Biomarkers to predict improvement of sperm parameters and hypogonadism after varicocele repair

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Abstract

Approximately 15% of couples in the US are affected by infertility, with male factor infertility acting as the sole or contributing factor in 20% and 40% of cases, respectively. Of the numerous potential causes of male infertility, varicocele is the most common and correctable. Although there are several hypotheses for the mechanism by which varicocele may cause symptoms such as infertility, pain, or hypogonadism, many patients with varicocele remain asymptomatic, and it remains unclear why only a subset of men with varicocele develop symptomatic pathology. Biomarkers are measurable indicators of disease presence or progression and have been proposed for use in the diagnosis and management of men with various reproductive conditions, including varicocele. This study examines a range of markers, including proteins, ribonucleic acid, deoxyribonucleic acid, and metabolites. Proteins implicated in heat shock reactions, oxidative stress, and mitochondrial function, including heat shock protein family A member 2, apolipoprotein A2, and TOM22, have been investigated within the context of varicocele when compared with their expression in healthy men. Additionally, potential biomarkers associated with sperm motility and spermatogenesis, such as serpin family A member 5 and adenosine triphosphate synthase delta domain protein, have been identified with studies showing improvement in concentrations post varicocelectomy. The pursuit of noninvasive biomarkers has gained significance for predicting improvement in fertility and assessing responses to varicocelectomy, offering opportunities for early intervention, minimizing unnecessary surgeries, and optimizing patient outcomes. This review consolidates current knowledge, underscores existing gaps, and outlines future research directions refining diagnostic and therapeutic strategies for varicocele-related infertility.

预测精索静脉曲张修复术后精子参数改善和性腺功能减退的生物标志物
在美国,约有 15%的夫妇受到不育症的影响,其中男性因素导致的不育症分别占 20% 和 40%。在导致男性不育的众多潜在原因中,精索静脉曲张是最常见也是最容易矫正的。尽管对精索静脉曲张可能导致不育、疼痛或性腺功能减退等症状的机制有多种假设,但许多精索静脉曲张患者仍无症状,而且目前仍不清楚为什么只有一部分精索静脉曲张男性会出现有症状的病理变化。生物标志物是疾病存在或发展的可测量指标,已被建议用于诊断和管理患有各种生殖疾病(包括精索静脉曲张)的男性。本研究检测了一系列标记物,包括蛋白质、核糖核酸、脱氧核糖核酸和代谢物。研究了与热休克反应、氧化应激和线粒体功能有关的蛋白质,包括热休克蛋白 A 家族成员 2、脂蛋白 A2 和 TOM22,并将这些蛋白质在精索静脉曲张中的表达与在健康男性中的表达进行了比较。此外,与精子活力和精子发生相关的潜在生物标志物,如 serpin 家族 A 成员 5 和三磷酸腺苷合成酶 delta 结构域蛋白也已被确定,研究显示精索静脉曲张切除术后这些标志物的浓度有所提高。非侵入性生物标志物的研究对于预测生育能力的改善和评估精索静脉曲张切除术的反应具有重要意义,为早期干预、减少不必要的手术和优化患者预后提供了机会。本综述整合了当前的知识,强调了现有的差距,并概述了完善精索静脉曲张相关不育症诊断和治疗策略的未来研究方向。
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来源期刊
F&S reviews
F&S reviews Endocrinology, Diabetes and Metabolism, Obstetrics, Gynecology and Women's Health, Urology
CiteScore
3.70
自引率
0.00%
发文量
0
审稿时长
61 days
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