Yao Hangyu, Li Fuhao, Qiu Xianliang, Xu Yuanjie, Xue Pengfei, Chang Degui
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.
Medicine (Baltimore). 2020 Sep 18;99(38):e21960. doi: 10.1097/MD.0000000000021960.
Sperm DNA integrity has been considered as one of the important determinants of normal fertilization and embryonic development in natural and assisted pregnancy. It is difficult for men with high levels of sperm DNA fragmentation (SDF) in semen to conceive their partners naturally and assist in conception. The studies have found that the level of SDF in the semen of patients with varicocele (VC) was on the high side. In recent years, the effect of VC surgery on DNA fragmentation index has attracted the attention of researchers. In this study, we will evaluate the effectiveness of VC repair as a way to alleviate SDF and improve male fertility.
Electronic databases including English databases (PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library) and Chinese databases (China National Knowledge Infrastructure, China Biology Medicine Database, Wanfang Database, VIP Database) will be searched from their inception to December 2020 to recognize related studies. All the randomized controlled trials of microsurgical varicocelectomy for the management of VC patients will be included. The potential outcome will include improvement in SDF, oxidative stress markers (reactive oxygen species, nitric oxide, and lipid peroxidation products), sperm chromatin compaction, other advanced sperm function characteristics, follow-up of fertility results. We will conduct this study strictly according to the Cochrane Handbook for Systematic Reviews of Interventions.
The study is a protocol for systematic review and meta-analysis without results, and data analysis will be carried out after the protocol. We will share our findings on April 5th of 2021.
This systematic review will provide more evidence to assess whether varicocelectomy is an effective intervention for patients with SDF. The results will be published in a public issue journal and offer the urologists help to make clinical decisions.
Formal ethical approval is not required in this protocol. We will collect and analyze data based on published research. Since this research does not involve patients, personal privacy will not be affected. The results of this review will be distributed to peer-reviewed journals or submitted to relevant conferences.
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精子DNA完整性被认为是自然受孕和辅助受孕中正常受精及胚胎发育的重要决定因素之一。精液中精子DNA碎片率（SDF）较高的男性很难自然使伴侣受孕并辅助受孕。研究发现，精索静脉曲张（VC）患者精液中的SDF水平偏高。近年来，VC手术对DNA碎片指数的影响引起了研究人员的关注。在本研究中，我们将评估VC修复作为减轻SDF和提高男性生育力方法的有效性。
将检索英文数据库（PubMed、MEDLINE、EMBASE、Web of Science、Cochrane图书馆）和中文数据库（中国知网、中国生物医学数据库、万方数据库、维普数据库），检索时间从建库至2020年12月，以识别相关研究。将纳入所有关于显微外科精索静脉结扎术治疗VC患者的随机对照试验。潜在结果将包括SDF的改善、氧化应激标志物（活性氧、一氧化氮和脂质过氧化产物）、精子染色质浓缩、其他先进的精子功能特征、生育结果随访。我们将严格按照《Cochrane系统评价干预措施手册》进行本研究。
本研究是一项无结果的系统评价和荟萃分析方案，方案制定后将进行数据分析。我们将于2021年4月5日分享研究结果。
本系统评价将提供更多证据，以评估精索静脉结扎术对SDF患者是否为有效干预措施。结果将发表在公开期刊上，为泌尿外科医生提供临床决策帮助。
本方案无需正式伦理批准。我们将基于已发表的研究收集和分析数据。由于本研究不涉及患者，个人隐私不会受到影响。本综述结果将分发给同行评审期刊或提交至相关会议。
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