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自然妊娠成功后出现的继发性无精子症:一项前瞻性初步研究。

Secondary azoospermia after a successful natural pregnancy: a primary prospective study.

作者信息

Elahwany Amr, Alahwany Hisham, Torad Hesham, Ramzy David, Aboelkomsan Elshaimaa Ahmed Fahmy, GamalEl Din Sameh Fayek

机构信息

Department of Andrology and STDs Kasr Al-Ainy, Sexual medicine and STIs department, Faculty of Medicine, Cairo University, Al-Saray Street, El Manial, Cairo, 11956, Egypt.

Nile center for IVF, Cairo, Egypt.

出版信息

Basic Clin Androl. 2024 Aug 6;34(1):12. doi: 10.1186/s12610-024-00227-0.

Abstract

BACKGROUND

To date, there is a lack of studies conducted on males with secondary azoospermia as a potential cause of male infertility who had previously fathered children through natural conception. The current study aims to investigate the potential causes of secondary azoospermia as a presentation of male infertility as well as the prognostic factors that can impact sperm retrieval rate (SRR) while undergoing microdissection testicular sperm extraction (microTESE).

RESULTS

Thirty two patients were recruited from the andrology outpatient clinic from August 2023 till January 2024. The mean age of the patients was sixty-two years old. All patients had varicoceles. Twenty seven patients (84%) had palpable varicocele grade 2 and 3 on both sides. Further multivariate logistic regression analysis of the significant factors in the univariate regression revealed that younger age (OR 0.7, 95% C.I. 0.7-1.0, p = 0.03) and having a history of coronary artery disease (CAD) were predictable factors for negative TESE outcome (OR 123.1, 95% C.I. 3.2-4748.5, P = 0.01).

CONCLUSION

It appears that the etiopathogenesis of secondary azoospermia are multifactorial. Varicocele and CAD are major factors to be considered. Future studies should be implemented deploying larger pools of patients suffering from the same condition to affirm the findings of this primary study.

摘要

背景

迄今为止,对于曾通过自然受孕生育子女的继发性无精子症男性作为男性不育潜在病因的研究较少。本研究旨在调查继发性无精子症作为男性不育表现的潜在病因,以及在进行显微外科睾丸精子提取(microTESE)时可能影响精子获取率(SRR)的预后因素。

结果

2023年8月至2024年1月从男科门诊招募了32例患者。患者的平均年龄为62岁。所有患者均患有精索静脉曲张。27例患者(84%)双侧可触及2级和3级精索静脉曲张。对单因素回归中的显著因素进行进一步多因素逻辑回归分析发现,年龄较小(OR 0.7,95%置信区间0.7 - 1.0,p = 0.03)和有冠状动脉疾病(CAD)病史是TESE结果为阴性的可预测因素(OR 123.1,95%置信区间3.2 - 4748.5,P = 0.01)。

结论

继发性无精子症的发病机制似乎是多因素的。精索静脉曲张和CAD是需要考虑的主要因素。未来应开展研究,纳入更多患有相同病症的患者群体,以证实这项初步研究的结果。

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