男性生育力临床评估的新观念:睾丸储备功能
New concept in clinical evaluation of male fertility function: testicular reserve
周少虎 1翁治委 1李堂林2
作者信息
- 1. 广州中医药大学第一附属医院生殖医学科,广州510405
- 2. 湛江市妇幼保健院男科,广东湛江524038
- 折叠
摘要
目的:创造性地提出一种通过评估睾丸潜在功能,反映男性生殖能力的新观念:睾丸储备功能,即睾丸储备(Testicular reserve TR).方法:评估睾丸潜在功能的指标很多,可以通过患者年龄、睾丸体积质地、基础血清FSH、LH、T水平、血清IHN B、血清AMH、代谢综合征、CASA、睾丸活检等来评估,把睾丸储备功能分成0级至Ⅳ级,更能全面反映睾丸的功能.我们定义为:睾丸可能持续生成精子的数量和质量,以及分泌雄激素的潜能,强调的是这种潜在的能力.结果:目前男性不育大约75％病因不明,其中睾丸功能是关键因素,正确评价睾丸功能有助于优化男性不育症的临床诊疗策略,指导男方因素导致的不孕症进入辅助生殖技术方式的选择.结论:评估睾丸储备功能可以反映男性生育力,指导治疗方式的选择,同时可以预期药物治疗的预后,甚至可以预测睾丸或附睾取精的成功率,临床意义显著;也有助于平常男性生殖健康的防病管理.目前睾丸储备功能的理论还不够完善,还需更大样本的临床实验数据进一步阐明.
Abstract
Objectives:To creatively introduce a new concept in clinical evaluation of male fertility function:testicular reserve (TR).Methods:There were many indexes evaluating testicular potential functions,such as age,volume and texture of testis,the basic level of serum FSH、LH、T,serum INH B,serum AMH,the metabolic syndrome,CASA and testicular biopsy.To comprehensively reflect testicular function,the TR function was divided into level 0 ～ Ⅳ.The TR function was defined as the quantity and quality of sperm generating continuously and the potential capability of androgen secreting,emphasizing on the potential capability.Results:At present,causes of about 75％ male infertihty were unknown,with the testicalar function as a critical factor.Proper assessment of testicular function was conducive to optimizing the diagnosis and treatment strategy of male infertility and guiding the choice of assisted reproductive technology.Conclusions:Assessing the TR function can reflect male fertility potentiality,guide the choice of best treatment method,and anticipate prognosis of medicine treatment and even the success rate of testicular/epididymal sperm extraction,all of significant clinical significance.Besides,it also facilitates the prevention and control of male reproductive health.But theory of TR function is not complete at present,which needs more clinical and experiment data for further development.
关键词
睾丸储备功能/生育力/评估方法Key words
Testicular reserve (TR) function/Fertility potentiality/Assessment method引用本文复制引用
出版年
2016
NETL
NSTL
维普
万方数据