Department of Urology Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Andrologia. 2012 Jun;44(3):205-9. doi: 10.1111/j.1439-0272.2010.01130.x. Epub 2011 Jul 25.
The objective of research was to determine the sensitivity, specificity and positive predictive value of serum follicle stimulating hormone and testis size in predicting spermatogenesis in infertile men with azoospermia. In a prospective study, azoospermic men were studied. Serum follicle stimulating hormone measurement and scrotal sac ultrasonography were performed. Bilateral testis biopsy was performed for all of these patients. The sensitivity and specificity of follicle stimulating hormone and testis size were determined to predict the existence of different cellular steps of spermatogenesis. Of eighty infertile men who recruited into the study, 53 patients did not represent any different cellular steps of spermatogenesis, while 27 of them had various steps of such differentiation. Among the 53 patients without cellular steps of spermatogenesis in the biopsy, 41 were predicted to be azoospermic based on their serum follicle stimulating hormone levels (77.3% sensitivity), and of 27 patients with various cellular steps of spermatogenesis in the biopsy, 23 were predicted to have spermatozoa according to the follicle stimulating hormone level (85.2%) specificity. It is suggested that combination of these two indicators can substitute the invasive testis biopsy for predicting the existence of spermatozoa in infertile men with azoospermia.
本研究旨在确定血清卵泡刺激素和睾丸大小在预测无精子症不育男性生精功能中的敏感性、特异性和阳性预测值。前瞻性研究了无精子症男性。对所有患者进行血清卵泡刺激素测定和阴囊超声检查,并进行双侧睾丸活检。确定卵泡刺激素和睾丸大小的敏感性和特异性,以预测生精过程中不同细胞阶段的存在。在纳入研究的 80 名不育男性中,53 名患者没有表现出生精过程的任何不同细胞阶段,而其中 27 名患者有不同的分化阶段。在活检中没有生精细胞阶段的 53 名患者中,根据血清卵泡刺激素水平预测 41 名患者为无精子症(77.3%的敏感性),在活检中有不同生精细胞阶段的 27 名患者中,根据卵泡刺激素水平预测 23 名患者有精子(85.2%的特异性)。因此,建议将这两个指标结合起来,可以替代有创性睾丸活检,预测无精子症不育男性精子的存在。