Clinical, genetic, biochemical, and testicular biopsy findings among 1,213 men evaluated for infertility
Clinical, genetic, biochemical, and testicular biopsy findings among 1,213 men evaluated for infertility
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DOI：
10.1016/j.fertnstert.2016.09.015
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发表时间：
2017-01-01
影响因子：
6.7
通讯作者：
Juul, Anders
中科院分区：
文献类型：
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作者：
Olesen, Inge Ahlmann;Andersson, Anna-Maria;Juul, Anders
目的：研究男性不育症的病理结果。设计：回顾性，单中心，横断面研究。设置：大学医院为基础的研究中心。参与者：我们纳入了2005年至2009年1,213例诊断性检查的不育男性病历数据。干预措施：无。主要结果测量：健康史、临床表现、染色体/遗传畸变、精液质量、生殖激素。结果：64.4%的不育男性有一种或多种生殖障碍或影响生育的因素，其中35.6%诊断为特发性不育。在244例患者（20%）中，包括7例睾丸癌和/或生殖细胞原位瘤形成，病理结果首次在诊断检查中发现。204例患者（16.8%）有隐睾病史，154例（12.7%）有精索静脉曲张（2级和3级）病史。33例患者有染色体异常，包括16例性染色体异常（11例47，XXY）。65例患者（5.4%）检测到Y染色体微缺失。133例无精子症，其中58例有睾丸活检结果（仅支持细胞综合征：n = 23;生精停滞：n = 7;生精受损和萎缩：n = 28）。此外，在特发性不育男性和伴有睾丸发育不全综合征其他症状的不育男性中，22.5%的患者存在一定程度的间质细胞功能不全，其中精子浓度最高（33.1%）
Objective: To study the pathologic findings among men evaluated for infertility.Design: A retrospective, single-center, cross-sectional study.Setting: University hospital-based research center.Participant(s): We included data from 1,213 medical records from infertile men referred for diagnostic work-up from 2005 to 2009.Interventions(s): None.Main Outcome Measure(s): Health history, clinical findings, chromosome/genetic aberrations, semen quality, reproductive hormones.Result(s): In total, 64.4% of the infertile men had one or more reproductive disorders or factors influencing fertility, leaving 35.6% diagnosed as idiopathic infertile. In 244 patients (20%), including seven cases of testicular cancer and/or germ cell neoplasia in situ, a pathologic finding was first detected during diagnostic work-up. Two hundred four patients (16.8%) had a history of cryptorchidism and 154 (12.7%) of varicocele (grade 2 and 3). Thirty-three patients had chromosomal abnormalities, including 16 with sex chromosome abnormalities (11 with 47, XXY). Y-chromosome microdeletions were detected in 65 patients (5.4%). One hundred thirty-three had azoospermia, of which 58 had testicular biopsy findings (Sertoli cell-only syndrome: n = 23; spermatogenic arrest: n = 7; impaired spermatogenesis and atrophy: n = 28). Additionally, in idiopathic infertile men and infertile men with additional symptoms of testicular dysgenesis syndrome, 22.5% presented with a degree of Leydig cell insufficiency, with the highest frequency (33.1%) among patients with sperm concentration