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ABSTRACT: It is still controversial whether the serum inhibin B level is a superior predictor of the presence of sperm in testicular sperm extraction (TESE) in azoospermic men compared with serum follicle-stimulating hormone (FSH). In this study, we evaluated the diagnostic accuracy of serum inhibin B levels as a predictor of the outcome of TESE in Chinese non-obstructive azoospermic men and compared it with the traditional marker serum FSH and testicular volumes.
Basal values of serum hormone levels, testicular volumes and histological evaluation of 305 Chinese non-obstructive azoospermic men were analyzed. The level of inhibin B was measured using a three-step enzyme-linked immunoassay before sperm extraction, and the diagnostic accuracy of prediction of the outcome of TESE was compared for different markers by the receiver operating characteristics (ROC) curve analysis.
Testicular sperm was successfully retrieved in 137 of 305 patients (44.9%). The serum level of inhibin B, the FSH and the testicular volume were significantly different between the successful TESE group and the unsuccessful group. According to the ROC curve analysis, for inhibin B, the cut-off value for discriminating between successful and failed TESE was 28.39 pg/ml (sensitivity 83.5%, specificity 79.1%). For FSH, the best cut-off value for discriminating was 11.05 pg/ml (sensitivity 83.5%, specificity 74.5%). The area under the ROC curve of serum inhibin B was similar to that of FSH. Combining the serum inhibin B with FSH levels did not improve the predictive value for successful TESE.
Serum inhibin B and FSH levels are correlated with spermatogenesis. However, inhibin B is not superior to FSH in predicting the presence of sperm in TESE. And the combination of them does not improve the diagnostic accuracy on TESE outcome.
Chinese medical journal 08/2012; 125(16):2885-9. · 0.86 Impact Factor
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Wen-hao Tang,
Hui Jiang,
Lu-lin Ma,
Kai Hong,
Lian-ming Zhao,
Jia-ming Mao,
De-feng Liu,
Yi Yang, Quan Bai,
Xiang Huang,
Xin Zhang
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ABSTRACT: To investigate the correlation of the testis volume and reproductive hormone level with the results of testicular sperm aspiration (TESA) in non-obstructive azoospermia (NOA) patients, and to explore the cut-off value of the testis volume and reproductive hormone level in predicting the results of TESA so as to provide reliable information for the diagnosis and treatment of NOA.
We enlisted 121 NOA patients in this study, divided them into a sperm group and a non-sperm group based on the results of TESA, and measured their testis volumes and reproductive hormone levels.
The left testis volume, the right testis volume, and the levels of prolactin (PRL), follicle-stimulating hormone (FSH), luteinising hormone (LH), estradiol (E2) and total testosterone (T) in the non-sperm and sperm groups were (7.07 +/- 1.06) ml vs (11.75 +/- 1.38) ml, (7.37 +/- 1.37) ml vs (11.70 +/- 1.98) ml, (12.43 +/- 11.69) ng/ml vs (9.60 +/- 4.55) ng/ml, (15.77 +/- 10.84) mIU/ml vs (8.01 +/- 7.43) mIU/ml, (6.12 +/- 2.92) mIU/ml vs (8.11 +/- 20.11) mIU/ml, (119.36 +/- 43.52) pmol/L vs (141.12 +/- 48.33) pmol/L, and (11.43 +/- 4.05) nmol/L vs (12.46 +/- 4.60) nmol/L, respectively. The mean levels of serum FSH and PRL were significantly higher in the non-sperm than in the sperm group. Although the mean testis volume of the former was less than that of the latter, there were no significant differences between the two groups, and nor were any significant differences in age and the levels of E2 and T. The cut-off value of the testis volume was 9 ml, with sensitivity of 93.8%/89.6% (left/right) and specificity of 100%/94.3% (left/right). The area under curve (AUC) of the left testis volume was 0.984 and that of the right was 0.961, indicating a high diagnostic accuracy. The cut-off value of the serum FSH level was 8.18 mIU/ml, with a sensitivity of 71.2% and a specificity of 75.0%. The AUC of the FSH level was 0.743, suggestive of a moderate diagnostic accuracy.
The testis volume and FSH level are important for predicting the TESA results of NOA patients, and the former has even a higher diagnostic accuracy than the latter.
Zhonghua nan ke xue = National journal of andrology 01/2012; 18(1):48-51.
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ABSTRACT: To compare clinical outcome of intracytoplasmic sperm injection (ICSI) cycle by using fresh and cryopreserved-thawed testicular and epididymal spermatozoa in azoospermic patients.
