男性因素不育的新概念：临床与实验室视角
Novel concepts in male factor infertility: clinical and laboratory perspectives.
作者信息
Esteves Sandro C
机构信息
ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Av. Dr. Heitor Penteado, 1464, Campinas, SP, 13075-460, Brazil.
出版信息
J Assist Reprod Genet. 2016 Oct;33(10):1319-1335. doi: 10.1007/s10815-016-0763-8. Epub 2016 Jul 16.
Abstract
In recent years, the management of male factor infertility has undergone important changes with the introduction of novel concepts, advanced testing, and therapeutic interventions. This review highlights some of these changes and discusses their impact to routine clinical practice. First, we discuss the recent changes in the World Health Organization (WHO) laboratory methods and reference values for the examination of human semen. Second, we examine the role of sperm chromatin integrity tests in light of increasing evidence of the detrimental effect of sperm DNA fragmentation on reproductive outcomes. Third, we summarize the main findings of varicocele-related infertility and the outcomes of microsurgical varicocele repair to different case scenarios. Lastly, we critically discuss the current management of men with nonobstructive azoospermia seeking fertility and the new opportunities that emerged to help these men achieve biological fatherhood.
摘要
近年来，随着新概念、先进检测方法和治疗干预措施的引入，男性因素不孕症的管理发生了重大变化。本综述重点介绍了其中的一些变化，并讨论了它们对常规临床实践的影响。首先，我们讨论世界卫生组织（WHO）人类精液检查实验室方法和参考值的最新变化。其次，鉴于越来越多的证据表明精子DNA碎片化对生殖结果有不利影响，我们研究精子染色质完整性检测的作用。第三，我们总结精索静脉曲张相关性不孕症的主要研究结果以及不同病例情况下显微外科精索静脉曲张修复术的结果。最后，我们批判性地讨论了寻求生育的非梗阻性无精子症男性的当前管理方法以及出现的帮助这些男性实现亲生父亲身份的新机会。
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