Clinical, genetic, biochemical, and testicular biopsy findings among 1,213 men evaluated for infertility
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OBJECTIVE: To study the pathologic findings among men evaluated for infertility.
DESIGN: A retrospective, single-center, cross-sectional study.
SETTING: University hospital-based research center.
PARTICIPANT(S): We included data from 1,213 medical records from infertile men referred for diagnostic work-up from 2005 to 2009.
INTERVENTIONS(S): None.
MAIN OUTCOME MEASURE(S): Health history, clinical findings, chromosome/genetic aberrations, semen quality, reproductive hormones.
RESULT(S): In total, 64.4% of the infertile men had one or more reproductive disorders or factors influencing fertility, leaving 35.6% diagnosed as idiopathic infertile. In 244 patients (20%), including seven cases of testicular cancer and/or germ cell neoplasia in situ, a pathologic finding was first detected during diagnostic work-up. Two hundred four patients (16.8%) had a history of cryptorchidism and 154 (12.7%) of varicocele (grade 2 and 3). Thirty-three patients had chromosomal abnormalities, including 16 with sex chromosome abnormalities (11 with 47,XXY). Y-chromosome microdeletions were detected in 65 patients (5.4%). One hundred thirty-three had azoospermia, of which 58 had testicular biopsy findings (Sertoli cell-only syndrome: n = 23; spermatogenic arrest: n = 7; impaired spermatogenesis and atrophy: n = 28). Additionally, in idiopathic infertile men and infertile men with additional symptoms of testicular dysgenesis syndrome, 22.5% presented with a degree of Leydig cell insufficiency, with the highest frequency (33.1%) among patients with sperm concentration <5 million/mL.
CONCLUSION(S): We report pathologic findings that could explain the male-factor infertility in two-thirds of infertile men referred to our center. Thus, male infertility may be a sign of an underlying disease that warrants attention.
Originalsprog | Engelsk |
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Tidsskrift | Fertility and Sterility |
Vol/bind | 107 |
Udgave nummer | 1 |
Sider (fra-til) | 74-82.e7 |
ISSN | 0015-0282 |
DOI | |
Status | Udgivet - jan. 2017 |
ID: 176702634