Department of Urology, Menoufiya University, 3481 Shebin El-Kom, Egypt.
Asian J Androl. 2011 Nov;13(6):867-71. doi: 10.1038/aja.2011.48. Epub 2011 Jul 25.
The aim of this study was to verify the role of antegrade scrotal sclerotherapy for the treatment of varicoceles in infertile men with severe oligo-astheno-teratozoospermia (OAT). The 59 patients with severe OAT in this study underwent antegrade scrotal sclerotherapy for the treatment of varicoceles. The outcome was assessed in terms of improvement in semen parameters and spontaneous conception rate. Semen parameters and reproductive hormones were evaluated before antegrade sclerotherapy (AS) and 6 months after AS. After an average follow-up time of 34.8±3.2 months, significant improvement was noted in the mean sperm concentration, motility and morphology in 36 patients (61%). Spontaneous pregnancy occurred in nine couples (15%). Six months after treatment, inhibin B levels were significantly higher (P<0.04), whereas follicle-stimulating hormone (FSH) levels were significantly lower (P<0.001) than before treatment. Antegrade internal spermatic vein sclerotherapy can significantly improve seminal parameters and hormonal parameters in men with severe OAT and may even result in spontaneous pregnancy in couples who would otherwise be candidates for intracytoplasmic sperm injection (ICSI).
本研究旨在验证顺行阴囊内精索静脉硬化治疗对严重少弱畸形精子症（OAT）不育男性精索静脉曲张的作用。本研究中 59 例严重 OAT 患者接受顺行阴囊内精索静脉硬化治疗精索静脉曲张。根据精液参数的改善和自然受孕率评估疗效。在顺行硬化治疗（AS）前和 AS 后 6 个月评估精液参数和生殖激素。平均随访 34.8±3.2 个月后，36 例（61%）患者的平均精子浓度、活力和形态有显著改善。9 对夫妇自然妊娠（15%）。治疗 6 个月后，抑制素 B 水平显著升高（P<0.04），而卵泡刺激素（FSH）水平显著降低（P<0.001）。顺行精索内静脉硬化治疗可显著改善严重少弱畸形精子症患者的精液参数和激素参数，甚至可使 otherwise 为 ICSI 候选者的夫妇自然受孕。
