无精子症患者血清FSH、INHB、染色体核型对睾丸穿刺取精术成功率的影响
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摘要
目的分析无精子症患者血清促卵泡刺激素(FSH)、抑制素B(INHB)及染色体核型对睾丸穿刺取精术成功率的影响。方法选取本院108例行睾丸穿刺取精术的育龄期无精子症患者,其中41例血清FSH水平异常为M组,67例血清FSH水平正常为N组。比较两组INHB含量、INHB/FSH比值及外周血染色体核型的情况。结果 M组INHB含量、INHB/FSH比值均明显低于N组,差异具有统计学意义(t=3. 89、4. 24,均P <0. 05); M组性染色体异常、其他染色体异常及性染色体多态性发生率明显高于N组,差异具有统计学意义(χ~2=13. 96,P <0. 01); M组睾丸穿刺取精术成功率(21. 95%)明显低于N组(67. 16%),差异具有统计学意义(χ~2=7. 89,P <0. 01)。结论结合血清FSH、INHB及染色体核型检查可综合评估无精子症患者行睾丸穿刺取精术的成功率,对血清FSH、INHB及染色体核型异常的患者,行睾丸穿刺取精术的成功率较低。
Objective To analyze the effect of serum follicle stimulating hormone( FSH),inhibin B( INHB) and chromosomal karyotypeon the success rate of testicular needle aspiration in patients with azoospermia.Methods 108 patients with azoospermia who received testicular needle aspiration were selected in our hospital,of which 41 cases with abnormal serum FSH levels were chosen as group M and 67 caseswith normal serum level of FSH as group N. The INHB,ratio of INHB/FSH and peripheral blood karyotype were compared betweenthe two groups.Results The INHB level and ratio of INHB/FSH ingroup M were significantly lower than those in group N( t =3. 89,4. 24,all P < 0. 05). The incidences of chromosomal abnormalities,other chromosomal abnormalities and sex chromosome polymorphism in group M were significantly higher than those ingroup N( χ~2= 13. 96,P < 0. 01). The success rate of testicular needle aspiration in the group M( 21. 95%) was significantly lower than that of group N( 67. 16%)( χ~2= 7. 89,P < 0. 01). Conclusions The combination of serum FSH,INHB and chromosome karyotype examination can evaluate the success rate oftesticular needle aspiration in patients with azoospermia,and thesuccess rate of testicular needle aspiration is low in patients with the abnormal serum FSH,INHB and chromosomal karyotype.
Objective To analyze the effect of serum follicle stimulating hormone( FSH),inhibin B( INHB) and chromosomal karyotypeon the success rate of testicular needle aspiration in patients with azoospermia.Methods 108 patients with azoospermia who received testicular needle aspiration were selected in our hospital,of which 41 cases with abnormal serum FSH levels were chosen as group M and 67 caseswith normal serum level of FSH as group N. The INHB,ratio of INHB/FSH and peripheral blood karyotype were compared betweenthe two groups.Results The INHB level and ratio of INHB/FSH ingroup M were significantly lower than those in group N( t =3. 89,4. 24,all P < 0. 05). The incidences of chromosomal abnormalities,other chromosomal abnormalities and sex chromosome polymorphism in group M were significantly higher than those ingroup N( χ~2= 13. 96,P < 0. 01). The success rate of testicular needle aspiration in the group M( 21. 95%) was significantly lower than that of group N( 67. 16%)( χ~2= 7. 89,P < 0. 01). Conclusions The combination of serum FSH,INHB and chromosome karyotype examination can evaluate the success rate oftesticular needle aspiration in patients with azoospermia,and thesuccess rate of testicular needle aspiration is low in patients with the abnormal serum FSH,INHB and chromosomal karyotype.
引文
[1] Shiraishi K,Oka S,Matsuyama H. Predictivefactors for sperm recovery rfter varicocelectomy in men with nonobstructive azoospermia[J]. J Urol,2017,197(2):485-490.
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[6] Chen XF,Chen B,Liu W,et al. Microsurgical vasoepididymostomy for patients with infectious obstructive azoospermia:Cause,outcome,and associated factors[J]. Asian J Androl,2016,18(5):759-762.
[7] Majumdar SS,Sarda K,Bhattacharya I,et al. Insufficient androgen and FSH signaling may be responsible for the azoospermia of the infantile primate testes despite exposure to an adult-like hormonal milieu[J]. Hum Reprod,2012,27(8):2515-2525.
[8]丁智勇,张大虎,陈怀波,等. 80例输精管道梗阻性无精子症的临床诊断及治疗[J].中国性科学,2016,25(9):87-89.
[9]李朋,谭广兴,黄煜华,等.梗阻性无精子症显微外科重建策略分析[J].上海交通大学学报(医学版),2017,37(3):420-422.
[10] Zhang S,An Y,Li J,et al. Relation between the testicular sperm assay and sex hormone level in patients with azoospermia induced by mumps[J]. Int J Clin Exp Med,2015,8(11):21669-21673.
[11]李朋,陈慧兴,黄煜华,等.显微交叉吻合术治疗复杂性梗阻性无精子症的效果[J].中华医学杂志,2016,96(36):2868-2871.
