Abstract：
OBJECTIVE: Despite the significant role of varicocele in the pathogenesis of male infertility, its association with anti-sperm antibodies (ASA) remains controversial. This systematic review and meta-analysis (SRMA) aims to investigate the frequency of ASA positivity in men with varicocele.
METHODS: This SRMA is conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology guidelines. We investigated the frequency of ASA positivity in ejaculates or serum of men with varicocele as compared to men without varicocele (controls). A literature search was performed using the Scopus and PubMed databases following the Population Exposure Comparison Outcome, Study Design model. Data extracted from eligible studies were meta-analyzed and expressed as odds ratios (ORs) and confidence intervals (CIs).
RESULTS: Out of 151 abstracts identified during the initial screening, 6 articles met the inclusion criteria and were included in the meta-analysis. Using mixed antiglobulin reaction (MAR) assay, 61 out of the 153 (39.8%) patients with varicocele tested positive for ASA in their ejaculates as compared to 22 out of the 129 control subjects (17%, OR=4.34 [95% CI: 1.09-17.28]; p=0.04). Using direct or indirect immunobead test, 30 out of 60 cases diagnosed with varicocele (50%) had shown ASA positivity in their ejaculates as compared to 16 out of 104 controls (15.4%, OR=3.57 [95% CI: 0.81-15.68]; p=0.09). Using enzyme-linked immunosorbent assay (ELISA), out of 89 varicocele patients, 33 (37.1%) tested positive for serum ASA as compared to 9 out of 57 participants in the control group (15.8%, OR=7.87 [95% CI: 2.39-25.89]; p<0.01).
CONCLUSIONS: This SRMA indicates that ASA positivity is significantly higher among men with varicocele when tested by direct method (MAR) or indirect method (ELISA). This data suggests an immunological pathology in infertile men with varicocele and may have implications for the management of these patients.
METHODS: This SRMA is conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology guidelines. We investigated the frequency of ASA positivity in ejaculates or serum of men with varicocele as compared to men without varicocele (controls). A literature search was performed using the Scopus and PubMed databases following the Population Exposure Comparison Outcome, Study Design model. Data extracted from eligible studies were meta-analyzed and expressed as odds ratios (ORs) and confidence intervals (CIs).
RESULTS: Out of 151 abstracts identified during the initial screening, 6 articles met the inclusion criteria and were included in the meta-analysis. Using mixed antiglobulin reaction (MAR) assay, 61 out of the 153 (39.8%) patients with varicocele tested positive for ASA in their ejaculates as compared to 22 out of the 129 control subjects (17%, OR=4.34 [95% CI: 1.09-17.28]; p=0.04). Using direct or indirect immunobead test, 30 out of 60 cases diagnosed with varicocele (50%) had shown ASA positivity in their ejaculates as compared to 16 out of 104 controls (15.4%, OR=3.57 [95% CI: 0.81-15.68]; p=0.09). Using enzyme-linked immunosorbent assay (ELISA), out of 89 varicocele patients, 33 (37.1%) tested positive for serum ASA as compared to 9 out of 57 participants in the control group (15.8%, OR=7.87 [95% CI: 2.39-25.89]; p<0.01).
CONCLUSIONS: This SRMA indicates that ASA positivity is significantly higher among men with varicocele when tested by direct method (MAR) or indirect method (ELISA). This data suggests an immunological pathology in infertile men with varicocele and may have implications for the management of these patients.
摘要：
目的：尽管精索静脉曲张在男性不育的发病机制中具有重要作用，其与抗精子抗体(ASA)的相关性仍存在争议.本系统评价和荟萃分析（SRMA）旨在调查男性精索静脉曲张患者ASA阳性的频率。
方法：本SRMA是根据流行病学指南中观察性研究的Meta分析进行的。我们调查了与没有精索静脉曲张的男性（对照组）相比，精索静脉曲张的男性的射精或血清中ASA阳性的频率。根据人群暴露比较结果，使用Scopus和PubMed数据库进行文献检索，研究设计模型。从符合条件的研究中提取的数据进行荟萃分析，并表示为比值比（ORs）和置信区间（CIs）。
结果：在初步筛选期间确定的151篇摘要中，6篇文章符合纳入标准，纳入荟萃分析。使用混合抗球蛋白反应（MAR）测定法，153名精索静脉曲张患者中有61名（39.8％）在射精中检测出ASA阳性，而129名对照受试者中有22名（17％，OR=4.34[95%CI：1.09-17.28]；p=0.04)。使用直接或间接免疫珠测试，诊断为精索静脉曲张的60例（50％）中有30例表现出射精中的ASA阳性，而104例对照中有16例（15.4％，OR=3.57[95%CI：0.81-15.68]；p=0.09)。使用酶联免疫吸附测定（ELISA），在89名精索静脉曲张患者中，33（37.1％）的血清ASA检测呈阳性，而对照组的57名参与者中有9名（15.8％，OR=7.87[95%CI：2.39-25.89]；p<0.01）。
结论：该SRMA表明，通过直接法（MAR）或间接法（ELISA）检测，男性精索静脉曲张患者的ASA阳性率明显更高。该数据表明精索静脉曲张不育男性的免疫学病理学，可能对这些患者的治疗产生影响。
方法：本SRMA是根据流行病学指南中观察性研究的Meta分析进行的。我们调查了与没有精索静脉曲张的男性（对照组）相比，精索静脉曲张的男性的射精或血清中ASA阳性的频率。根据人群暴露比较结果，使用Scopus和PubMed数据库进行文献检索，研究设计模型。从符合条件的研究中提取的数据进行荟萃分析，并表示为比值比（ORs）和置信区间（CIs）。
结果：在初步筛选期间确定的151篇摘要中，6篇文章符合纳入标准，纳入荟萃分析。使用混合抗球蛋白反应（MAR）测定法，153名精索静脉曲张患者中有61名（39.8％）在射精中检测出ASA阳性，而129名对照受试者中有22名（17％，OR=4.34[95%CI：1.09-17.28]；p=0.04)。使用直接或间接免疫珠测试，诊断为精索静脉曲张的60例（50％）中有30例表现出射精中的ASA阳性，而104例对照中有16例（15.4％，OR=3.57[95%CI：0.81-15.68]；p=0.09)。使用酶联免疫吸附测定（ELISA），在89名精索静脉曲张患者中，33（37.1％）的血清ASA检测呈阳性，而对照组的57名参与者中有9名（15.8％，OR=7.87[95%CI：2.39-25.89]；p<0.01）。
结论：该SRMA表明，通过直接法（MAR）或间接法（ELISA）检测，男性精索静脉曲张患者的ASA阳性率明显更高。该数据表明精索静脉曲张不育男性的免疫学病理学，可能对这些患者的治疗产生影响。
