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精浆中抗苗勒管激素和抑制素 B 的水平不能预测非梗阻性无精子症患者的睾丸精子提取:一项对 139 名男性的研究。

Seminal plasma levels of anti-Müllerian hormone and inhibin B are not predictive of testicular sperm retrieval in nonobstructive azoospermia: a study of 139 men.

机构信息

Laboratoire de Spermiologie, Hôpital A. Calmette, Groupe de recherche EA 4308 Spermatogenesis and Male Gamete Quality, CHRU, Lille cedex, France.

出版信息

Fertil Steril. 2010 Nov;94(6):2147-50. doi: 10.1016/j.fertnstert.2009.11.046. Epub 2010 Feb 20.

Abstract

OBJECTIVE

To evaluate the seminal levels of the Sertoli anti-Müllerian hormone (AMH) and inhibin B in the testicular sperm extraction (TESE) in nonobstructive azoospermia.

DESIGN

Prospective study.

SETTING

Reproductive biology division in a university hospital.

PATIENT(S): One hundred thirty-nine men.

INTERVENTION(S): Men were classified on the basis of positive and negative TESE.

MAIN OUTCOME MEASURE(S): Seminal levels of AMH and inhibin B, serum levels of FSH and inhibin B, testicular volume, sperm retrieval, and spermatogenesis.

RESULT(S): The mean serum FSH and inhibin B concentrations were 21.4 IU/L and 54.68 pg/mL. Spermatozoa were retrieved in 43.17% of the men. Mean seminal AMH and inhibin B concentrations were 12.06±37.30 pmol/L and 142.72±950.91 pmol/L, respectively. Seminal AMH and inhibin B levels were simultaneously undetectable in 35.97% of subjects. Seminal plasma levels of AMH and inhibin B were positively correlated, as were seminal and serum inhibin B concentrations. The successful and failed TESE groups did not differ significantly in terms of either AMH or inhibin B seminal plasma concentrations. Combining the latter parameters with the serum FSH level did not improve the predictive value for successful TESE. The presence or absence of germ cells did not have a statistically significant relationship with seminal plasma AMH and inhibin B concentrations.

CONCLUSION(S): There is no value in seminal plasma levels of AMH and inhibin B as criteria for sperm extraction in men with nonobstructive azoospermia.

摘要

目的

评估非梗阻性无精子症睾丸精子抽吸术(TESE)中 Sertoli 抗苗勒管激素(AMH)和抑制素 B 的精液水平。

设计

前瞻性研究。

地点

大学医院生殖生物学科。

患者

139 名男性。

干预措施

根据 TESE 的阳性和阴性对男性进行分类。

主要观察指标

AMH 和抑制素 B 的精液水平、血清 FSH 和抑制素 B 水平、睾丸体积、精子获取和生精情况。

结果

平均血清 FSH 和抑制素 B 浓度分别为 21.4 IU/L 和 54.68 pg/mL。43.17%的男性可获取精子。平均精液 AMH 和抑制素 B 浓度分别为 12.06±37.30 pmol/L 和 142.72±950.91 pmol/L。35.97%的受试者同时检测不到精液 AMH 和抑制素 B。精液 AMH 和抑制素 B 水平呈正相关,精液和血清抑制素 B 浓度也呈正相关。TESE 成功组和失败组在 AMH 或抑制素 B 精液浓度方面无显著差异。将这些参数与血清 FSH 水平结合起来并不能提高 TESE 成功的预测价值。有或无生殖细胞与 AMH 和抑制素 B 的精液浓度无统计学显著关系。

结论

非梗阻性无精子症患者的精液 AMH 和抑制素 B 水平对精子提取没有价值。

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