[12] Iwatsuki S,Sasaki S,Taguchi K,et al. Effect of obesity on sperm retrieval outcome and reproductive hormone levels in Japanese azoospermic men with and without Klinefelter syndrome[J]. Andrology,2017,5(1):82-86.
[13]颜秋霞,陈润强,周秀琴,等.睾丸体积、卵泡刺激素和精浆中性α-糖苷酶在无精子症分型诊断中的应用[J].中国男科学杂志,2016,30(12):55-58.
[14] Ando M,Yamaguchi K,Chiba K,et al. Outcome of microdissection testicular sperm extraction in azoospermic patients with Klinefelter syndrome and other sex-chromosomal anomalies[J]. SystBiolReprod Med,2013,59(4):210-213.
[15] Tincani BJ,Mascagni BR,Pinto RD,et al. Klinefelter syndrome:an unusual diagnosis in pediatric patients[J]. J Pediatr(Rio J),2012,88(4):323-327.
[16] Beck-Fruchter R,Lavee M,Weiss A,et al. Rescue intracytoplasmic sperm injection:A systematic review[J]. Fertil Steril,2014,101(3):690-698.
[17] Deruyver Y,Vanderschueren D,Van Der Aa F. Outcome ofmicrodissection TESE compared with conventional TESE in non-obstructive azoospermia:A systematic review[J]. Andrology,2014,2(1):20-24.
[18] Esteves SC,Lee W,Benjamin DJ,et al. Reproductive potential ofmen with obstructive azoospermia undergoing percutaneous spermretrieval andintracytoplasmic sperm injection according to the cause of obstruction[J]. J Urol,2013,189(1):232-237.
[2] Baziz M,Hamouli-Said Z,Ratbi I,et al. Cytogeneticinvestigation in a group of ten infertile men with non-obstructive azoospermia:First algerian 46,XX syndrome[J]. Iran J Public Health,2016,45(6):739-747.
[3]李芃,宋世威.无精子症患者血清抑制素B测定的临床意义[J].中国性科学,2016,25(10):105-106.
[4] Bonarriba CR,Burgués JP,Vida1a V,et al. Predictive factors of successful sperm retrieval in azoospermia[J]. Actas Urol Esp,2013,37(5):266-272.
[5]石亮,李卫巍,周雪,等.血清抑制素B检测在无精子症患者经睾丸抽吸术结局预评估中的应用[J].中华男科学杂志,2016,22(12):1095-1098.
[6] Chen XF,Chen B,Liu W,et al. Microsurgical vasoepididymostomy for patients with infectious obstructive azoospermia:Cause,outcome,and associated factors[J]. Asian J Androl,2016,18(5):759-762.
[7] Majumdar SS,Sarda K,Bhattacharya I,et al. Insufficient androgen and FSH signaling may be responsible for the azoospermia of the infantile primate testes despite exposure to an adult-like hormonal milieu[J]. Hum Reprod,2012,27(8):2515-2525.
[8]丁智勇,张大虎,陈怀波,等. 80例输精管道梗阻性无精子症的临床诊断及治疗[J].中国性科学,2016,25(9):87-89.
[9]李朋,谭广兴,黄煜华,等.梗阻性无精子症显微外科重建策略分析[J].上海交通大学学报(医学版),2017,37(3):420-422.
[10] Zhang S,An Y,Li J,et al. Relation between the testicular sperm assay and sex hormone level in patients with azoospermia induced by mumps[J]. Int J Clin Exp Med,2015,8(11):21669-21673.
[11]李朋,陈慧兴,黄煜华,等.显微交叉吻合术治疗复杂性梗阻性无精子症的效果[J].中华医学杂志,2016,96(36):2868-2871.
[12] Iwatsuki S,Sasaki S,Taguchi K,et al. Effect of obesity on sperm retrieval outcome and reproductive hormone levels in Japanese azoospermic men with and without Klinefelter syndrome[J]. Andrology,2017,5(1):82-86.
[13]颜秋霞,陈润强,周秀琴,等.睾丸体积、卵泡刺激素和精浆中性α-糖苷酶在无精子症分型诊断中的应用[J].中国男科学杂志,2016,30(12):55-58.
[14] Ando M,Yamaguchi K,Chiba K,et al. Outcome of microdissection testicular sperm extraction in azoospermic patients with Klinefelter syndrome and other sex-chromosomal anomalies[J]. SystBiolReprod Med,2013,59(4):210-213.
[15] Tincani BJ,Mascagni BR,Pinto RD,et al. Klinefelter syndrome:an unusual diagnosis in pediatric patients[J]. J Pediatr(Rio J),2012,88(4):323-327.
[16] Beck-Fruchter R,Lavee M,Weiss A,et al. Rescue intracytoplasmic sperm injection:A systematic review[J]. Fertil Steril,2014,101(3):690-698.
[17] Deruyver Y,Vanderschueren D,Van Der Aa F. Outcome ofmicrodissection TESE compared with conventional TESE in non-obstructive azoospermia:A systematic review[J]. Andrology,2014,2(1):20-24.
[18] Esteves SC,Lee W,Benjamin DJ,et al. Reproductive potential ofmen with obstructive azoospermia undergoing percutaneous spermretrieval andintracytoplasmic sperm injection according to the cause of obstruction[J]. J Urol,2013,189(1):232-237.