td align="center" valign="middle" >23.37 &#177; 6.28</td><td align="center" valign="middle" >1.14 &#177; 0.26</td><td align="center" valign="middle" >3.11 &#177; 0.24</td></tr><tr><td align="center" valign="middle" >Control group</td><td align="center" valign="middle" >60</td><td align="center" valign="middle" >7.15 &#177; 1.33</td><td align="center" valign="middle" >5.13 &#177; 0.53</td><td align="center" valign="middle" >72.34 &#177; 5.11</td><td align="center" valign="middle" >3.87 &#177; 0.67</td><td align="center" valign="middle" >7.15 &#177; 0.76</td></tr><tr><td align="center" valign="middle" >t</td><td align="center" valign="middle" ></td><td align="center" valign="middle" >50.293</td><td align="center" valign="middle" >14.612</td><td align="center" valign="middle" >46.851</td><td align="center" valign="middle" >5.37</td><td align="center" valign="middle" >39.265</td></tr><tr><td align="center" valign="middle" >P</td><td align="center" valign="middle" ></td><td align="center" valign="middle" >0.000</td><td align="center" valign="middle" >0.000</td><td align="center" valign="middle" >0.000</td><td align="center" valign="middle" >0.000</td><td align="center" valign="middle" >0.000</td></tr></tbody></table></table-wrap><table-wrap id="table3" ><label><xref ref-type="table" rid="table3">Table 3</xref></label><caption><title> Comparison of diagnostic detection rate [n (%)]</title></caption><table><tbody><thead><tr><th align="center" valign="middle" >Test items</th><th align="center" valign="middle" >Positive rate</th></tr></thead><tr><td align="center" valign="middle" >Abnormal sperm quality</td><td align="center" valign="middle" >52 (86.67)</td></tr><tr><td align="center" valign="middle" >Abnormal ovulation</td><td align="center" valign="middle" >49 (81.67)</td></tr><tr><td align="center" valign="middle" >Sex hormones</td><td align="center" valign="middle" >52 (86.67)</td></tr><tr><td align="center" valign="middle" >Joint detection</td><td align="center" valign="middle" >60 (100.00)</td></tr></tbody></table></table-wrap></sec></sec><sec id="s4"><title>4. DISCUSSION</title><p>Research shows that [4,5], couples of childbearing age who do not take contraceptive measures have an average 25% chance of pregnancy in each menstrual cycle, 50% should be able to conceive within 3 months after marriage, 72% should be able to conceive within 6 months after marriage, 80% - 85% should be able to conceive within 12 months after marriage, and infertility may affect about 10% of couples of childbearing age. Therefore, if you have regular sex for more than one year after marriage without taking any contraceptive measures, and your spouse is unable to conceive or can conceive but fails to conceive and deliver, you should consider the possibility of infertility, which is collectively referred to as infertility in medicine, including male infertility and female infertility. Affected by living conditions, work pressure, personal bad living habits and other factors, the incidence of infertility is gradually on the rise. With the proposal of national policies, eugenic birth and eugenic rearing, it is necessary to strengthen the examination of infertility in couples of childbearing age and determine the causes of infertility [6,7].</p><p>Male infertility is mostly related to sperm quality decline, testicular damage, varicocele, reproductive tract infection, etc. Sperm quality includes quantity, activity and morphology [<xref ref-type="bibr" rid="scirp.121898-ref8">8</xref>]. According to the new WHO semen testing manual, the sperm concentration should be at least 15 million/ml, the semen volume should be ≥1.5 ml, and the forward motile sperm should be ≥32%. In terms of sperm morphology, the healthy sperm should be ≥4%, and the malformation rate should be &lt;96%. In daily life, smoking, drug taking, alcoholism, drug abuse, extramarital sexual behavior and other bad habits will affect the secretion of male hormones, harm the gonads and reproductive tract, induce erectile dysfunction or loss of libido, sperm malformation, and eventually cause male infertility [9,10]. Female infertility is mainly caused by the lesions of reproductive system related tissues or diseases of uterus and ovary. In addition, ovulation dysfunction and endocrine diseases related to sex hormone abnormalities are also the main problems of clinical