Chiles Kelly A, Schlegel Peter N
Department of Urology, Weill Cornell Medical College, New York, USA.
Asian J Androl. 2016 Mar-Apr;18(2):259-61. doi: 10.4103/1008-682X.172644.
The advent of innovative techniques for addressing infertility has made for exciting times in the arena of andrology. The success of microTESE for retrieving sperm has enabled azoospermic men to have the opportunity to father biological children when it was previously impossible. The ability to offer a variety of assisted reproductive techniques that includes intracytoplasmic sperm injection has opened the door for couples with male factor infertility who were otherwise untreatable. With the multitude of options available to infertile couples, however, comes an unsurprising degree of controversy regarding what treatments should be offered and when. Complicating the picture is the question of if and when varicocele repair should be undertaken, and the financial implications of the treatment decisions that are made. The infertile couple with varicocele warrants careful consideration. The overall efficacy of varicocele repair as well as cost-effectiveness of repair compared to immediate microTESE in azoospermic men and assisted reproductive technology in men with suboptimal semen parameters will be reviewed.
用于解决不孕症的创新技术的出现，使得男科学领域迎来了激动人心的时代。显微睾丸精子提取术（microTESE）在获取精子方面的成功，让无精子症男性有机会生育亲生子女，而这在以前是不可能的。能够提供包括胞浆内单精子注射在内的多种辅助生殖技术，为原本无法治疗的男性因素不孕症夫妇打开了大门。然而，对于不孕夫妇有众多选择的情况，在应该提供何种治疗以及何时提供治疗方面出现了程度不出人意料的争议。精索静脉曲张修复手术是否应该进行以及何时进行的问题，以及所做治疗决策的财务影响，使情况变得更加复杂。患有精索静脉曲张的不孕夫妇值得仔细考虑。本文将综述精索静脉曲张修复术的总体疗效，以及与无精子症男性立即进行显微睾丸精子提取术和精液参数欠佳男性采用辅助生殖技术相比，修复术的成本效益。
