Jankowska Katarzyna, Suszczewicz Natalia, Rabijewski Michał, Dudek Piotr, Zgliczyński Wojciech, Maksym Radosław B
Department of Endocrinology, Centre of Postgraduate Medical Education, ul. Cegłowska 80, 01-809 Warsaw, Poland.
Department of Mini-invasive and Endoscopic Gynecology, Military Institute of Medicine, ul. Zegrzyńska 8, 05-119 Legionowo, Poland.
Life (Basel). 2022 Mar 30;12(4):511. doi: 10.3390/life12040511.
Biochemical markers of spermatogenesis and fertility assessment are important in the practical management of infertile males and the determination of an individual’s prognosis. We performed an analysis on 100 males with a male infertility factor. The following study inclusion parameters were analyzed: seminogram, FSH, LH, testosterone, estradiol, prolactin, TSH, and inhibin B concentrations. The patients were subsequently treated by reproductive endocrinologists in accordance with AUA/ASRM and EAU guidelines. The reproductive status was evaluated over a period of 3 years. We found a strong correlation of sperm count with inhibin B (r = 0.74, p < 0.001) and FSH concentration levels (r = −0.46, p < 0.001). Among 95 patients at follow-up, pregnancies occurred for 59 of their partners (48 spontaneous, 5 after IVF−ET, and 6 after IUI). Thirty-six patients remained childless despite the therapy. Sperm count and inhibin B level were the best predictors of natural fertilization (ROC AUC: 0.86 and 0.84; cut-off: 2.7 mln/mL and 45 pg/mL). Although inhibin B and FSH can be used to evaluate spermatogenesis and fertility, the initial sperm concentration appeared to be the best predictor of success. Pregnancy was achieved in a surprisingly large proportion of patients with a very low concentration of inhibin B and a low initial sperm count. It is noteworthy that 81% of the pregnancies were achieved without medically assisted reproduction.
精子发生和生育力评估的生化标志物在不育男性的实际管理和个体预后的判定中具有重要意义。我们对100名存在男性不育因素的男性进行了分析。对以下研究纳入参数进行了分析：精液分析、卵泡刺激素（FSH）、黄体生成素（LH）、睾酮、雌二醇、催乳素、促甲状腺激素（TSH）和抑制素B浓度。随后，生殖内分泌学家按照美国泌尿外科学会（AUA）/美国生殖医学学会（ASRM）和欧洲泌尿外科学会（EAU）的指南对患者进行治疗。在3年的时间里对生殖状况进行了评估。我们发现精子计数与抑制素B（r = 0.74，p < 0.001）和FSH浓度水平（r = -0.46，p < 0.001）之间存在强相关性。在95名接受随访的患者中，其伴侣中有59人怀孕（48例自然受孕，5例体外受精-胚胎移植术后，6例子宫内人工授精术后）。尽管进行了治疗，仍有36名患者未生育。精子计数和抑制素B水平是自然受孕的最佳预测指标（受试者工作特征曲线下面积：0.86和0.84；临界值：270万/mL和45 pg/mL）。虽然抑制素B和FSH可用于评估精子发生和生育力，但初始精子浓度似乎是成功的最佳预测指标。在抑制素B浓度极低且初始精子计数低的患者中，有相当大比例的人意外怀孕。值得注意的是，81%的怀孕是在没有医学辅助生殖的情况下实现的。
