各种类型无精子症患者行睾丸精子抽吸术后发生性腺功能减退症的风险：一项前瞻性队列研究。
The risk of hypogonadism after testicular sperm extraction in men with various types of azoospermia: a prospective cohort study.
机构信息
Amsterdam UMC location University of Amsterdam, Reproductive Biology Laboratory, Center for Reproductive Medicine, Amsterdam, The Netherlands.; Amsterdam Reproduction and Development, Amsterdam, The Netherlands.
Amsterdam UMC location University of Amsterdam, Reproductive Biology Laboratory, Center for Reproductive Medicine, Amsterdam, The Netherlands.
出版信息
Reprod Biomed Online. 2023 Jun;46(6):973-981. doi: 10.1016/j.rbmo.2023.02.003. Epub 2023 Feb 10.
RESEARCH QUESTION
What is the risk of hypogonadism in men with obstructive azoospermia, non-obstructive azoospermia (NOA) or Klinefelter syndrome after testicular sperm extraction (TESE)?
DESIGN
This prospective longitudinal cohort study was carried out between 2007 and 2015.
RESULTS
Around 36% of men with Klinefelter syndrome, 4% of men with obstructive azoospermia and 3% of men with NOA needed testosterone replacement therapy (TRT). Klinefelter syndrome was strongly associated with TRT while no association was found between obstructive azoospermia or NOA and TRT. Irrespective of the pre-operative diagnosis, a higher testosterone concentration before TESE was associated with a lower chance of needing TRT.
CONCLUSIONS
Men with obstructive azoospermia or NOA have a similar moderate risk of clinical hypogonadism after TESE, while this risk is much larger for men with Klinefelter syndrome. The risk of clinical hypogonadism is lower when testosterone concentrations are high before TESE.
研究问题
睾丸精子抽取（TESE）后，梗阻性无精子症、非梗阻性无精子症（NOA）或克氏综合征患者发生性腺功能减退症的风险是多少？
设计
这是一项在 2007 年至 2015 年间进行的前瞻性纵向队列研究。
结果
大约 36%的克氏综合征患者、4%的梗阻性无精子症患者和 3%的非梗阻性无精子症患者需要接受睾酮替代治疗（TRT）。克氏综合征与 TRT 密切相关，而梗阻性无精子症或非梗阻性无精子症与 TRT 之间没有关联。无论术前诊断如何，TESE 前较高的睾酮浓度与较低的 TRT 需求相关。
结论
TESE 后，梗阻性无精子症或非梗阻性无精子症患者发生临床性腺功能减退症的风险相似，中度风险，而克氏综合征患者的风险则大得多。TESE 前睾酮浓度较高时，临床性腺功能减退症的风险较低。
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