显微精索静脉结扎术对不育男性患者精子 DNA 碎片和精子参数的影响：基于最新证据的系统评价和荟萃分析。
Microsurgical varicocelectomy effects on sperm DNA fragmentation and sperm parameters in infertile male patients: A systematic review and meta-analysis of more recent evidence.
机构信息
Department of Urology, Hasan Sadikin Academic Medical Center, Faculty of Medicine, Universitas Padjadjaran Bandung.
出版信息
Arch Ital Urol Androl. 2022 Sep 27;94(3):360-365. doi: 10.4081/aiua.2022.3.360.
BACKGROUND
Varicocele is known to have impacts in infertility cases and sperm quality. This review aimed to evaluate the effects of microsurgical varicocelectomy on sperm DNA fragmentation index (DFI) and sperm parameters.
METHODS
Open full English text articles from January 2017 to October 2021 were searched from online database including PubMed, EMBASE, Scopus, Cochrane Library and Google Scholar.
RESULTS
Systematic search resulted in 277 potential papers. After throughout paper analysis, 5 studies were included in this review. From all five analyzed studies, microsurgical varicocelectomy was statistically proven to reduce DNA fragmentation index by 5.46% (mean difference -5.46; 95% CI: -4.79, -6.13; p < 0.00001). Moreover, the procedure also significantly improved other sperm parameters (sperm concentration +8.23%, sperm motility +7.17%, sperm progressive motility +2.77%, sperm morphology +0.64%).
CONCLUSION
Microsurgical varicocelectomy significantly improves spermatogenesis as reflected by biomarkers of infertile men including semen parameters and sperm DNA fragmentation (SDF).
背景
精索静脉曲张已知会对不孕病例和精子质量产生影响。本综述旨在评估显微镜精索静脉结扎术对精子 DNA 碎片指数（DFI）和精子参数的影响。
方法
从 2017 年 1 月至 2021 年 10 月，我们从在线数据库（包括 PubMed、EMBASE、Scopus、Cochrane 图书馆和 Google Scholar）中搜索了开放全文的英文文章。
结果
系统搜索产生了 277 篇潜在论文。经过全面的论文分析，有 5 项研究纳入了本综述。在所有分析的五项研究中，显微镜精索静脉结扎术在统计学上被证明可以将 DNA 碎片指数降低 5.46%（平均差异-5.46；95%CI：-4.79，-6.13；p<0.00001）。此外，该手术还显著改善了其他精子参数（精子浓度+8.23%，精子活力+7.17%，精子前向运动能力+2.77%，精子形态+0.64%）。
结论
显微镜精索静脉结扎术显著改善了精液参数和精子 DNA 碎片（SDF）等不育男性的生物标志物反映的生精作用。
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