Follicle-stimulating hormone may predict sperm retrieval rate and guide surgical approach in patients with non-obstructive azoospermia
Follicle-stimulating hormone may predict sperm retrieval rate and guide surgical approach in patients with non-obstructive azoospermia
复制标题
卵泡刺激激素可以预测非梗阻性无精症患者的精子取出率并指导手术方法。
DOI：
10.1016/j.repbio.2020.10.006
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发表时间：
2020-12-01
影响因子：
2.1
通讯作者：
Su, Ying-Chun
中科院分区：
文献类型：
--
作者：
Liu, Ya-Ping;Qi, Lin;Su, Ying-Chun
睾丸精子抽吸术（TESA）或显微解剖睾丸精子提取术（MD-TESE）联合卵胞浆内单精子注射（ICSI）是非梗阻性无精子症（NOA）患者获得生物学后代的唯一选择，他们在精子回收方面的成功率不同。我们的研究旨在寻找预测NOAs精子回收率（SRR）的预测因子，并指导临床医生选择不同的手术方法，TESA或MD-TESE治疗NOAs。将294例接受TESA或MD-TESE治疗的NOA患者分为TESA组和MD-TESE组。根据精子回收的不同，每组又分为两个亚组：成功亚组和失败亚组。分别为24例和131例，53例和86例。以回顾性方式分析临床数据，包括体重指数（BMI）、睾丸体积和血清激素水平。结果表明：TESA组卵泡刺激素（FSH）、黄体生成素（LH）水平及SRR均低于MD-TESE组（P < 0.05），而睾丸体积高于MD-TESE组（P < 0.05）。取精术式对SRR有显著影响（P < 0.05）。TESA各亚组间睾丸体积、FSH、LH差异有统计学意义（P < 0.05）。在MD-TESE亚组中，两组间FSH、LH水平差异有统计学意义（P < 0.05）。Logistic回归分析显示，FSH与SRR在TESA组呈负相关（β =-0.083），在MD-TESE组呈正相关（β = 0.064）（P < 0.05）。结论：血清FSH水平可预测NOAs的SRR，指导临床选择合适的手术方式。(C)2020年生殖生物学学会和波兰科学院动物生殖和食品研究所在奥尔斯廷。Elsevier B. V.出版，保留所有权利。
Testicular sperm aspiration- (TESA) or micro-dissection testicular sperm extraction- (MD-TESE) combined intracytoplasmic sperm injection (ICSI) was the only option for non-obstructive azoospermia (NOA) patients to have a biological offspring and they had different success rates in sperm retrieval. Our study aimed to find predictor(s) for predicting the sperm retrieval rate (SRR) in NOAs and guide clinicians in choosing different surgical approaches, TESA or MD-TESE for NOAs. 294 NOAs who had undergone TESA or MD-TESE were divided into TESA group and MD-TESE group. Depending on sperm retrieval, each group was divided into two subgroups: successful subgroups and failure subgroups. They respectively were 24 cases and 131 cases, 53 cases and 86 cases. Clinical data, including body mass index (BMI), testicular volume, and serum hormone levels, were analyzed in a retrospective manner. The results showed that follicle- stimulating hormone (FSH) and luteinizing hormone (LH) levels and SRR were lower in TESA group as compared to these in MD-TESE group, while testicular volume was higher (P < 0.05). The surgical approach of sperm retrieval significantly affected the SRR (P < 0.05). In TESA subgroups, testicular volume, FSH and LH differed significantly (P < 0.05). In MD-TESE subgroups, the level of FSH and LH differed significantly between both groups (P < 0.05). Using logistics regression, we found a negative correlation (beta=-0.083) between FSH and the SRR in TESA group but a positive correlation (beta = 0.064) in MD-TESE group (P < 0.05). In conclusion, serum FSH level can predict the SRR of NOAs and guide the clinicians while selecting the suitable surgery approach for NOAs. (C) 2020 Society for Biology of Reproduction & the Institute of Animal Reproduction and Food Research of Polish Academy of Sciences in Olsztyn. Published by Elsevier B.V. All rights reserved.