female infertility [<xref ref-type="bibr" rid="scirp.121898-ref11">11</xref>]. Studies have shown that [<xref ref-type="bibr" rid="scirp.121898-ref12">12</xref>] ovulation dysfunction occurs in 15 percent of all pregnant couples, and up to 40 percent of female infertility can lead to significant menstrual disturbances (infrequent menstruation or amenorrhea), and may also reduce symptoms. The most common causes include polycystic ovary complex (PCOS), obesity, weight gain or loss, strenuous exercise, thyroid dysfunction, hyperprolactinemia, etc. Therefore, it is necessary to combine clinical experience and theoretical knowledge to select appropriate examination methods to diagnose infertility, help improve the patient’s pregnancy function and meet their fertility requirements [<xref ref-type="bibr" rid="scirp.121898-ref13">13</xref>]. According to the research results, the data show that the low sperm activity, low concentration, low survival rate and high abnormal sperm index of infertile men will affect the fertility quality. In the sex hormone examination indicators, it can be found that there are abnormalities in the sex hormone indicators in the observation group. FSH and LH are related to the control of reproductive activities; LH has the role of ovulation promotion; Together with FSH, it acts on the corpus luteum and secretes progesterone; The abnormally high level of FSH indicates premature ovarian failure; The low level of LH indicates that there is dysfunction in the pituitary or hypothalamus, which leads to infertility [14,15]. Serum E2 is an important indicator for monitoring menstrual abnormalities. By observing serum sex hormone indicators, we can understand the functional status of hypothalamus and ovary, predict ovulation time and evaluate ovarian function, and also help clinicians understand the changes and progress of female infertility [16,17]. Anti-mullerian hormone (AMH) is a dimeric glyconeptide, also known as Mullerian duct inhibitor (MIS), which is mainly produced by granulosa cells and has the highest expression in secondary follicles, presinus follicles and small sinus follicles. The level of AMH is relatively stable within and during the menstrual cycle and is an excellent indicator for assessing ovarian reserve. In view of ovulation, vaginal Doppler ultrasound technology is used to understand the size of the ovary and the number of follicles with the help of high-frequency probes. By monitoring the development of follicles, we can observe whether they are factors affecting female infertility, and also observe whether there are abnormalities in the structure of the uterus and ovary. If the ovary is small and the number of ovulations is small, it indicates that abnormal ovulation will lead to decreased fertility. In addition, vaginal ultrasound can also monitor ovarian reflux; It plays an important role in predicting ovulation and evaluating ovarian function [18,19]. The detection methods of three groups have relatively accurate diagnosis results, but there are also subjectivity, misdiagnosis, missed diagnosis and other problems. The research results show that, compared with the single indicators of three groups, the detection rate of joint testing for 60 cases of couples is higher (P &lt; 0.05), indicating that in order to better improve the diagnosis of infertility and help patients develop more reasonable and effective treatment methods, multiple joint testing can provide more diagnostic basis for patients’ follow-up treatment, and help to meet the pregnancy needs of patients [20,21].</p></sec><sec id="s5"><title>5. CONCLUSION</title><p>To sum up, for the diagnosis of infertility, the combined detection method of sperm quality, sex hormone and ovulation can effectively identify the problems of both couples, significantly improve the detection rate of patients’ causes, which can be further promoted and applied in clinical practice.</p></sec><sec id="s6"><title>6. LIMITATIONS OF THE STUDY</title><p>The main business of the Reproductive Health Research Center is to carry out work around human assisted reproductive technology. Most of the selected research objects are infertile people, with a narrow regional scope. The research results obtained do not represent the conventional level of normal and healthy semen of men who have given birth, but also have certain limitations. It is necessary to expand the scope of research, or select men who have naturally had a first child as the research object, which is more representative.