Departments of Urology and Obstetrics and Gynecology Andrology Lab, Fertility Center, CHA Gangnam Medical Center, CHA University, Seoul, Korea.
Int J Urol. 2010 Nov;17(11):937-43. doi: 10.1111/j.1442-2042.2010.02628.x. Epub 2010 Sep 10.
To investigate the natural courses of mild, moderate and severe idiopathic oligozoospermia, and which factors or semen variables were of utmost importance in predicting the courses.
A total of 208 men (age 29-47years) who were diagnosed with mild, moderate and severe idiopathic oligozoospermia in a 9-year-period between January 2000 and December 2008 were followed up for more than 6months.
Overall, 16 (24.6%) of 65 patients with severe oligozoospermia developed azoospermia, whereas two (3.1%) patients with moderate oligozoospermia developed azoospermia and none of the patients with mild oligozoospermia developed azoospermia. Initial follicle stimulating hormone level and testicular volume between the subgroups were significantly different (P=0.0071 and 0.0039, respectively). The subgroup of patients who became azoospermic (n=18) showed statistically significant differences in terms of body mass index and the level of prolactin (PRL) from the subgroup that maintained the initial lingering sperm count (n=190; P=0.0086 and 0.0154, respectively). As the vitality of semen variables increased 1%, the risk of progression to azoospermia diminished by 0.892-fold, according to Cox's proportional hazards model analysis. A receiver operating characteristic curve analysis showed that the area under the curve was 0.755 and the sperm concentration value with the highest sensitivity and specificity was the reference value of 3-5 million/mL, with a sensitivity of 0.746 and specificity of 0.711 (P=0.01).
Patients with severe oligozoospermia should be warned of the possibility of becoming azoospermic and hence sperm freezing should be encouraged as early as possible.
研究轻度、中度和重度特发性少精子症的自然病程，以及哪些因素或精液变量对预测病程最为重要。
在 2000 年 1 月至 2008 年 12 月的 9 年期间，共对 208 名被诊断为轻度、中度和重度特发性少精子症的男性（年龄 29-47 岁）进行了随访，随访时间超过 6 个月。
总体而言，65 名严重少精子症患者中有 16 名（24.6%）发展为无精子症，而 2 名（3.1%）中度少精子症患者发展为无精子症，轻度少精子症患者无一例发展为无精子症。初始卵泡刺激素水平和睾丸体积在亚组之间差异显著（P=0.0071 和 0.0039）。发生无精子症的亚组（n=18）在体重指数和催乳素（PRL）水平方面与维持初始精子计数的亚组（n=190）存在显著差异（P=0.0086 和 0.0154）。根据 Cox 比例风险模型分析，当精液变量的活力增加 1%时，进展为无精子症的风险降低 0.892 倍。受试者工作特征曲线分析显示，曲线下面积为 0.755，具有最高敏感性和特异性的精子浓度值为 3-500 万/ml 的参考值，其敏感性为 0.746，特异性为 0.711（P=0.01）。
应警告严重少精子症患者可能发生无精子症，并尽早鼓励精子冷冻。
