PDF(Pubmed)
Abstract：
BACKGROUND: The dilation and torsion of testicular veins in the plexus pampiniformis causes Varicocele, which is a surgically repairable cause of male infertility. This study assessed the impact of varicocelectomy on semen characteristics, total motile sperm count (TMSC) and sperm DNA integrity in patients with severe oligoasthenoteratozoospermia (OAT).
METHODS: In this prospective study, semen samples of 360 men with severe OAT who underwent varicocelectomy according to World Health Organization (WHO) criteria 2021 were studied (pre-operatively and at 6, 12, and 18 months post-operatively).
RESULTS: The average age of our patients was 38.5 years. The mean spermatozoa concentration was found to be 1.60 ± 0.83 million/ml pre-operatively, while the mean post-operative concentration was 5.17 ± 1.23 million/ml at 6 months, 8.32 ± 0.98 million/ml at 12 months, and 13.51 ± 1.48 million/ml at 18 months (P<0.0001). The mean percentage of A+B motile spermatozoa was 2.92 ± 1.17% pre-operatively, 6.10 ± 1.51% at six months, 9.58 ± 1.49% at 12 months and 13.92 ± 1.88% at 18 months postoperatively (P<0.0001). The mean Modified David\'s morphology score was 3.80 ± 1.43% pre-operatively, 5.95 ± 1.23% at 6 months, 7.94 ± 1.18% at 12 months, and 10.82 ± 1.91% at 18 months post-operatively (P<0.0001). The mean of total motile sperm count (TMSC) was statistically improved after varicocelectomy (P<0.001). The mean of DNA fragmentation index (DFI) of the spermatozoa was 31.40 ± 0.52% pre-operatively, and post-operatively at 28.20 ± 0.32% at 6 months, 25.90 ± 0.31% at 12 months and 20.50 ± 0.40% at 18 months (P<0.001).
CONCLUSIONS: Varicocelectomy was associated with significant improvement of sperm parameters and DNA fragmentation resulting in significant improvement of spermatogenesis quality. We believe that universalization in the routinely used sperm dispersion chromatin (SDC) test could be beneficial in the treatment of infertility.
METHODS: In this prospective study, semen samples of 360 men with severe OAT who underwent varicocelectomy according to World Health Organization (WHO) criteria 2021 were studied (pre-operatively and at 6, 12, and 18 months post-operatively).
RESULTS: The average age of our patients was 38.5 years. The mean spermatozoa concentration was found to be 1.60 ± 0.83 million/ml pre-operatively, while the mean post-operative concentration was 5.17 ± 1.23 million/ml at 6 months, 8.32 ± 0.98 million/ml at 12 months, and 13.51 ± 1.48 million/ml at 18 months (P<0.0001). The mean percentage of A+B motile spermatozoa was 2.92 ± 1.17% pre-operatively, 6.10 ± 1.51% at six months, 9.58 ± 1.49% at 12 months and 13.92 ± 1.88% at 18 months postoperatively (P<0.0001). The mean Modified David\'s morphology score was 3.80 ± 1.43% pre-operatively, 5.95 ± 1.23% at 6 months, 7.94 ± 1.18% at 12 months, and 10.82 ± 1.91% at 18 months post-operatively (P<0.0001). The mean of total motile sperm count (TMSC) was statistically improved after varicocelectomy (P<0.001). The mean of DNA fragmentation index (DFI) of the spermatozoa was 31.40 ± 0.52% pre-operatively, and post-operatively at 28.20 ± 0.32% at 6 months, 25.90 ± 0.31% at 12 months and 20.50 ± 0.40% at 18 months (P<0.001).
CONCLUSIONS: Varicocelectomy was associated with significant improvement of sperm parameters and DNA fragmentation resulting in significant improvement of spermatogenesis quality. We believe that universalization in the routinely used sperm dispersion chromatin (SDC) test could be beneficial in the treatment of infertility.
摘要：
背景：盘状神经丛中睾丸静脉的扩张和扭转导致精索静脉曲张，这是男性不育的手术可修复的原因。这项研究评估了精索静脉曲张切除术对精液特征的影响，重度少弱精子症（OAT）患者的活动精子总数（TMSC）和精子DNA完整性。
方法：在这项前瞻性研究中，研究了根据世界卫生组织(WHO)2021年标准(术前以及术后6,12和18个月)接受精索静脉曲张切除术的360例重度OAT男性患者的精液样本.
结果：我们患者的平均年龄为38.5岁。术前平均精子浓度为1.60±0.83百万/ml，术后6个月的平均浓度为5.17±123万/ml，12个月时8.32±0.98百万/ml，18个月时为13.51±1.48百万/ml(P<0.0001)。术前A+B活动精子的平均百分比为2.92±1.17%，6个月时6.10±1.51%，术后12个月为9.58±1.49%,18个月为13.92±1.88%(P<0.0001)。术前平均改良大卫形态学评分为3.80±1.43%，6个月时5.95±1.23%，12个月时为7.94±1.18%，术后18个月为10.82±1.91%(P<0.0001)。精索静脉曲张切除术后，活动精子总数（TMSC）的平均值有统计学提高（P<0.001）。术前精子DNA片段化指数(DFI)平均值为31.40±0.52%,术后6个月为28.20±0.32%，12个月时25.90±0.31%,18个月时20.50±0.40%(P<0.001)。
结论：精索卵巢切除术与精子参数和DNA断裂的显著改善相关，从而显著改善精子发生质量。我们认为，在常规使用的精子分散染色质（SDC）测试中的普遍化可能对不孕症的治疗有益。
方法：在这项前瞻性研究中，研究了根据世界卫生组织(WHO)2021年标准(术前以及术后6,12和18个月)接受精索静脉曲张切除术的360例重度OAT男性患者的精液样本.
结果：我们患者的平均年龄为38.5岁。术前平均精子浓度为1.60±0.83百万/ml，术后6个月的平均浓度为5.17±123万/ml，12个月时8.32±0.98百万/ml，18个月时为13.51±1.48百万/ml(P<0.0001)。术前A+B活动精子的平均百分比为2.92±1.17%，6个月时6.10±1.51%，术后12个月为9.58±1.49%,18个月为13.92±1.88%(P<0.0001)。术前平均改良大卫形态学评分为3.80±1.43%，6个月时5.95±1.23%，12个月时为7.94±1.18%，术后18个月为10.82±1.91%(P<0.0001)。精索静脉曲张切除术后，活动精子总数（TMSC）的平均值有统计学提高（P<0.001）。术前精子DNA片段化指数(DFI)平均值为31.40±0.52%,术后6个月为28.20±0.32%，12个月时25.90±0.31%,18个月时20.50±0.40%(P<0.001)。
结论：精索卵巢切除术与精子参数和DNA断裂的显著改善相关，从而显著改善精子发生质量。我们认为，在常规使用的精子分散染色质（SDC）测试中的普遍化可能对不孕症的治疗有益。
