Relationship between serum reproductive hormones and sperm parameters and surgical outcomes in Micro-TESE
10.3969/j.issn.1009-8291.2023.12.006
- VernacularTitle:血清生殖激素和精子参数与显微睾丸切开取精手术结局的相关性
- Author:
Chenyao DENG
1
,
2
;
Defeng LIU
3
;
Wenhao TANG
1
,
2
;
Lianming ZHAO
1
,
2
;
Haocheng LIN
1
,
2
;
Jiaming MAO
3
;
Zhe ZHANG
1
,
2
;
Yuzhuo YANG
3
;
Haitao ZHANG
1
,
2
;
Hui JIANG
1
,
2
,
4
;
Kai HONG
2
,
3
Author Information
1. Department of Urology, Peking University Third Hospital, Beijing 100191, China
2. Center for Gynecology, Peking University Third Hospital, Beijing 100191, China
3. Center for Reproduction, Peking University Third Hospital, Beijing 100191, China
4. Center for Reproduction, Peking University Third Hospital, Beijing 100191, China
- Publication Type:Journal Article
- Keywords:
reproductive hormones;
male infertility;
non-obstructive azoospermia;
anti-mullerian hormone;
Micro-TESE;
sperm morphology;
sperm concentration;
forward moving sperm
- From:
Journal of Modern Urology
2023;28(12):1032-1037
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To investigate the relationship between serum reproductive hormones and sperm parameters and outcomes of micro-testicular sperm extraction (Micro-TESE). 【Methods】 Clinical data of 1 091 patients treated in our hospital during Jan. and Dec.2021 were retrospectively analyzed. According to the sperm concentration,the patients were divided into non-obstructive azoospermia (NOA) group (group A,n=418),normal sperm concentration group (group B,n=615),mild to moderate oligospermia group (group C,n=18),severe oligospermia group (group D,n=18),and obstructive azoospermia group (group E,n=22). In group A,244 cases treated with Micro-TESE were grouped into the sperm-acquired group (Micro-TESE positive group,n=82) and non-sperm-acquired group (Micro-TESE negative group,n=162),and according to the pathological types of testicular tissue,the patients were divided into normal testicular tissue with hypospermatogenesis group (HYPO group,n=129),maturation arrest group (MA group,n=10),and support-only cell syndrome group (SCO group,n=122). Differences in semen parameters and reproductive hormone levels were compared,and relationship between reproductive hormones and sperm parameters and Micro-TESE outcomes was determined with Pearson correlation analysis. 【Results】 In the sperm concentration subgroup,the testicular volume of group A was lower than that of group B and group E (P<0.05); the levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in group A were the highest (P<0.05),but the level of testosterone (T) was the lowest (P<0.05); the levels of anti-mullerian hormone (AMH) and serum inhibin B (INHB) in group A were lower than those in group B and group E (P<0.05),the normal sperm morphology rate in group B was higher than that in group A and group E (P<0.05); the percentage of forward moving sperm in group B was the highest (P<0.05). Pearson correlation analysis revealed that sperm concentration,normal sperm morphology rate,and percentage of forward moving sperm were negatively correlated with age,FSH,LH (P<0.05),and positively correlated with testicular volume,T,AMH,and INHB (P<0.05). NOA patients were grouped according to testicular histology and pathology. The INHB in the SCO group was the smallest of the three groups (P<0.05); the FSH and LH levels in the SCO group were higher than those in the MA group (P<0.05),while the 17β-estradiol (E2) levels in the HYPO group were higher than those in the SCO group (P<0.05). NOA patients were grouped according to the results of Micro-TESE surgical treatment. There was a statistically significant difference in AMH and INHB levels between the Micro-TESE positive and negative groups (P<0.05). The binary logistic regression analysis of factors affecting the Micro-TESE outcomes of NOA patients showed AMH was negatively correlated with the Micro-TESE outcome (OR=0.904,95%CI:0.91-1.08,P<0.05). 【Conclusion】 Age,FSH,LH,AMH,and INHB are correlated with sperm concentration,normal sperm morphology rate,and percentage of forward moving sperm. The INHB level was the lowest in the SCO group. The results of Micro-TESE in patients with NOA can be predicted by serum AMH level.
