Mohamed Essam-Elden, Gawish Mahwer, Mohamed Aly
a Department of Dermatology and Andrology , Al-Azhar University Hospital , Assiut , Egypt.
b Department of Urology , Al-Azhar University Hospital , Assiut , Egypt.
Hum Fertil (Camb). 2017 Dec;20(4):293-296. doi: 10.1080/14647273.2017.1315778. Epub 2017 Apr 19.
In a prospective study, the outcomes of microsurgical varicocelectomy in men with primary versus secondary infertility were compared. Ninety-two infertile men with a varicocele were included. They were classified into those with primary infertility (n = 57) and secondary infertility (n = 35). Clinical data, semen parameters and scrotal ultrasound finding were available for all patients and microsurgical varicocelectomy was performed on all of them. Spontaneous pregnancy rates and improvement in semen parameters in those men with primary versus secondary infertility were recorded 1 year after surgery. Preoperatively, there was no significant difference in the mean semen parameters in both groups (p > 0.05) and the mean semen parameters showed no significant difference between men with primary and secondary infertility. After microsurgical varicocelectomy, the mean semen parameters improved significantly in both group (p < 0.05 for each), but there were no significant difference in mean semen parameters between men with primary versus secondary infertility (p > 0.05 for each). After adjustment for patient and partner ages, the pregnancy rate at the end of the follow-up period did not significantly differ between the primary (24/57, 42.1%) and secondary (11/35, 31.4%) infertility group (Pearson's Chi-squared = 1.05). We concluded from this study that semen parameters and pregnancy rates after microsurgical varicocelectomy were similar between men with primary and secondary infertility.
在一项前瞻性研究中，对患有原发性与继发性不育症的男性进行显微外科精索静脉曲张切除术的结果进行了比较。纳入了92名患有精索静脉曲张的不育男性。他们被分为原发性不育组（n = 57）和继发性不育组（n = 35）。所有患者均有临床数据、精液参数和阴囊超声检查结果，并对所有患者进行了显微外科精索静脉曲张切除术。术后1年记录原发性与继发性不育男性的自然妊娠率和精液参数改善情况。术前，两组的平均精液参数无显著差异（p > 0.05），原发性和继发性不育男性的平均精液参数也无显著差异。显微外科精索静脉曲张切除术后，两组的平均精液参数均显著改善（每组p < 0.05），但原发性与继发性不育男性的平均精液参数无显著差异（每组p > 0.05）。在对患者及配偶年龄进行调整后，随访期末原发性不育组（24/57，42.1%）和继发性不育组（11/35，31.4%）的妊娠率无显著差异（Pearson卡方检验 = 1.05）。我们从这项研究得出结论，原发性和继发性不育男性在显微外科精索静脉曲张切除术后的精液参数和妊娠率相似。
