Nieschlag E, Hertle L, Fischedick A, Abshagen K, Behre H M
Institute of Reproductive Medicine of the University, and Clemenshospital Münster, Germany.
Hum Reprod. 1998 Aug;13(8):2147-50. doi: 10.1093/humrep/13.8.2147.
This prospective randomized study was performed in order to investigate the effects of interventive treatment or counselling on pregnancy rates in infertile couples in whose male partners a varicocele was diagnosed. The present report extends a previous study using the same design. A total of 125 couples were included in the current study while the previous report comprised 95 couples. Couples fulfilling the inclusion criteria were allocated randomly either to interventive treatment (surgical ligation or angiographic embolization of the spermatic vein) (n = 62) or to counselling as the sole treatment (n = 63). Couples were followed over the subsequent 12 months and seen at 3-monthly intervals. At the end of the 12 month period pregnancy rates, as the main outcome measure, were 29% in the group given interventive treatment and 25.4% in the counselled group and were not significantly different. The only significant difference found, regardless of treatment modality, was the wives' age at admittance: the 34 wives achieving a pregnancy were 28.8 +/- 0.6 years (mean +/- SE) old while the 91 non-pregnant wives were 31.2 +/- 0.3 years old (P < 0.05). The study suggests that regular counselling of the infertile couples is as effective as interventive treatment of varicoceles in achieving pregnancies.
本前瞻性随机研究旨在调查干预治疗或咨询对男性伴侣诊断为精索静脉曲张的不育夫妇妊娠率的影响。本报告扩展了之前采用相同设计的一项研究。本研究共纳入125对夫妇，而之前的报告纳入了95对夫妇。符合纳入标准的夫妇被随机分配至干预治疗组（精索静脉手术结扎或血管造影栓塞）（n = 62）或仅接受咨询治疗组（n = 63）。在随后的12个月内对夫妇进行随访，每3个月就诊一次。在12个月期末，作为主要结局指标的妊娠率在接受干预治疗组为29%，在咨询治疗组为25.4%，两组无显著差异。无论治疗方式如何，唯一发现的显著差异是妻子入院时的年龄：34名成功妊娠的妻子年龄为28.8±0.6岁（均值±标准误），而91名未妊娠的妻子年龄为31.2±0.3岁（P < 0.05）。该研究表明，对不育夫妇进行定期咨询在实现妊娠方面与精索静脉曲张的干预治疗同样有效。
