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精索静脉曲张的治疗及其对生育能力的影响:一场大辩论

The great debate: varicocele treatment and impact on fertility.

机构信息

Department of Obstetrics and Gynecology, University of Michigan Hospitals, Ann Arbor, Michigan 48109, USA.

出版信息

Fertil Steril. 2011 Mar 1;95(3):841-52. doi: 10.1016/j.fertnstert.2011.01.002. Epub 2011 Jan 26.

DOI:10.1016/j.fertnstert.2011.01.002
PMID:21272869
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3046876/
Abstract

OBJECTIVE

To evaluate the current literature on the impact and potential mechanisms of varicocele repair on male fertility.

DESIGN

Pertinent articles were identified through computer PubMed search on varicocele repair and male factor infertility. References of selected articles were hand searched for additional citations.

CONCLUSION(S): Varicocele repair has been shown to reverse a spectrum of effects contributing to men with impaired fertility. Clinical studies on the intervention have illustrated variable effects on postoperative sperm parameters and pregnancy rates (PR). Studies with conflicting results suffer from a significant number of confounding variables such as variable repair technique or lack of controls. Additional studies are warranted on the role of modern microsurgical varicocelectomy given the improvements in assisted reproductive technologies (ART).

摘要

目的

评估精索静脉曲张修复对男性生育力影响及其潜在机制的现有文献。

设计

通过计算机 PubMed 搜索精索静脉曲张修复和男性因素不育症,确定相关文章。为获取更多引文,对入选文章的参考文献进行手工检索。

结论

精索静脉曲张修复已被证明可以逆转一系列导致生育力受损男性的影响。干预精索静脉曲张修复的临床研究表明,对术后精子参数和妊娠率(PR)有不同的影响。研究结果存在冲突的原因是存在大量混杂变量,如修复技术的差异或缺乏对照。鉴于辅助生殖技术(ART)的进步,现代显微精索静脉结扎术的作用需要进一步研究。

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本文引用的文献

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Evaluation of zeta and HA-binding methods for selection of spermatozoa with normal morphology, protamine content and DNA integrity.评估 Zeta 和 HA 结合方法对具有正常形态、组蛋白含量和 DNA 完整性的精子的选择。
Andrologia. 2010 Feb;42(1):13-9. doi: 10.1111/j.1439-0272.2009.00948.x.
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The effect of prior varicocelectomy in patients with nonobstructive azoospermia on intracytoplasmic sperm injection outcomes: a retrospective pilot study.精索静脉结扎术对非梗阻性无精子症患者卵胞浆内单精子注射结局的影响:一项回顾性初步研究。
Urology. 2010 Jan;75(1):83-6. doi: 10.1016/j.urology.2009.09.023. Epub 2009 Nov 13.
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Right subclinical varicocele: how to manage in infertile patients with clinical left varicocele?右侧亚临床精索静脉曲张:对于临床左侧精索静脉曲张的不育患者,应如何处理?
Fertil Steril. 2009 Dec;92(6):2050-3. doi: 10.1016/j.fertnstert.2009.05.069. Epub 2009 Jul 16.
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Int J Surg. 2009 Aug;7(4):356-60. doi: 10.1016/j.ijsu.2009.05.009. Epub 2009 May 29.
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