系统综述和荟萃分析:精索静脉曲张切除术是否适用于患有孤立性畸形精子症的不育男性?

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
ACS Applied Electronic Materials Pub Date : 2024-11-01 Epub Date: 2024-02-12 DOI:10.1111/andr.13602
Murat Dursun, Hüseyin Beşiroğlu, Reşat Aydın, Turgay Kaçan, Ahmet Halil Sevinç, Ateş Kadıoğlu
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引用次数: 0

摘要

背景:临床上很少观察到可触及的精索静脉曲张同时伴有孤立的畸形精子症。因此,精索静脉曲张切除术对精子形态学的影响尚不明确。本荟萃分析旨在汇编评估精索静脉曲张切除术对孤立性畸形精子症有效性的研究,以得出更一致、更可靠的结论:本荟萃分析已在 PROSPERO(CRD42023467933)上注册。我们采用PRISMA(系统综述和荟萃分析首选报告项目)指南来报告结果。研究纳入了 2023 年 10 月 1 日之前发表的文章。检索词为畸形精子症、孤立性畸形精子症、孤立性畸形精子症精索静脉曲张切除术、孤立性畸形精子症精索静脉曲张切除术后精液分析:我们使用该方法和检索词在完整出版物或摘要中找到了 1,013 项研究。其中五项研究被纳入系统回顾,四项被纳入荟萃分析。五项研究(10-14)共纳入 348 名 18-44 岁的患者。汇总分析显示,接受精索静脉曲张切除术的孤立性畸形精子症患者的精子形态有明显改善(Q = 199.42,P 2 = 98.49%)。汇总分析显示,接受精索静脉曲张切除术的孤立性畸形精子症患者的精子浓度没有明显改善(Q = 5.69,P = 0.058;I2 = 64.85%)。有三项研究提供了有关怀孕率的信息,所有研究的怀孕率都很高。根据纽卡斯尔-奥托瓦量表(NOS)评估,所有研究的总质量分为 7 分。漏斗图检验显示了明显的不对称,Begg 和 Mazumdar 的秩相关检验证实了发表偏倚(P = 0.04):讨论:对于孤立的形态异常和临床可触及的静脉曲张患者,静脉曲张切除术是一种有效、可靠的治疗方案:这项荟萃分析表明,精索静脉曲张切除术可改善孤立性畸形精子症不育男性的精液参数,从而提高受孕率,但这一结论还需要进一步的证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Is varicocoelectomy indicated in infertile men with isolated teratozoospermia? a systematic review and meta-analysis.

Background: Clinical palpable varicocoeles in conjunction with isolated teratozoospermia are rarely observed. Therefore, the effects of varicocoelectomy on sperm morphology are not clear. The aim of this meta-analysis is to compile studies that assess the effectiveness of varicocoelectomy in isolated teratozoospermia to reach a more consistent and reliable conclusion.

Material-methods: The present meta-analysis was registered to PROSPERO (CRD42023467933). We utilized the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline to report the outcomes. Articles published before 1 October 2023 were included in the study. The search terms used were teratozoospermia, isolated teratozoospermia, varicocoelectomy for isolated teratozoospermia, and semen analysis after varicocoelectomy in isolated teratozoospermia.

Results: We identified 1,013 studies in full publications or abstracts using the methodology and the search terms. Five studies were included for systematic review, while four were included for meta-analysis. The five studies (10-14) included 348 patients aged 18-44 years. The pooled analysis revealed a significant improvement in sperm morphology in isolated teratozoospermia patients undergoing varicocoelectomy (Q = 199.42, p < 0.0001; I2 = 98.49%). The pooled analysis revealed no significant improvement in sperm concentration in isolated teratozoospermia patients undergoing varicocoelectomy (Q = 5.69, p = 0.058; I2 = 64.85%). Three of the examined studies provided information regarding pregnancy rate and it was high in all studies. According to the Newcastle-Ottowa scale (NOS) assessment, the total quality score of all studies was 7. The funnel plot test demonstrated a visible asymmetry, and Begg and Mazumdar's rank correlation test confirmed the publication bias (p = 0.04).

Discussion: Varicocoelectomy can be an effective and reliable treatment option in patients with isolated morphology abnormalities and clinically palpable varicocoele.

Conclusion: This meta-analysis reported that varicocoelectomy may increase pregnancy rates by improving semen parameters in infertile men with isolated teratozoospermia, although this conclusion requires further evidence.

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