</p></sec><sec id="s7"><title>ACKNOWLEDGEMENTS</title><p>During the process of this topic research, we got much help from many departments and individuals, and other personnel not involved in this project research. All of them offered a great support and help in this research. Now here, all of members in this research show our deepest appreciation to them, and wish them good health and everything goes well.</p></sec><sec id="s8"><title>FUND PROJECT</title><p>The project funded by the Administration of Traditional Chinese Medicine of Guangxi Zhuang Autonomous Region in 2021 (No.: GXZYZ20210050).</p></sec><sec id="s9"><title>CONFLICTS OF INTEREST</title><p>The authors declare no conflicts of interest regarding the publication of this paper.</p></sec><sec id="s10"><title>REFERENCES</title></sec><sec id="s11"><title>NOTES</title></sec></body><back><ref-list><title>References</title><ref id="scirp.121898-ref1"><label>1</label><mixed-citation publication-type="other" xlink:type="simple">Cao, Q.C., Lai, Y.H. and Chen, H.L. (2021) Analysis of the Value of Combined Detection of Estradiol, Progesterone and Anti HCG Antibody in the Diagnosis of Female Infertility. Sichuan Journal of Physiological Sciences, 43, 794-795.</mixed-citation></ref><ref id="scirp.121898-ref2"><label>2</label><mixed-citation publication-type="other" xlink:type="simple">Zhang, H.J., Zhou, G.Y., Zhang, G.H., et al. (2021) Application of Serum Hormone Combined with Immune Antibody in Infertility Screening. Clinical Research, 29, 120-121.</mixed-citation></ref><ref id="scirp.121898-ref3"><label>3</label><mixed-citation publication-type="other" xlink:type="simple">Zhang, G.L. and Huang, Z.H. (2020) The Clinical Value of Serum Reproductive Hormone, Acrosin Antibody and Sperm Protein 17 Antibody in Infertile Women. China Maternal and Child Health Care, 35, 2673-2675.</mixed-citation></ref><ref id="scirp.121898-ref4"><label>4</label><mixed-citation publication-type="other" xlink:type="simple">Tang, M., Nie, A., Chen, M., et al. (2021) The Expression and Significance of Serum LH, FSH, E2, T, P, PRL in Infertility Patients. Contemporary Medicine, 27, 58-61.</mixed-citation></ref><ref id="scirp.121898-ref5"><label>5</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Li</surname><given-names> S.J. </given-names></name>,<etal>et al</etal>. (<year>2021</year>)<article-title>Analysis on the Significance of Serum Sex Hormone Indicators in Infertile Women</article-title><source> Journal of Shanxi Health Vocational College</source><volume> 31</volume>,<fpage> 39</fpage>-<lpage>40</lpage>.<pub-id pub-id-type="doi"></pub-id></mixed-citation></ref><ref id="scirp.121898-ref6"><label>6</label><mixed-citation publication-type="other" xlink:type="simple">Schisterman, E.F., Sjaarda, L.A., Clemons, T., et al. (2020) Effect of Folic Acid and Zinc Supplementation in Men on Semen Quality and Live Birth among Couples Undergoing Infertility Treatment: A Randomized Clinical Trial. JAMA, 323, 35-48. https://doi.org/10.1001/jama.2019.18714</mixed-citation></ref><ref id="scirp.121898-ref7"><label>7</label><mixed-citation publication-type="other" xlink:type="simple">Lundy, S.D., Sangwan, N., Parekh, N.V., et al. (2021) Functional and Taxonomic Dysbiosis of the Gut, Urine, and Semen Microbiomes in Male Infertility. European Urology, 79, 826-836. https://doi.org/10.1016/j.eururo.2021.01.014</mixed-citation></ref><ref id="scirp.121898-ref8"><label>8</label><mixed-citation publication-type="other" xlink:type="simple">Li, G.Y., Liu, J. and Wang, Y.Y. (2017) The Significance of Combined Detection of Sperm Quality, Sex Hormone and Ovulation in the Diagnosis of Infertility. Chinese Practical Medicine, 12, 60-61.</mixed-citation></ref><ref id="scirp.121898-ref9"><label>9</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Zhang</surname><given-names> Y.T. </given-names></name>,<etal>et al</etal>. (<year>2017</year>)<article-title>The Value of Sex Hormone Test in the Diagnosis of Infertility</article-title><source> Journal of Community Medicine</source><volume> 15</volume>,<fpage> 21</fpage>-<lpage>22</lpage>.