Vermeulen A, Vandeweghe M, Deslypere J P
J Androl. 1986 May-Jun;7(3):147-55. doi: 10.1002/j.1939-4640.1986.tb00899.x.
To evaluate whether correction of varicocele improves fertility, pregnancy rates were compared in 115 varicocele patients consulting for infertility and having oligozoospermia, asthenospermia, or teratozoospermia, in any combination, and FSH levels within the normal range. Ninety of these patients had corrected, and 25 had uncorrected varicoceles, respectively. The value of clinical and seminal parameters for predicting the eventuality of pregnancy for varicocele patients was also studied. Although both groups were comparable in terms of duration of infertility, mean age, sperm density, motility or fertility index, cumulative pregnancy rates over 12 months were similar, whether or not the varicocele was corrected. The value of clinical or seminal parameters, in any combination, for the prediction of outcome for varicocele patients was poor. The prognosis was poor for men with less than 15% of spermatozoa with normal morphology, FSH levels higher than the mean + 3 SD of those values found in young fathers, and a fertility index below 3. In subjects who achieved pregnancy within one year, pretreatment sperm characteristics were similar in both the corrected and uncorrected groups. Correction of varicocele slightly improved sperm characteristics. It seems likely that in most men with subfertility and varicocele, other factors besides venous reflux are responsible for their infertility.
为评估精索静脉曲张的矫正是否能提高生育能力，对115名因不育前来咨询且患有少精子症、弱精子症或畸形精子症（任意组合）且促卵泡生成素（FSH）水平在正常范围内的精索静脉曲张患者的妊娠率进行了比较。其中90名患者进行了精索静脉曲张矫正，25名患者未进行矫正。还研究了临床和精液参数对预测精索静脉曲张患者妊娠可能性的价值。尽管两组在不育持续时间、平均年龄、精子密度、活力或生育指数方面具有可比性，但无论精索静脉曲张是否得到矫正，12个月内的累积妊娠率相似。临床或精液参数以任何组合形式对预测精索静脉曲张患者的结局价值都不大。对于正常形态精子低于15%、FSH水平高于年轻父亲平均值+3标准差且生育指数低于3的男性，预后较差。在一年内成功妊娠的受试者中，矫正组和未矫正组的治疗前精子特征相似。精索静脉曲张的矫正略微改善了精子特征。在大多数患有亚生育力和精索静脉曲张的男性中，除静脉反流外，其他因素可能也是导致其不育的原因。
