台灣生育率自1950年代的7.0一路下滑至1983年的2.1,已經不足以維持世代替換之水平。2003年起更跌破1.3,成為最低生育率(Lowerest-low fertility)的國家。人口老化、勞動力不足等生會安全議題逐漸浮現。低生育率的原因包含經濟壓力、婦女受教程度提高、婦女就業率提高及晚婚等等;然而,男女生殖、內分泌以及泌尿道病理性因素或不孕則鮮少被討論。男性因素在探討生育率時更時常不被重視,在台灣相關的統計、研究也十分缺乏。
本研究蒐集設籍在台灣台北市男性的精液樣本,並依照世界衛生組織(WHO)的檢驗方法和判讀標準統計出台灣男性精液指標。總計823位民眾自2008年至2015年七月自發性前往台北市立聯合醫院忠孝院區接受篩檢。本研究主要目的有二,首先探討2008年至2015年精液指標合格率,並根據2012年至2015年之資料(總計有421位民眾),探討精液指標與年齡之相關,其次探討精液指標合格率與生育率之相關。統計方法主要以Pearson相關係數探討各因子間的相關性,也同時以ANOVA分析比較各年度間精液指標之差異性。
研究結果顯示年齡與正常精子活動力比例以及正常精子型態比例呈現顯著負相關。精子密度差異在四年度之間有統計顯著意義。精液合格率在去除龍年影響之後與出生率之相關係數為0.595,然而並無達到統計顯著。
台灣地區較少有分析精液之研究,未來可針對各種影響精液品質的因素加以控制,並且拉長研究時間,做更完整對於生育率相關之研究。也可藉此建立台灣精液品質資料庫,研究不孕、男性生殖疾病等領域。
The total fertility rate in Taiwan had decreased from 7.0, in the 1950s, to 2.1 within 30 years since 1983. Even lower number, which was 1.3, has been recorded since 2003, which made Taiwan the “lowerest-low fertility” country. The issues for population, for examples, aging and decreasing amount of labors started to emerge. The attribution of low fertility rate includes socioeconomic stress, higher degree of female education, higher female employee rate and delayed marriage. Pathological problems of both sex, nonetheless, such as genital or endocrinal abnormality, are not at the point. Male issues are even more neglected and lack of either statistics or research.
This study collected the semen sample form the men who resided in Taipei city and has married but without the first children. A total of 823 people has randomly came to Taipei Municipal Hospital, Zhongxiao Branch for semen analysis since 2008 until July 2015. Methods for sampling and examine are in accordance with WHO standard procedures. There are two purposes of the study: (1) to establish the relation between semen parameters and age by analyzing data collected from the recent four years (2012-2015) and (2) the relation between semen quality and total fertility rate by using more extended data (2008-2015).
Statistics showed negative relation between age and normal semen mortality and normal semen morphology. There was significant difference of sperm density within the four-year period (2012-2015). The Pearson correlation coefficient of qualified rate of semen and total fertility was 0.595; however, it was not statistically significant.
There is few research about semen quality in Taiwan. More factors which may affect semen quality can be controlled or adjusted and study period can be elongated in future studies.