Department of Growth and Reproduction, International Research and Research Training Center in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Growth and Reproduction, International Research and Research Training Center in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Fertil Steril. 2017 Jan;107(1):74-82.e7. doi: 10.1016/j.fertnstert.2016.09.015. Epub 2016 Oct 25.
To study the pathologic findings among men evaluated for infertility.
A retrospective, single-center, cross-sectional study.
University hospital-based research center.
PARTICIPANT(S): We included data from 1,213 medical records from infertile men referred for diagnostic work-up from 2005 to 2009.
INTERVENTIONS(S): None.
MAIN OUTCOME MEASURE(S): Health history, clinical findings, chromosome/genetic aberrations, semen quality, reproductive hormones.
RESULT(S): In total, 64.4% of the infertile men had one or more reproductive disorders or factors influencing fertility, leaving 35.6% diagnosed as idiopathic infertile. In 244 patients (20%), including seven cases of testicular cancer and/or germ cell neoplasia in situ, a pathologic finding was first detected during diagnostic work-up. Two hundred four patients (16.8%) had a history of cryptorchidism and 154 (12.7%) of varicocele (grade 2 and 3). Thirty-three patients had chromosomal abnormalities, including 16 with sex chromosome abnormalities (11 with 47,XXY). Y-chromosome microdeletions were detected in 65 patients (5.4%). One hundred thirty-three had azoospermia, of which 58 had testicular biopsy findings (Sertoli cell-only syndrome: n = 23; spermatogenic arrest: n = 7; impaired spermatogenesis and atrophy: n = 28). Additionally, in idiopathic infertile men and infertile men with additional symptoms of testicular dysgenesis syndrome, 22.5% presented with a degree of Leydig cell insufficiency, with the highest frequency (33.1%) among patients with sperm concentration <5 million/mL.
CONCLUSION(S): We report pathologic findings that could explain the male-factor infertility in two-thirds of infertile men referred to our center. Thus, male infertility may be a sign of an underlying disease that warrants attention.
研究评估男性不育症的病理发现。
回顾性、单中心、横断面研究。
大学医院研究中心。
我们纳入了 2005 年至 2009 年期间因诊断性检查而转诊的 1213 例男性不育症患者的病历数据。
无。
健康史、临床发现、染色体/遗传异常、精液质量、生殖激素。
共有 64.4%的不育男性存在一种或多种生殖障碍或影响生育的因素，35.6%被诊断为特发性不育。在 244 例患者（20%）中，包括 7 例睾丸癌和/或生殖细胞原位癌，在诊断性检查中首次发现病理发现。204 例患者（16.8%）有隐睾史，154 例（12.7%）有精索静脉曲张（2 级和 3 级）。33 例患者存在染色体异常，包括 16 例性染色体异常（11 例 47，XXY）。Y 染色体微缺失在 65 例患者中检测到（5.4%）。133 例患者无精子症，其中 58 例有睾丸活检结果（唯支持细胞综合征：n=23；生精阻滞：n=7；生精障碍和萎缩：n=28）。此外，在特发性不育症男性和伴有睾丸发育不良综合征其他症状的不育症男性中，22.5%存在莱迪希细胞功能不足程度，其中精子浓度<500 万/ml 的患者频率最高（33.1%）。
我们报告了可以解释三分之二转诊至我们中心的男性不育症患者的病理发现。因此，男性不育症可能是潜在疾病的一个表现，需要引起重视。
