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Abstract：
Varicocele repair (VR) is associated with improved sperm parameters in subfertile patients. We examined the association of the levels of reproductive hormones, scrotal colour Doppler ultrasound (CDU) and seminal parameters in subfertile men, before and after VR. Fifty subfertile males, with left-side varicocele, were enrolled in this retrospective study. The serum levels of FSH, LH and total testosterone (TT), along with continuous left spermatic venous reflux (SVR) and testicular volumes at CDU were evaluated, before and six months after VR by a left-side retrograde internal spermatic vein sclero-embolisation (SVE). Left-side SVR was either no longer present or significantly reduced in all patients after VR (p < 0.0001). Sperm parameters, in particular, the total sperm motile count (TMC), were found significantly improved after VR (p < 0.0001). Post-VR, no differences were observed in the baseline values of the reproductive hormones. Only SVR change was seen to predict TMC change (p = 0.026) in the univariate analysis, while reproductive hormones change had no effect on TMC change (FSH:p = 0.85;LH:p = 0.44;TT:p = 0.76). In conclusion, the improved sperm parameters were associated with the disappearance or reduction in SVR and not with changes in the levels of reproductive hormones after SVE. Thus, SVR change at CDU was the only predictor of improved sperm quality after VR in subfertile males.
摘要：
精索静脉曲张修复（VR）与低生育能力患者精子参数的改善有关。我们检查了生殖激素水平的关联，阴囊彩色多普勒超声（CDU）和精液参数，VR之前和之后五十只不生育的雄性，左侧精索静脉曲张,参加了这项回顾性研究。血清FSH水平,LH和总睾酮（TT），同时评估持续的左精索静脉回流（SVR）和CDU时的睾丸体积，通过左侧逆行精索内静脉巩膜栓塞术（SVE）进行VR之前和之后六个月。在VR后所有患者中左侧SVR不再存在或显著降低(p<0.0001)。精子参数,特别是,总精子运动计数(TMC)，发现VR后明显改善（p<0.0001）。后VR,生殖激素基线值无差异.在单变量分析中，仅SVR变化可预测TMC变化（p=0.026），而生殖激素变化对TMC变化没有影响（FSH：p=0.85；LH：p=0.44；TT：p=0.76）。总之,精子参数的改善与SVR的消失或降低有关,而与SVE后生殖激素水平的变化无关.因此，CDU时的SVR变化是不育症男性VR后精子质量改善的唯一预测指标。