<pub-id pub-id-type="doi"></pub-id></mixed-citation></ref><ref id="scirp.121898-ref10"><label>10</label><mixed-citation publication-type="other" xlink:type="simple">Li, Y.L., Lou, Q.W. and Chen, X.G. (2011) The Application of Combined Detection of Sperm Quality, Sex Hormone and Ovulation in the Analysis of Infertility Etiology. Shandong Pharmaceutical, 51, 99-100.</mixed-citation></ref><ref id="scirp.121898-ref11"><label>11</label><mixed-citation publication-type="other" xlink:type="simple">Song, X.Y., Song, B. and Feng, G.M. (2016) Study on the Diagnostic Value of Three Combined Tests in Infertility. International Journal of Laboratory Medicine, 37, 2619-2621.</mixed-citation></ref><ref id="scirp.121898-ref12"><label>12</label><mixed-citation publication-type="other" xlink:type="simple">He, H.Q., Zhou, Y.Y. and Song, S.Z. (2002) Analysis of Detection Results of Chlamydia Trachomatis and Ureaplasma urealyticum in 92 Infertile Couples. Chinese Journal of Family Planning, 10, 554-555.</mixed-citation></ref><ref id="scirp.121898-ref13"><label>13</label><mixed-citation publication-type="other" xlink:type="simple">Donders, G.G.G., Bosmans, E., Reumers, J., et al. (2022) Sperm Quality and Absence of SARS-CoV-2 RNA in Semen after COVID-19 Infection: A Prospective, Observational Study and Validation of the SpermCOVID Test. Fertility and Sterility, 117, 287-296. https://doi.org/10.1016/j.fertnstert.2021.10.022</mixed-citation></ref><ref id="scirp.121898-ref14"><label>14</label><mixed-citation publication-type="other" xlink:type="simple">Zhang, H., He, J., Zhao, Y., et al. (2021) Effect of Glutathione S-Transferase Gene Polymorphisms on Semen Quality in Patients with Idiopathic Male Infertility. Journal of International Medical Research, 49.https://doi.org/10.1177/03000605211061045</mixed-citation></ref><ref id="scirp.121898-ref15"><label>15</label><mixed-citation publication-type="other" xlink:type="simple">Yang, S.Y., Yang, Z.H. and Chen, X.L. (2018) Study on the Detection Value of AsAb, EmAb, AcAb, AoAb, ToxAb in Peripheral Blood and Endometrium of Infertile Patients. Hebei Medical Journal, 40, 368-371.</mixed-citation></ref><ref id="scirp.121898-ref16"><label>16</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Wang</surname><given-names> L.J. </given-names></name>,<etal>et al</etal>. (<year>2017</year>)<article-title>Comparison of Three Detection Techniques in Detection of Ureaplasma urealyticum in Infertile Patients</article-title><source> Laboratory and Laboratory Medicine</source><volume> 35</volume>,<fpage> 239</fpage>-<lpage>240</lpage>.<pub-id pub-id-type="doi"></pub-id></mixed-citation></ref><ref id="scirp.121898-ref17"><label>17</label><mixed-citation publication-type="other" xlink:type="simple">Wen, H.Y., Jiang, Y.Y. and Miao, L.L. (2018) Study on the Detection Value of EMAb, AsAb and AMH in Peripheral Blood of Infertile Patients. Journal of Modern Integrated Chinese and Western Medicine, 27, 1909-1911.</mixed-citation></ref><ref id="scirp.121898-ref18"><label>18</label><mixed-citation publication-type="other" xlink:type="simple">Chen, Y.Q., Li, J., Jing, X.Z., et al. (2022) Diagnostic Value of Combined Detection of miR-34b, miR-122 and miR-429 in Semen for Male Infertility. International Journal of Laboratory Medicine, 43, 2046-2048.</mixed-citation></ref><ref id="scirp.121898-ref19"><label>19</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Guo</surname><given-names> M. </given-names></name>,<etal>et al</etal>. (<year>2012</year>)<article-title>Analysis of the Results of Serum Antisperm Antibodies in Infertile Patients in Xinjiang (A Report of 1200 Cases)</article-title><source> Chinese Journal of Aesthetic Medicine</source><volume> 21</volume>,<fpage> 295</fpage>-<lpage>296</lpage>.<pub-id pub-id-type="doi"></pub-id></mixed-citation></ref><ref id="scirp.121898-ref20"><label>20</label><mixed-citation publication-type="other" xlink:type="simple">Zhang, H., Liu, R.M., Wu, Z., et al. (2003) Application of Antisperm Antibody Detection in Infertility. Journal of Cell and Molecular Immunology, 19, 614-614.</mixed-citation></ref><ref id="scirp.121898-ref21"><label>21</label><mixed-citation publication-type="other" xlink:type="simple">Liang, Y.H., Zhang, J. and Xie, Q. (2018) Detection and Clinical Significance of Peripheral Blood DNT Cells and T Cell Subsets in Female Infertile Patients. Journal of Ningxia Medical University, 40, 971-974.</mixed-citation></ref></ref-list></back></article>