Correlation of 17-OH Progesterone Changes With Semen Parameters and Pregnancy Outcomes in Hypogonadal and Eugonadal Patients After Varicocelectomy.

IF 2.1 3区 医学 Q2 UROLOGY & NEPHROLOGY Urology Pub Date : 2025-03-12 DOI:10.1016/j.urology.2025.03.007
Muhammed Arif Ibis, Selman Unal, Ezel Aydog, Efe Semetey Oguz, Murat Can Karaburun, Cagri Akpinar, Kaan Aydos, Onder Yaman
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Abstract

Objective: To evaluate the impact of varicocele repair on serum 17-OH progesterone (17-OHP) levels and investigate its relationship with semen parameters and pregnancy outcomes in hypogonadal and eugonadal patients. Additionally, to address the unclear association between varicocele and serum 17-OHP levels in male infertility.

Methods: This prospective study included 135 men who underwent microscopic subinguinal varicocelectomy. Preoperative and postoperative (3-6 months) hormone levels, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), and 17-OHP, and semen parameters, such as total motile sperm count (TMS) and sperm morphology, were analyzed. Patients were categorized as hypogonadal (TT <300 ng/dL) or eugonadal (TT ≥300 ng/dL). Pregnancy outcomes were recorded over a 12-month follow-up period.

Results: Significant increases in TT and 17-OHP levels were observed only in hypogonadal men, while TMS and sperm morphology improved in both groups. In hypogonadal men, changes in serum 17-OHP levels (Δ-17-OHP) positively correlated with TMS improvement (r=0.388, p=0.009). Furthermore, in hypogonadal patients, although not statistically significant, Δ-17-OHP were higher in men whose partners achieved pregnancy compared to those whose partners did not.

Conclusions: Varicocele repair improves semen parameters in both hypogonadal and eugonadal men. In hypogonadal men, increases in Δ-17-OHP are linked to TMS improvements, highlighting its potential as a clinical biomarker. Further studies are warranted to validate 17-OHP as a predictor of pregnancy outcomes.

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目的评估精索静脉曲张修复对血清17-OH孕酮(17-OHP)水平的影响,并研究其与性腺功能低下和优生优育患者的精液参数和妊娠结局之间的关系。此外,该研究还旨在解决男性不育症中精索静脉曲张与血清 17-OHP 水平之间关系不明确的问题:这项前瞻性研究包括135名接受显微镜下精索静脉曲张切除术的男性。分析了术前和术后(3-6 个月)的激素水平,包括卵泡刺激素(FSH)、黄体生成素(LH)、总睾酮(TT)和 17-OHP,以及精液参数,如总活力精子计数(TMS)和精子形态。患者被归类为性腺功能低下(TT 结果):仅在性腺功能低下的男性中观察到 TT 和 17-OHP 水平的显著增加,而两组患者的 TMS 和精子形态均有所改善。在性腺功能低下的男性中,血清 17-OHP 水平(Δ-17-OHP)的变化与 TMS 的改善呈正相关(r=0.388,p=0.009)。此外,在性腺功能低下的患者中,尽管没有统计学意义,但与伴侣未怀孕的男性相比,伴侣怀孕的男性血清中的Δ-17-OHP含量更高:结论:精索静脉曲张修复术可改善性腺功能低下和优生男性的精液参数。在性腺功能低下的男性中,Δ-17-OHP的增加与TMS的改善有关,突出了其作为临床生物标志物的潜力。还需要进一步的研究来验证 17-OHP 作为妊娠结果预测指标的有效性。
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来源期刊
Urology
Urology 医学-泌尿学与肾脏学
CiteScore
3.30
自引率
9.50%
发文量
716
审稿时长
59 days
期刊介绍: Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.
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