Between September 2006 and May 2007, 208 azoospermic patients underwent in vitro fertilization (IVF) were treated in Center of Reproductive Medicine, Peking University Third Hospital. Those couples were divided into two groups based on their wishes, including 171 cases in fresh group and 37 cases in cryopreserved-thawed group. The cryopreserved testicular or epididymal spermatozoa were thawed and recovered before ICSI procedure in thawed group. The outcomes of ICSI in each group were compared, including clinical outcomes (two pronuclear fertilization, high quality embryo, clinical pregnancy and embryo implantation) and pregnancy outcomes (spontaneous miscarriage, gestational weeks and neonatal birth weight).
(1) The utilization rate were 92% (23/25) in cryopreserved-thawed testicular spermatozoa and 100% (12/12) in epididymal spermatozoa. (2) Between fresh and cryopreserved-thawed groups, no statistical difference was observed in two pronuclear fertilization rate [62.25% (973/1563) vs. 64.53% (282/437), P = 0.960], high quality embryo rate [78.9% (768/973) vs. 79.1% (223/282), P = 0.985], clinical pregnancy rate per embryo transfer [44.4% (60/135) vs. 46.9% (15/32), P = 0.688] and embryo implantation rate [29.3% (84/287) vs. 33.3% (23/69), P = 0.508]. (3) No significant difference between fresh and cryopreserved group was found in spontaneous miscarriage rate (11% vs.7%, P = 1.000), gestational weeks (single birth: 39.0 weeks vs.38.7 weeks, P = 0.538; twins: 36.8 weeks vs.36.3 weeks, P = 0.571) and birth weight (single birth: 3409 g vs.3350 g, P = 0.699; twins: 2584 g vs. 2635 g, P = 0.703).
It suggested that tissue from the azoospermic patients who underwent diagnostic testicular and epididymal biopsy should be cryopreseved for IVF-ET.
Zhonghua fu chan ke za zhi 10/2009; 44(10):740-4.
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ABSTRACT: The proposed hypothesis for this study was that seminal testosterone/estradiol levels and/or their ratios may be a good indicator for predicting normal spermatogenesis. The concentrations of estradiol and testosterone in seminal fluid were measured using competitive immunoassay techniques in specimens collected from 192 infertile patients and 103 normospermic men. Infertile patients were subdivided into three groups according to their semen analysis results and testicular biopsy: oligozoospermia, obstructive azoospermia (OA), and nonobstructive azoospermia (NOA). Results showed that seminal testosterone levels in the infertile groups were lower than in the normospermic individuals (P < .01), whereas seminal estradiol levels in the OA group were significantly higher than those in normospermic and NOA groups (P < .01). Testosterone/estradiol ratios in the seminal plasma from the infertile groups were significantly lower than that in the normospermic group (P < .01). However, seminal estradiol levels among normospermic and NOA groups showed no significant differences. These results suggest that the local balance between androgen and estrogen, or their ratios, may play an important role in maintaining normal spermatogenesis. Also, decreased seminal testosterone/estradiol ratio may be a good indicator for identifying the absence of sperm production in NOA patients.
Journal of Andrology 09/2009; 31(2):215-20. · 2.97 Impact Factor
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Ling-feng Tang,
Hui Jiang,
Xue-jun Shang,
Lian-ming Zhao, Quan Bai,
Kai Hong,
De-feng Liu,
Jian-ming Liu,
Ren-pei Yuan,
Qian Chen,
Lu-lin Ma
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ABSTRACT: To evaluate the association between vasectomy and prostate cancer.
We searched comprehensively the databases, CBMDisc, CMCC, CMAC, CNKI (from 1978 to January 6, 2009), and PubMed (from 1965 to January 6, 2009) using the key words "vasectomy" and "prostate cancer", screened the retrieved literature according to the inclusion and exclusion criteria, performed a Meta-analysis with the software RevMan 4.2 after identification of the relevant data, and calculated the overall pooled OR (95% CI) as well as that of the association of prostate cancer with <20 and > or =20 yr vasectomy.
A total of 20 088 cases and 232 506 controls in 27 reports (7 cohort and 20 case-control studies) were included in this investigation. The overall pooled OR (95% CI) was 1.10 (0.97-1.24), and those of <20 and > or =20 yr vasectomy were 0.94 (0.83-1.06) and 1.05 (0.90-1.23), respectively.
No existing literature show any positive association between vasectomy and prostate cancer.
Zhonghua nan ke xue = National journal of andrology 06/2009; 15(6):545-50.
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Ling-Feng Tang,
Hui Jiang,
Xue-Jun Shang,
Lian-Ming Zhao, Quan Bai,
Kai Hong,
De-Feng Liu,
Jian-Ming Liu,
Ren-Pei Yuan,
Qian Chen,
Lu-Lin Ma
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ABSTRACT: To investigate the relationship of seminal plasma levocarnitine with sperm concentration, vitality and motility.
