Wang Yingjun, Zhang Weili, Li Dawen
Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2012 Dec;37(12):1228-32. doi: 10.3969/j.issn.1672-7347.2012.12.008.
To assess how high ligation of varicocele improves sperm DNA integrity in patients with asthenospermia.
The DNA fragmentation index (DFI) and semen analysis were conducted in 30 subjects with normal sperm samples, and the parameters were used as references. Fifty-six patients from the Department of Urology of the Second Affiliated Hospital of Chongqing Medical University from April 2009 to April 2011 all signed the informed consent. Semen was collected 1 week before the high ligation of varicocele and 3 months after the surgery. We compared the change of the integrity of sperm DNA and semen.
Three months after the high ligation of varicocele, DFI and semen indexes significantly improved (P<0.05), but no significant difference was found between open surgery and laparoscopic surgery, unilateral varicocele and bilateral varicocele and Grade I, Grade II, Grade III varicocele (P>0.05). Six months later, 27 spouses were pregnant out of the 53 surgical patients (50.9%). DFI of the pregnancy group and the non-pregnancy group was (13.90±9.70)% and (20.10±10.27)%, with significant different (P<0.05).
Varicocelectomy can improve the sperm DNA integrity in patients with asthenospermia, whose effect is not related to surgical approach, unilateral or bilateral varicocele or varicocele grade.
评估精索静脉曲张高位结扎术如何改善弱精子症患者的精子DNA完整性。
对30例精子样本正常的受试者进行DNA碎片化指数(DFI)和精液分析,并将这些参数用作对照。2009年4月至2011年4月重庆医科大学附属第二医院泌尿外科的56例患者均签署了知情同意书。在精索静脉曲张高位结扎术前1周和术后3个月收集精液。我们比较了精子DNA完整性和精液的变化。
精索静脉曲张高位结扎术后3个月,DFI和精液指标显著改善(P<0.05),但开放手术与腹腔镜手术、单侧精索静脉曲张与双侧精索静脉曲张以及I级、II级、III级精索静脉曲张之间无显著差异(P>0.05)。6个月后,53例手术患者中有27例配偶怀孕(50.9%)。怀孕组和未怀孕组的DFI分别为(13.90±9.70)%和(20.10±10.27)%,差异有统计学意义(P<0.05)。
精索静脉曲张切除术可改善弱精子症患者的精子DNA完整性,其效果与手术方式、单侧或双侧精索静脉曲张或精索静脉曲张分级无关。