Efficacy of Aromatase Inhibitors for Azoospermia Caused by AZFc Microdeletion: A Cross-Sectional Descriptive Research Study in Chinese Population

IF 2.1 4区医学 Q3 ANDROLOGY

Andrologia Pub Date : 2023-05-13 DOI:10.1155/2023/1870530

Ningjing Ou, Yifan Sun, Jianxiong Zhang, Shiwei Liu, Yuxiang Zhang, Jingpeng Zhao, Haowei Bai, Peng Li, Erlei Zhi, Yuhua Huang, Ruhui Tian, Chencheng Yao, Zheng Li

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Abstract

Background. Aromatase inhibitors (AIs) can significantly improve semen parameters in infertile men. In this study, we investigated the efficacy of AIs for azoospermia in a Chinese population with AZFc microdeletion. Aims. Patients with AZFc microdeletion who were treated with AIs were analyzed retrospectively by collecting clinical data, including their hormone profile and treatment outcome. Patients were divided into those with sperm in their semen after AI treatment (group A) and those without sperm in their semen after AI treatment (group B). Results. The rate of Y chromosome AZF microdeletions was 9.30% (313/3364) from March 2015 to March 2021, among which patients with complete AZFc microdeletion accounted for 63.2% (198/313), and of the 198 patients with AZFc microdeletion, 69.7% (138/198) showed azoospermia. Forty-six (33.3%) of the azoospermic patients had sperm in their semen after AI administration. Testosterone (T) and testosterone-to-estradiol ratio (T/E₂) levels were higher in group A than those in group B after treatment, and the differences were significant (T, P = 0.038; T/E₂, P = 0.004). Paired t-test demonstrated that the change of T levels before and after treatment was statistically significant (P = 0.003). The increased E₂ and T/E₂ ratio levels before and after treatment were not statistically significant (P = 0.057 and 0.080), but they were close to the threshold value (P = 0.05). Conclusions. Patients with AZFc microdeletion accounted for the largest proportion of male infertility caused by Y chromosome microdeletions. AIs can promote spermatogenesis in azoospermic patients with AZFc microdeletion, and sperm could be found in the semen of some patients after AI administration. T and T/E₂ levels after AI treatment could be used as biomarkers to distinguish azoospermic patients with AZFc microdeletion who responded better to AIs from those who did not respond well.

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芳香化酶抑制剂对AZFc微缺失所致无精子症的疗效:一项中国人群的横断描述性研究

背景。芳香酶抑制剂(AIs)可以显著改善不育男性的精液参数。在这项研究中，我们研究了AIs对中国AZFc微缺失人群无精子症的疗效。目标通过收集临床资料，包括激素谱和治疗结果，回顾性分析接受AIs治疗的AZFc微缺失患者。将患者分为人工智能治疗后精液中有精子组(A组)和人工智能治疗后精液中无精子组(B组)。2015年3月至2021年3月，Y染色体AZF微缺失率为9.30%(313/3364)，其中AZFc完全微缺失患者占63.2%(198/313)，198例AZFc微缺失患者中69.7%(138/198)为无精子症。46例(33.3%)无精子症患者在给药后精液中仍有精子。A组治疗后睾酮(T)、睾酮与雌二醇比值(T/E2)水平均高于B组，差异有统计学意义(T, P = 0.038;T/ e2, p = 0.004)。配对t检验显示，治疗前后t水平变化有统计学意义(P = 0.003)。治疗前后E2、T/E2比值升高，差异无统计学意义(P = 0.057、0.080)，但均接近阈值(P = 0.05)。结论。AZFc微缺失患者在Y染色体微缺失导致的男性不育中所占比例最大。AI可促进AZFc微缺失无精子患者的精子发生，部分患者给药后精液中可发现精子。人工智能治疗后的T和T/E2水平可作为区分AZFc微缺失无精子患者对人工智能反应较好和反应不佳的生物标志物。

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来源期刊

Andrologia 医学-男科学

CiteScore

5.60

自引率

8.30%

发文量

292

审稿时长

6 months

期刊介绍： Andrologia provides an international forum for original papers on the current clinical, morphological, biochemical, and experimental status of organic male infertility and sexual disorders in men. The articles inform on the whole process of advances in andrology (including the aging male), from fundamental research to therapeutic developments worldwide. First published in 1969 and the first international journal of andrology, it is a well established journal in this expanding area of reproductive medicine.