精索静脉曲张术前血清促卵泡生成素水平与术后精液参数改善的关系

Correlation between pre-surgical serum follicle-stimulating hormone levels and post-surgical improvement in seminal parameters in surgery for varicocele

目的探讨精索静脉曲张(VC)术前血清促卵泡生成素(FSH)水平与术后精液参数改善的关系。方法选择行左侧精索内静脉高位结扎术治疗VC的82例不育患者,根据术前FSH水平分为FSH正常组(0.8 U/mL≤FSH≤5.1 U/mL,n=32)和FSH升高组(FSH>5.1 U/mL,n=50),比较两组术前和术后6个月精液参数(精子密度、精子活动率和精子活力)的变化。结果FSH正常组术后精子密度、精子活动率和精子活力均较术前显著提高(P=0.000 2、0.010 7和0.017 2);FSH升高组仅术后精子密度较术前显著提高(P=0.047 3)。FSH正常组术后精子密度提高程度与FSH升高组差异无统计学意义[(5.767±7.835)×106/mLvs(2.271±7.890)×106/mL,P=0.053 1];FSH正常组术后精子活动率和精子活力提高程度显著大于FSH升高组[(6.228±12.969)%vs(-0.797±10.616)%,P=0.009 0;(4.754±10.684)%vs(0.168±9.720)%,P=0.048 3]。结论VC术前FSH水平对术后精液参数的改善有一定预测价值。血清FSH水平未升高的VC患者应尽早行手术治疗。

Objective To investigate the correlation between pre-surgical serum follicle-stimulating hormone （FSH） levels and post-surgical improvement in seminal parameters in surgery for varicocele. Methods Eighty-two infertile patients with left varicocele who were subjected to surgical treatment were enrolled. Among them, 50 had elevated serum FSH levels （elevated FSH group, FSH 〉5.1 U/mL） and 32 had normal serum FSH levels （normal FSH group, 0.8 U/mL≤ FSH≤ 5.1 U/mL）. The seminal parameters such as sperm concentration, sperm motility and sperm vitality were compared pre- and post-surgery between these two groups. Results The sperm concentration, sperm motility and sperm vitality were significantly increased post-surgery than pre-surgery in norml FSH group （P =0. 000 2, 0. 010 7 and 0. 017 2, respectively）. While in elevated FSH group, only sperm concentration was significantly increased post-surgery than pre-surgery （ P = 0. 047 3 ）. There was no significant difference in the degree of sperm concentration increase between normal FSH group and elevated FSH group[ （5. 767 ±7.835） × 10^6/mL vs （2.271 ± 7. 890） × 10^6/mL, P = 0. 053 1] , while the degree of sperm motility increase and degree of sperm vitality increase were significantly higher in normal FSH group than those in elevated FSH group [（6. 228± 12. 969）% vs （ -0. 797 ± 10. 616）%,P =0. 009 0; （4. 754 ± 10. 684）% vs （0. 168 ±9. 720） % , P = 0. 048 3 ]. Conclusion Pre-surgical serum FSH levels may serve as a predictor for the improvement of seminal parameters in surgery for varicocele. Earlier surgical treatment should be performed on patients with varicocele, especially on those with normal FSH levels.