Basic diagnostics in andrology
Basic diagnostics in andrology
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DOI：
10.1111/ddg.12177
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发表时间：
2013-09-01
影响因子：
3.6
通讯作者：
Paasch, Uwe
中科院分区：
文献类型：
--
作者：
Grunewald, Sonja;Paasch, Uwe
基本的男科诊断包括记录患者的病史和夫妇的病史，以及进行体检，包括生殖器超声波、精子检查和激素分析。如果需要，还可以进行睾丸活检和基因测试。最近的研究表明，生活方式因素对男性生育力的影响。因此，病史和临床/男科检查已扩大到包括肥胖和糖尿病等代谢性疾病的信息。最大的变化发生在2010年出版的世界卫生组织实验室手册第五版以及德国医学会指南(RiliBAK)中关于精液分析的部分。几乎所有精子图参数的参考值都采用了基于证据的方法，使用了世界范围内的前瞻性人群研究。对于精子活力和形态等中央参数，评估标准发生了变化。新的独立标记物，如精子DNA碎片率，现在被常规用于临床诊断。对于德国的男科实验室，现在有强制性的精液分析质量保证措施(在德国的“RILI-BAK”指南中)。这些措施包括对所有标准精液参数进行重复测试，并定期进行实验室间比较。
Basic andrological diagnosis consists of taking the patient's medical history and the couple's history as well as performing a physical examination including genital ultrasound, spermiogram, and hormonal analysis. If needed, a testicular biopsy and genetic testing may also be performed. Recent studies have shown the effect of lifestyle factors on male fertility. Thus, the patient history and clinical/andrological examinations have been broadened to include information on metabolic disorders like obesity and diabetes mellitus.The biggest changes occurred with the publication of the fifth edition of the WHO laboratory manual in 2010 and the introduction of a section on semen analysis in the German Medical Association guidelines (RiliBAK). The reference values for almost all spermiogram parameters were adapted in an evidence-based approach using worldwide prospective population studies. For central parameters such as sperm motility and morphology, the assessment criteria were changed. New independent markers such as sperm DNA fragmentation rate are now routinely used in clinical diagnosis. For German andrological laboratories, there are now mandatory quality assurance measures for semen analysis (in the German "Rili-BAK" guidelines). These include duplicate testing of all standard semen parameters and inter-laboratory comparison at regular intervals.