Đánh Giá Khả Năng Có Thai Tự Nhiên Sau Vi Phẫu Cột Tĩnh Mạch Tinh Ở Các Trường Hợp Vô Sinh Thiểu Tinh Nặng Kèm Giãn Tĩnh Mạch Tinh

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Vũ Tân Lê, Bá Tiến Dũng Mai, Phúc Cẩm Hoàng Nguyễn, Vĩnh Phú Phạm

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2023

Mô tả vật lý: tr.92

Bộ sưu tập: Metadata

ID: 339147

Thêm vào giỏ Liên kết toàn văn

- Mục tiêu: Đánh giá sự cải thiện các thông số tinh dịch và tỉ lệ mang thai tự nhiên sau phẫu thuật cột tĩnh mạch tinh ở nam giới vô sinh thiểu tinh nặng.- Đối tượng và phương pháp: 100 trường hợp được chẩn đoán vô sinh thiểu tinh nặng, đã được phẫu thuật cột tĩnh mạch tinh từ năm 2019 đến 2020 tại bệnh viện Bình Dân. Bệnh nhân vô tinh hoặc bất thường nhiễm sắc thể được loại ra khỏi nghiên cứu. Nồng độ hormone FSH, LH và testosterone được khảo sát. Tinh dịch đồ được phân tích trước phẫu thuật và mỗi 3 tháng sau phẫu thuật. Tình trạng có thai tự nhiên sẽ được ghi nhận trong suốt 12 tháng nghiên cứu. Hiệu quả về kinh tế được đánh giá và so sánh giữa thụ tinh trong ống nghiệm và phẫu thuật cột tĩnh mạch tinh.- Kết quả: Sau thời gian phẫu thuật trung bình là 7 tháng, mật độ tinh trùng trung bình tăng từ 2,9 (2 - 5) lên 11 (5 - 17) triệu/ mL (P <
,05), và độ di động của tinh trùng trung bình được cải thiện từ 3,5 (3-6)% lên 7% (giá trị p <
,05). Tổng số tinh trùng di động đã tăng lên 3,01 (1,02 - 5,83) triệu từ giá trị ban đầu là 0,3 (0,16 - 0,83) triệu. 25 trường hợp ghi nhận mang thai tự nhiên, trong đó 8 trường hợp xảy ra trong vòng 6 tháng hậu phẫu. Phân tích chi phí - hiệu quả của thụ tinh trong ống nghiệm và phẫu thuật cột tĩnh mạch tinh đã chỉ ra rằng phẫu thuật cột tĩnh mạch tinh có thể là một lựa chọn tốt cho nam giới vô sinh thiểu tinh nặng.- Kết luận: Phẫu thuật cột tĩnh mạch tinh có thể cải thiện chất lượng tinh trùng và khả năng sinh sản ở nam giới thiểu tinh nặng kèm giãn tĩnh mạch tinh. Phương pháp này nên được thảo luận với các bệnh nhân vô sinh thiểu tinh nặng như là một trong những lựa chọn điều trị đầu tiên.Abstract- Objectives: To evaluate improvement in semen parameters and partner spontaneous pregnancies (SP) post microsurgical varicocelectomy in infertile men with severe oligozoospermia (SO)- Materials and Methods: This study included 100 severely oligozoospermic patients who underwent microsurgical varicocelectomy between 2019 and 2020. Men with azoospermia or abnormal karyotype or Y-chromosome microdeletion were excluded. Serum luteinizing, follicle-stimulating,and testosterone hormones were measured preoperatively. Postoperative semen was analyzed first at 3 months and then every 3 months thereafter. SP was recorded on each visit. Cost-effectiveness for assisted reproductive technologies was calculated using reported costs.- Results: After the mean postoperative observation period of 7 months, the mean sperm concentration increased from 2.9 (2 - 5) to 11(5 - 17) million/mL (P <
.05), and the mean sperm motility improved from 3.5 (3-6) % to 7 % (p-value <
.05). Total motile sperm count was increased to 3.01 (1.02 - 5.83) million from the beginning value of 0.3 (0.16 - 0.83) million. 25 men in this study had their wives became pregnant within 1 year of post operation. In which, there were 8 out of 25 pregnancies occurred within six months after surgery. The cost-effectiveness analysis of IVF and varicocelectomy has shown that varicocelectomy may be a better first choice for infertile men even with very low preoperative TMSC.- Conclusions: Varicocelectomy may improve the sperm quality and fertility potential in men with SO, resulting in SP. It should be discussed as a treatment option for patients with SO. DOI: 10.59715/pntjmp.1.1.12

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR