精索静脉曲张手术在辅助生殖时代的意义

The Significance of Varicocele Surgery in the Era of Assisted Reproduction

临床上精索静脉曲张(以下简称精曲)对精液参数造成的不利影响,已是医学界公认造成男性不育的原因之一。确诊精曲的男性患者,现可采取精索静脉结扎术等手术治疗方式,改善精子数量、活力及畸形率等精液参数,治疗单纯由精曲引起的男性不育症。辅助生殖技术,包括宫腔内人工授精(intrauterine insemination,IUI),体外受精(in vitro fertilization,IVF)及卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI),是目前不孕不育夫妇解决生育困扰的重要手段。本综述收集查阅历年采取辅助生殖技术前优先完成精曲手术的相关文献,评估精曲手术对精曲患者精液参数的影响,判断精曲手术对辅助生殖结局的影响。

The adverse effects of clinical varicocele(hereafter referred to as seminal varicosities)on semen parameters have been recognized by the medical community as one of the causes of male infertility.Male patients with confirmed seminomegaly can now be treated for male infertility caused solely by seminomegaly by surgical treatment such as sperm ligation to improve semen parameters such as sperm count,viability and malformation rate.Assisted reproductive technologies,including intrauterine insemination(IUI),in vitro fertilization(IVF)and intracytoplasmic sperm injection(ICSI),are currently the most important options for infertility.ICSI is an important tool for infertility couples to solve their fertility problems.This review collected literature on the priority completion of spermatozoal surgery prior to the adoption of assisted reproductive technology to assess the effect of spermatozoal surgery on semen parameters in patients with spermatozoa and to determine the impact of spermatozoal surgery on assisted reproductive outcomes.