Effectiveness of two kind of medicine on non-obstructive azoospermia

摘要

Objective To assess the effectiveness of medicine on non-obstructive azoospermia (NOA). Cases 32 male patients were enrolled from March 2012 to March 2016, with age range of 23–41 years old and infertility time of 1–3 years. Methods According to “WHO Human Semen Detection and Processing Experiment Manual";;;;;; fifth edition, semen routine was based on manual detection and serum hormones based on chemiluminescence detection, semen volume, sperm density, forward moving sperm ratio. If sperm was detected in semen for more than two consecutive times, the treatment was considered effective and was included into the statistical analysis. The detection parameters took the first test data and the last test data. Treatment Andriol and tamoxifen were used for idiopathic NOA while aescuven forte and aspirin used for NOA with varicocele (including two varicocelectomy). The time was four months. Results Of the 32 patients, 13 underwent testicular biopsy, pathological results showed six patients (46 per cent) with hypospermatogenesis, five patients (39 per cent) with maturation arrest, and two patients (15 per cent) with sertoli cell syndrome. Nine patients (28 per cent) had varicocele; two patients (6 per cent) underwent surgical treatment. After treatment, sperm was detected in 20 patients (63 per cent), seven of them (22 per cent) had detectable sperm in semen after one month of treatment; five (19 per cent) had sperm after two months of treatment; eight (25 per cent) had sperm after three months of treatment. Among the 23 patients with idiopathic azoospermia, 13 patients had detectable sperm in semen after treatment (56 per cent). The level of hormone gradually increased in 15 patients, rapidly increased in four patients, but four patients had no obvious change of hormone level. Among the nine patients with varicocele, three persons (including one patient undergoing surgery) had normal sperm density after 3–4 months of treatment, continuing the treatment for another 2–3 months, wife of the patients gained pregnancies. After treatment, seven patients had gradually decreasing serum level of FSH, LH and T while two patients had increased serum level of hormones. Excluding the three pregnancy patients, it was showed that the sperm density increased (t=-3.342, p=0.004) after treatment, so did the forward moving sperm ratio (t=-4.037, p=0.001), but semen volume had no significant changes (t=-1.698, p=0.109). Conclusion The treatment of varococele is important for the NOA with varicocele while andriol and tamoxifen is other method for the treatment of idiopathic NOA.