Aboseif Ahmed Fathy, Nabil Nashaat, GamalEl Din Sameh Fayek, Abdelkareem Shaimaa, Onsi Aya Ahmed, Zaghloul Ahmad, Elseginy Amgad
Andrology & STDs Department, Beni Suef Faculty of Medicine, Beni Suef University.
Andrology & STDs Department, Kasr Alainy Faculty of Medicine, Cairo University.
Arch Ital Urol Androl. 2025 Mar 28;97(1):12832. doi: 10.4081/aiua.2025.12832. Epub 2025 Jan 23.
Varicocele (Vx) which is the most treatable cause of male infertility, is also associated with low sperm count, decreased sperm motility and increased sperm abnormal morphology. We aimed in the current study to evaluate the correlation between seminal α-Glycerylphosphorylcholine (αGPC) and semen parameters in infertile patients pre- and post- sub-inguinal micro-varicocelectomy.
The current comparative prospective study was carried out on 20 male patients who presented to Kasr Al-Ainy Hospitals from March 2022 to March 2023 as well as 20 healthy controls. The participants were divided into groups as follows: group (1) included fertile normozoospermic men (n = 20) who served as controls. Group (2) included infertile oligoasthenoteratozoospermia (OAT) men with varicocele (n = 20). Patients in group (2) were followed up to 3 months after microsurgical sub-inguinal Varicocelectomy. The examination included an assessment of Vx with scrotal Duplex. Semen analysis was done according to the 5th Edition of WHO manual for semen analysis.
The study demonstrates that αGPC level was significantly higher among fertile normozoospermic control group and infertile OAT men post varicocelectomy when compared to infertile OAT men preoperative (p<0.001). Moreover, it demonstrates that on follow up of infertile OAT group 3 months after sub-inguinal micro-varicocelectomy, all semen parameters showed significant improvement compared to the corresponding semen parameters pre-operatively among Vxs grade II and grade III (p<0.001, p<0.001, respectively). A significant positive correlation was found between αGPC level and semen parameters including sperm normal forms, sperm count and sperm motility. Using ROC curve, αGPC protein showed a sensitivity of (100%) and a specificity of (100%) at cut off value (≤ 1.975 pg/ml) in differentiation between infertile OAT patients with Vx and control fertile normozoospermic men (p<0.001).
αGPC may play an important role in infertility in men with Vx and correction of Vx improves the seminal αGPC level.
精索静脉曲张（Vx）是男性不育最可治疗的原因，也与精子数量减少、精子活力下降和精子形态异常增加有关。我们在本研究中的目的是评估不育患者在腹股沟下显微精索静脉结扎术前和术后精液中α-甘油磷酸胆碱（αGPC）与精液参数之间的相关性。
本比较性前瞻性研究对2022年3月至2023年3月到开罗艾因医院就诊的20名男性患者以及20名健康对照者进行。参与者分为以下几组：第（1）组包括生育力正常的正常精子症男性（n = 20）作为对照。第（2）组包括患有精索静脉曲张的不育少弱畸精子症（OAT）男性（n = 20）。第（2）组患者在进行显微腹股沟下精索静脉结扎术后随访3个月。检查包括用阴囊双功超声评估精索静脉曲张。精液分析按照世界卫生组织精液分析手册第5版进行。
研究表明，与术前不育的OAT男性相比，生育力正常的正常精子症对照组和精索静脉结扎术后不育的OAT男性的αGPC水平显著更高（p<0.001）。此外，研究表明，在腹股沟下显微精索静脉结扎术后3个月对不育的OAT组进行随访时，与精索静脉曲张II级和III级患者术前相应的精液参数相比，所有精液参数均有显著改善（分别为p<0.001，p<0.001）。在αGPC水平与精液参数（包括精子正常形态、精子数量和精子活力）之间发现显著正相关。使用受试者工作特征曲线（ROC曲线），在区分患有精索静脉曲张的不育OAT患者和生育力正常的正常精子症对照男性时，αGPC蛋白在临界值（≤1.975 pg/ml）时显示出100%的敏感性和100%的特异性（p<0.001）。
αGPC可能在患有精索静脉曲张的男性不育中起重要作用，精索静脉曲张的矫正可提高精液αGPC水平。