Enrolled in this study were 64 infertile men, who were divided according to the results of routine sperm tests into a normozoospermia (n = 12), an oligozoospermia (n = 16), an asthenozoospermia (n = 20) and an oligoasthenozoospermia group (n = 16). The level of seminal plasma levocarnitine was detected by LC-MS-MS, the concentration of seminal plasma testosterone measured by chemiluminescence immunoassay, the correlation of seminal plasma levocarnitine with sperm concentration, motility and vitality determined by bivariate correlation analysis with SPSS15.0, and so was the correlation between the carnitine and sperm concentration by partial correlation analysis with seminal plasma testosterone as a control variable to exclude the influence of testosterone.
The concentrations of total seminal plasma levocarnitine, free seminal plasma levocarnitine and seminal plasma acetolevocarnitine were (91.33 +/- 40.49) mg/L, (40.89 +/- 24.13) mg/L and (50.44 +/- 21.90) mg/L; the Pearson coefficients of correlation of the levocarnitine level with sperm motility, vitality and concentration were 0.161 (P = 0.235), 0.114 (P = 0.370) and 0.637 (P < 0.001), those of free seminal carnitine with sperm motility and vitality were 0.325 (P = 0.024) and 0.316 (P = 0.029), respectively, with the oligozoospermia group excluded, and that of partial correlation between the concentrations of seminal levocarnitine and sperm was 0.641 (P < 0.001).
The level of seminal plasma levocarnitine is positively correlated with sperm motility and vitality, and more significantly with sperm concentration.
Zhonghua nan ke xue = National journal of andrology 09/2008; 14(8):704-8.
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ABSTRACT: To investigate the knowledge of and attitude to sexual dysfunction in aged men, and to discuss the status and needs of male healthcare.
Two thousand seven hundred and twenty-eight men (40-70 years old) were surveyed on sexual dysfunction using the randomized questionnaire in Xicheng District, Beijing.
The prevalence of erectile dysfunction (ED) was 41.2%, and only 12.1% ED patients were to see the doctor. 52.4% aged men thought the sexual life was important or very important during the life, and 55.6% thought ED would exert negative impact on the quality of life and the partner relationship. Although 27.4% knew that ED was a kind of disease, 49.0% thought ED was a nature rule. Compare to the 41.2% ED prevalence, only 9.7% male were dissatisfied with their sexual life, and later ratio was 14.1% among the partner.
In China, the status of the knowledge of and attitude to sexual dysfunction in aged men was unsatisfactory to some extent. There is a lot of work to do especially in sexual healthcare education and improvement on diagnostic and treatment of sexual dysfunction.
Zhonghua nan ke xue = National journal of andrology 11/2005; 11(10):752-4.
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ABSTRACT: To determine the age-adjusted prevalence of erectile dysfunction (ED) in 3 big cities of China and to explore its potential sociodemographic, medical and lifestyle correlates.
A cross-sectional, population-based survey was conducted in three cities of China. Structured questionnaires were administered to 2 226 men, aged 20 - 86 years, by trained interviewers.
The age-adjusted prevalence of ED was 28.34 % (mild 15.99 %, moderate 7.14 %, severe 5.21 %). In the men above 40, the prevalence was 40.2 %. Age was positively correlated with ED (P<0.01). Education was negatively correlated with ED (P<0.01). Spouse companionship, living condition were positively correlated with ED (P<0.01). Histories of cardiovascular disease, diabetes, and hyperlipidemia were positively correlated with ED (P<0.01). Cigarette smoking was not correlated with ED (P>0.05), while the cigarette consumption and duration were positively correlated with ED (P<0.01). Alcohol drinking is negatively correlated with ED (P<0.01). The duration of drinking was positively correlated with ED (P<0.01). Weekly alcohol consumption was not correlated with ED (P>0.05). Conclusion: The prevalence of ED increased with age. Cardiovascular disease, diabetes and hyperlipidemia were positively correlated with the increased prevalence. Sociodemographic and lifestyle factors, such as education, spouse companionship, living condition, cigarette and alcohol consumption or duration also have association with the prevalence of ED.
Asian Journal of Andrology 12/2004; 6(4):343-8. · 1.52 Impact Factor
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ABSTRACT: To elucidate how chronic prostatitis affects the expression and activity of the plasminogen activator (PA) system and relates to male infertility.
Twenty-three normal fertile males and 80 chronic prostatitis patients (40 fertile and 40 infertile) were included in this research. SDS polyacrylamide gel electrophoresis and fibrin overlay method were used to estimate the total PA, and tissue PA (tPA), urokinase type PA (uPA) in semen.
Total PA, tPA and uPA highly expressed in normal males, but decreased in the semen of the chronic prostatitis patients of both the fertile and infertile groups. However, there was no significant difference in total PA between the fertile and infertile patients.
Chronic prostatitis reduces the secretory function and PA synthesis and secretion of the prostate, but the decrease of PA alone does not cause infertility. PA may be one of the tools for estimating the function of the prostate.
Zhonghua nan ke xue = National journal of andrology 09/2004; 10(8):586-8.
