Rodriguez-Rigau L J, Smith K D, Steinberger E
J Urol. 1978 Dec;120(6):691-4. doi: 10.1016/s0022-5347(17)57332-2.
Both partners of 455 infertile couples seen consecutively were evaluated. When indicated the female partners were treated. Six semen specimens from each male subject were analyzed. A varicocele was diagnosed in 23.7 per cent of the men. More than 60 per cent of the men with a varicocele had sperm counts less than 40 million per ml., while 67 per cent without a varicocele had sperm counts more than 40 million per ml. The mean and total sperm counts of men with a varicocele were significantly lower than those without a varicocele. However, the pregnancy rates were not significantly different. The pregnancy rate was 46 per cent in couples whose male partners underwent a varicocelectomy, not significantly different from the pregnancy rate achieved in couples when the varicoceles were not corrected surgically (51 per cent). Varicocelectomy resulted in improvement in sperm count only when preoperative counts were more than 10 million per ml. Pregnancy rates for couples in which a varicocelectomy did or did not result in improvement in sperm count or motility were identical (45.1 and 45.5 per cent, respectively). These findings suggest that in male partners of infertile couples the presence of a varicocele is associated with compromised semen quality but not with diminished fertility when the female partners are treated. This observation emphasizes the importance of considering infertility as a problem of a couple, rather than a specific disorder of one of the partners.
对连续就诊的455对不育夫妇的双方都进行了评估。如有需要，对女性伴侣进行治疗。对每位男性受试者的六份精液标本进行了分析。在23.7%的男性中诊断出患有精索静脉曲张。精索静脉曲张患者中超过60%的人精子计数低于每毫升4000万，而无精索静脉曲张的男性中67%的人精子计数超过每毫升4000万。精索静脉曲张男性的平均精子计数和总精子计数显著低于无精索静脉曲张者。然而，妊娠率没有显著差异。男性伴侣接受精索静脉曲张切除术的夫妇的妊娠率为46%，与未进行手术矫正精索静脉曲张的夫妇的妊娠率（51%）没有显著差异。仅当术前精子计数超过每毫升1000万时，精索静脉曲张切除术才会使精子计数有所改善。精索静脉曲张切除术导致或未导致精子计数或活力改善的夫妇的妊娠率相同（分别为45.1%和45.5%）。这些发现表明，在不育夫妇的男性伴侣中，精索静脉曲张的存在与精液质量受损有关，但在对女性伴侣进行治疗时与生育能力下降无关。这一观察结果强调了将不育视为夫妇双方的问题，而不是一方的特定疾病的重要性。
