欧洲男科学会（EAA）对健康、可育男性的超声研究：临床、精液及生化特征
The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: clinical, seminal and biochemical characteristics.
作者信息
Lotti Francesco, Frizza Francesca, Balercia Giancarlo, Barbonetti Arcangelo, Behre Hermann M, Calogero Aldo E, Cremers Jann-Frederik, Francavilla Felice, Isidori Andrea M, Kliesch Sabine, La Vignera Sandro, Lenzi Andrea, Marcou Marios, Pilatz Adrian, Poolamets Olev, Punab Margus, Peraza Godoy Maria Fernanda, Rajmil Osvaldo, Salvio Gianmaria, Shaeer Osama, Weidner Wolfgang, Maseroli Elisa, Cipriani Sarah, Baldi Elisabetta, Degl'Innocenti Selene, Danza Giovanna, Caldini Anna Lucia, Terreni Alessandro, Boni Luca, Krausz Csilla, Maggi Mario
机构信息
Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
Endocrinology Unit, Ospedali Riuniti Ancona, Polytechnic University of Marche, Ancona, Italy.
出版信息
Andrology. 2020 Sep;8(5):1005-1020. doi: 10.1111/andr.12808. Epub 2020 Jun 1.
BACKGROUND
Infertility affects 7%-12% of men, and its etiology is unknown in half of cases. To fill this gap, use of the male genital tract color-Doppler ultrasound (MGT-CDUS) has progressively expanded. However, MGT-CDUS still suffers from lack of standardization. Hence, the European Academy of Andrology (EAA) has promoted a multicenter study ("EAA ultrasound study") to assess MGT-CDUS characteristics of healthy, fertile men to obtain normative parameters.
OBJECTIVES
To report (a) the development and methodology of the "EAA ultrasound study," (b) the clinical characteristics of the cohort of healthy, fertile men, and (c) the correlations of both fertility history and seminal features with clinical parameters.
METHODS
A cohort of 248 healthy, fertile men (35.3 ± 5.9 years) was studied. All subjects were asked to undergo, within the same day, clinical, biochemical, and seminal evaluation and MGT-CDUS before and after ejaculation.
RESULTS
The clinical, seminal, and biochemical characteristics of the cohort have been reported here. The seminal characteristics were consistent with those reported by the WHO (2010) for the 50th and 5th centiles for fertile men. Normozoospermia was observed in 79.6% of men, while normal sperm vitality was present in almost the entire sample. Time to pregnancy (TTP) was 3.0[1.0-6.0] months. TTP was negatively correlated with sperm vitality (Adj.r =-.310, P = .011), but not with other seminal, clinical, or biochemical parameters. Sperm vitality and normal morphology were positively associated with fT3 and fT4 levels, respectively (Adj.r = .244, P < .05 and Adj.r = .232, P = .002). Sperm concentration and total count were negatively associated with FSH levels and positively, along with progressive motility, with mean testis volume (TV). Mean TV was 20.4 ± 4.0 mL, and the lower reference values for right and left testes were 15.0 and 14.0 mL. Mean TV was negatively associated with gonadotropin levels and pulse pressure. Varicocoele was found in 33% of men.
CONCLUSIONS
The cohort studied confirms the WHO data for all semen parameters and represents a reference with which to assess MGT-CDUS normative parameters.
背景
不育影响7% - 12%的男性，其中半数病例病因不明。为填补这一空白，男性生殖道彩色多普勒超声（MGT - CDUS）的应用逐渐增多。然而，MGT - CDUS仍缺乏标准化。因此，欧洲男科学会（EAA）开展了一项多中心研究（“EAA超声研究”），以评估健康、有生育能力男性的MGT - CDUS特征，从而获得规范参数。
目的
报告（a）“EAA超声研究”的开展情况和方法，（b）健康、有生育能力男性队列的临床特征，以及（c）生育史和精液特征与临床参数的相关性。
方法
对248名健康、有生育能力的男性（35.3 ± 5.9岁）进行了研究。所有受试者均被要求在同一天内接受临床、生化和精液评估，以及射精前后的MGT - CDUS检查。
结果
本文报告了该队列的临床、精液和生化特征。精液特征与世界卫生组织（2010年）报告的有生育能力男性第50和第5百分位数的特征一致。79.6%的男性精液正常，几乎整个样本的精子活力均正常。受孕时间（TTP）为3.0[1.0 - 6.0]个月。TTP与精子活力呈负相关（调整后r = - 0.310，P = 0.011），但与其他精液、临床或生化参数无关。精子活力和正常形态分别与游离三碘甲状腺原氨酸（fT3）和游离甲状腺素（fT4）水平呈正相关（调整后r = 0.244，P < 0.05和调整后r = 0.232，P = 0.002）。精子浓度和总数与促卵泡激素（FSH）水平呈负相关，与平均睾丸体积（TV）呈正相关，同时与前向运动能力也呈正相关。平均TV为20.4 ± 4.0 mL，右侧和左侧睾丸的下限参考值分别为15.0 mL和14.0 mL。平均TV与促性腺激素水平和脉压呈负相关。33%的男性发现有精索静脉曲张。
结论
所研究的队列证实了世界卫生组织关于所有精液参数的数据，并代表了评估MGT - CDUS规范参数的一个参考标准。
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