Dadfar Mohammadreza, Ahangarpour Akram, Habiby Aliakbar, Khazaely Dinyar
Department of Urology, Imam Khomeini Hospital, School of Medicine, Jundishapoor University of Medical Sciences, Ahwaz, Iran.
Urol J. 2010 Jun 10;7(2):110-4.
Due to various reasons, spermatogenesis might not improve after varicocelectomy. Inhibin B, a sertoli cell glycoprotein, has proved itself as a marker of spermatogenesis. In this study, we measured serum level of inhibin B in patients with varicocele and through comparing pre and post operative semen analysis data, we tried to use serum level of inhibin B as a predictor of spermatogenetic improvement.
This prospective clinical trial was carried out between September 2007 and September 2008 on 36 infertile men with high grade unilateral or bilateral varicocele. Scrotal ultrasonography and measurement of seminal parameters and serum level of inhibin B were performed for the patients and after confirmation of impaired spermatogenesis, they underwent a subinguinal nonmicroscopic varicocelectomy by a single surgeon. Physical examination, scrotal ultrasonography, and semen analysis were repeated at postoperative months of 3 and 6. Statistical data analysis was done by independent and paired sample t test and Spearman's Rho test.
Mean size of the testis remained the same (P = .5), but mean sperm density, normal morphology, and motility all increased statistically significant after the operation (P < .05, P = .042, P = .023). A significant relationship was found between serum levels of inhibin B and the testis sperm count and morphology (P < .05), but not sperm motility (P > 0.05).
It seems that serum level of inhibin B can be used as a reliable pre-operative marker of testicular potential activity and can also predict chance of spermatogenesis after varicocelectomy and save patients from useless surgical procedures.
由于各种原因，精索静脉曲张手术后精子发生可能并未改善。抑制素B是一种支持细胞糖蛋白，已被证明是精子发生的标志物。在本研究中，我们测量了精索静脉曲张患者血清抑制素B水平，并通过比较术前和术后精液分析数据，试图将血清抑制素B水平作为精子发生改善的预测指标。
这项前瞻性临床试验于2007年9月至2008年9月对36例患有重度单侧或双侧精索静脉曲张的不育男性进行。对患者进行阴囊超声检查、精液参数测量以及血清抑制素B水平检测，在确认精子发生受损后，由一名外科医生为他们实施经腹股沟下非显微镜下精索静脉结扎术。在术后3个月和6个月重复进行体格检查、阴囊超声检查和精液分析。采用独立样本t检验、配对样本t检验和Spearman秩相关检验进行统计数据分析。
睾丸平均大小保持不变（P = 0.5），但术后精子平均密度、正常形态率和活力均有统计学显著增加（P < 0.05，P = 0.042，P = 0.023）。血清抑制素B水平与睾丸精子计数和形态之间存在显著相关性（P < 0.05），但与精子活力无关（P > 0.05）。
似乎血清抑制素B水平可作为睾丸潜在活性的可靠术前标志物，还可预测精索静脉曲张切除术后精子发生的可能性，使患者避免不必要的手术。
