Zhang Jian-Wei, Xu Quan-Quan, Kuang You-Lin, Wang Yan, Xu Feng, Tian Yu-Dong
Department of Urology Surgery, The First Affiliated Hospital of Zhengzhou University, # 1 Jian She Dong Road, Zhengzhou, 450052, Henan, China.
Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Int Urol Nephrol. 2017 Jun;49(6):955-960. doi: 10.1007/s11255-017-1564-4. Epub 2017 Mar 15.
The purpose of this study is to determine the possible preoperative predictors of spontaneous pregnancy (SPR) for infertile males with varicocele after microsurgical subinguinal varicocelectomy (MVL) performed in two medical centers in a prospective cohort study.
A total of 120 males with varicocele that underwent MVL between June 2013 and June 2014 in two medical centers were documented. Related data, including male and female partner age, male body mass index (BMI), female BMI, preoperative semen parameters, hormone levels, testicular volume, grade and side of varicocele, were collected and analyzed. The follow-up assessment was also conducted within a 2-year period after the surgery. The outcome measure was SPR within the 2-year follow-up reported. The possible determinants of SPR were also analyzed and indentified using Cox regression analysis.
Of the 110 patients that accomplished the 2-year follow-up, 42 patients reported pregnancy outcome. Using Cox regression analysis, total motile sperm count [TMC; RR (95% CI) = 1.362 (1.120-1.560), p = 0.003] and follicle-stimulating hormone [FSH; RR (95% CI) = 0.726 (0.541-0.980), p = 0.020] levels posed significant determinants for SPR.
Our study indicated that males who underwent MVL with higher TMC and lower FSH preoperatively have higher possibility of pregnancy postoperatively.
本研究旨在通过一项前瞻性队列研究，确定在两个医疗中心接受显微腹股沟下精索静脉结扎术（MVL）的精索静脉曲张不育男性自发妊娠（SPR）的术前可能预测因素。
记录了2013年6月至2014年6月期间在两个医疗中心接受MVL的120例精索静脉曲张男性患者的相关数据，包括男性和女性伴侣的年龄、男性体重指数（BMI）、女性BMI、术前精液参数、激素水平、睾丸体积、精索静脉曲张的分级和侧别，并进行分析。术后还进行了为期2年的随访评估。观察指标为报告的2年随访期内的SPR。还使用Cox回归分析对SPR的可能决定因素进行了分析和识别。
在完成2年随访的110例患者中，42例报告了妊娠结局。通过Cox回归分析，总活动精子数[TMC；RR（95%CI）=1.362（1.120-1.560），p=0.003]和促卵泡生成素[FSH；RR（95%CI）=0.726（0.541-0.980），p=0.020]水平是SPR的重要决定因素。
我们的研究表明，术前TMC较高且FSH较低的接受MVL的男性术后妊娠可能性更高。
