精索静脉曲张不育患者术后未育者精子穿卵率的远期观察

Observation on Sperm Penetration Rate of Infertile Men with Varicocele at 1.5 to 2 Years after Varicolectomy

目的 :对精索静脉曲张不育患者术后未育者的精子穿卵率作远期观察。方法 :1双侧经髂窝或经腹腔镜精索静脉高位结扎术 ;2人精子去透明带地鼠卵穿透试验 (SPA)。结果 :2 9例精索静脉曲张不育患者 ,术后 1 .5～ 2年随访仍未育 ,作 SPA,与术前 SPA穿卵率对比 ,精索静脉曲张 °组 (n=1 7)有 7例改善了穿卵率 ,精索静脉曲张 °组 (n=1 2 )有 2例改善了穿卵率。但两组穿卵率的升高幅度不大。结论 :精索静脉曲张不育患者术后较长时间仍未育者 ,虽部份患者的精子穿卵率已有改善 ,但穿卵率的增加程度不高。术前精索静脉曲张严重的患者 ,术后可能难以提高穿卵率。应建立 SPA对患者术后精子受精能力作评估 ,以及时调整治疗措施。

Objective:To observe the sperm penetration rate among treated but “unsuccessful” infertile men with varicocele.Material & Methods:Twenty-nine infertile males with II°(n=17) or III°(n=12) varicocele were enrolled into this study. They underwent a varicolectomy, but their spouses had not achieved a pregnancy after 1.5~2 years of treatment. The sperm zona-free hamster oocyte penetration assay (SPA) was used to compare the sperm penetration rate (PR) before treatment and 1.5~2 years after treatment. Results: After varicolectomy, enhanced PR were observed in 7 cases of the II°group and in 1 case of the III°group. However, the PR values of these 8 cases were still below 20% PR-level. Conclusion:Among the treated but “unsuccessful” men, some patients could obtain improvements on PR after varicolectomy. But PRs of men with III°grade varicele would still remain a low PR-level which indicate varicolectomy is ineffective in increasing PR among part of sever varicocele patients. SPA is a useful test for evaluating the fertilizing potential of treated infertile males with varicocele.