丸激素和黄素激素预测,在接受阿纳斯特罗治疗的不孕男性中,精液参数的改善
Bryan D Naelitz1, Tommy Jiang2, Carlos Munoz-Lopez3
1Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
Fertility and sterility
|July 1, 2023
概括
阿纳斯托治疗改善了不孕男性的精液参数,特别是那些具有较高的激素与黄化激素比率和非精子精子. 这一发现为精选的患者群体改善生育结果提供了希望.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 安德罗学与人类学
- 男人不孕症研究研究
背景情况:
- 异形性男性不孕症影响了大量寻求生育治疗的夫妇.
- 像阿纳斯托这样的芳酶抑制剂正在被探索,因为它们有可能改善精液参数.
- 确定治疗反应的预测因素对于优化治疗策略至关重要.
研究的目的:
- 为了确定患者特异性因素,与治疗后的精液参数显著改善相关.
- 评估阿纳斯特罗在改善精子度,运动性和形态学方面的疗效.
- 开发一种预测模型,用于在不育男性中预测阿纳斯托治疗反应.
主要方法:
- 在两个学术医疗中心进行了90名不育男性接受阿纳斯托治疗的回顾性队列研究.
- 对治疗前和治疗后精液参数的分析,包括世界卫生组织精子度类别 (WHO-SCC) 的升级.
- 单变量和多变量逻辑回归,以及分区分析,以确定重要的预测因素.
主要成果:
- 在46%的男性中,阿纳斯托治疗导致了WHO-SCC升级;12%的男性经历了降级.
- 受访者表现出较低的黄素激素 (LH) 和卵泡刺激激素 (FSH) 的基线水平,以及较高的 (T) 水平.
- 与LH的比率 (T-LH比率) ≥100和基线非亚子精是WHO-SCC升级的显著预测因素 (AUC:0.77).
结论:
- 阿纳斯托治疗在临床上改善了大约一半患有异常不孕症的男性的精液参数.
- 具有100或更高的T-LH比率的非雄性精子男性最有可能从阿纳斯特罗中受益.
- 患有亚精子症的男性对阿纳斯特醇反应的可能性很低,因此应该考虑替代治疗方法.
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