METHODS: Data from 1,230 consecutive men presenting for primary couple\'s infertility were analyzed. Health-significant comorbidities were scored with Charlson comorbidity index. Quartiles of FSH and InhB were considered to determine threshold values. Descriptive statistics and logistic regression models tested association between FSH and InhB values.
RESULTS: Overall, 1,080 (87.8%) men had concordant FSH and InhB values. Conversely, 150 patients (12.2%) had discrepancies in FSH and InhB, with 78 (6.3%) and 72 (5.9%) men reporting both low and high FSH and InhB values, respectively. Infertile men with discordant values were younger (median [interquartile range] 38.0 years [34-41 years] vs. 36.0 years [31-40 years]); had smaller testicular volume (TV) (12 mL [10-15 mL] vs. 15 mL [12-20 mL]); and, had more frequently a sperm DNA fragmentation test >30% (179 [59.1%] vs. 40 [78.4%]) than those with concordant values (all p<0.05). Moreover, a higher frequency of previous cryptorchidism (27.3% vs. 11.9%), lower sperm concentration (3.0 million/mL [0.9-11.0 million/mL] vs. 13.8 million/mL [3.1-36.0 million/mL]), lower progressive sperm motility rates (12.0% [5.0%-25.3%] vs. 20.0% [7.0%-36.0%]), and greater rates of non-obstructive azoospermia (36.4% vs. 23.9%) were found in men with discordant FSH and InhB values (all p≤0.005). At multivariable logistic regression analysis, higher body mass index (odds ratio [OR], 1.08; p=0.001), smaller TV (OR, 0.91; p<0.001), and a history of cryptorchidism (OR, 2.49; p<0.001) were associated with discordant FSH and InhB values.
CONCLUSIONS: More than one out of ten infertile men had discordant FSH and InhB values in the real-life setting showing worse clinical profiles than those with concordant levels. Smaller TV and history of cryptorchidism could be used as clinical markers to better tailor the need to test InhB.
方法:分析了1,230名连续出现原发夫妇不孕症的男性的数据。用Charlson合并症指数对健康显著合并症进行评分。考虑FSH和InhB的四分位数来确定阈值。描述性统计和逻辑回归模型测试了FSH和InhB值之间的关联。
结果:总体而言,1,080名(87.8%)男性的FSH和InhB值一致。相反,150例患者(12.2%)FSH和InhB有差异,78(6.3%)和72(5.9%)男性报告低和高FSH和InhB值,分别。不孕症患者的年龄较小(中位数[四分位数间距]38.0岁[34-41岁]与36.0年[31-40年]);睾丸体积(TV)较小(12mL[10-15mL]与15毫升[12-20毫升]);以及,更频繁地进行精子DNA碎片测试>30%(179[59.1%]与40[78.4%])比具有一致值的那些(所有p<0.05)。此外,以前的隐睾频率较高(27.3%与11.9%),较低的精子浓度(300万/mL[0.9-1100万/mL]与1380万/毫升[3.1-36.0万/毫升]),较低的进行性精子活力率(12.0%[5.0%-25.3%]与20.0%[7.0%-36.0%]),非梗阻性无精子症的发生率更高(36.4%vs.在FSH和InhB值不一致的男性中发现了23.9%)(所有p≤0.005)。在多变量逻辑回归分析中,较高的体重指数(比值比[OR],1.08;p=0.001),较小的电视(或,0.91;p<0.001),和隐睾史(或者,2.49;p<0.001)与FSH和InhB值不一致相关。
结论:在现实生活中,超过十分之一的不育男性的FSH和InhB值不一致,其临床特征比那些具有一致水平的男性更差。较小的TV和隐睾病史可用作临床标志物,以更好地调整测试InhB的需求。