Preoperative semen quality is superior to the quality shortly after orchiectomy in patients with testicular germ cell tumour - a retrospective study from two centres in Germany.
Klaus-Peter Dieckmann, Johanna Hochmuth-Tisch, Andrea Salzbrunn, Cord Matthies, Kathrein von Kopylow, Christian Wülfing, Uwe Pichlmeier, Armin Soave, Christian Guido Ruf
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引用次数: 0
Abstract
Background: Sperm cryopreservation in patients with testicular germ cell tumours (GCTs) is traditionally performed after orchiectomy. But, some evidence suggests preoperative semen quality to be superior. We aimed to clarify the optimal time-point of cryopreservation.In a retrospective study, semen quality of 163 patients analysed preoperatively was compared with 242 patients analysed shortly after orchiectomy. Descriptive statistical methods with standard tests for comparisons were employed along with stratified analyses regarding the influence of clinical factors.
Results: All major semen parameters were significantly better in the preoperative group: median ejaculate volume (3 ml preoperatively vs. 2 ml postoperatively); median total sperm count (56.9 x106vs.13 x 106), median progressive motility (40% vs. 25%); azoospermia (4.9% vs. 14.9%). Stratified analysis of subgroups did not reveal significant impact of particular clinical factors on the superiority of preoperative semen quality. Limitations relate to the design of group comparison rather than intraindividual longitudinal comparisons and to selective inclusion of patients opting for cryopreservation.
Conclusions: In GCT patients, semen quality before orchiectomy is significantly superior to that found immediately after surgery. This superiority encompasses all major semen quality parameters. Of particular note is a threefold increase of azoospermia postoperatively. GCT patients are best advised to have cryopreservation performed before orchiectomy.
背景:睾丸生殖细胞肿瘤(gct)患者的精子冷冻保存传统上是在睾丸切除术后进行的。但是,一些证据表明术前精液质量更好。我们旨在明确冷冻保存的最佳时间点。在一项回顾性研究中,163例患者术前精液质量分析与242例患者术后精液质量分析进行了比较。采用描述性统计方法和标准检验进行比较,并对临床因素的影响进行分层分析。结果:术前组所有主要精液参数均显著改善:射精量中位数(术前3ml vs术后2ml);总精子数中位数(56.9 x106vs。13 x 106),中位进行性运动力(40% vs. 25%);无精子症(4.9% vs. 14.9%)。亚组的分层分析未显示特定临床因素对术前精液质量优势的显著影响。局限性在于组间比较的设计而非个体间纵向比较,以及选择性纳入选择低温保存的患者。结论:在GCT患者中,睾丸切除术前的精液质量明显优于术后立即发现的精液质量。这种优势包括所有主要的精液质量参数。特别值得注意的是,术后无精子症的发病率增加了三倍。GCT患者最好在睾丸切除术前进行冷冻保存。
期刊介绍:
Basic and Clinical Andrology is an open access journal in the domain of andrology covering all aspects of male reproductive and sexual health in both human and animal models. The journal aims to bring to light the various clinical advancements and research developments in andrology from the international community.