| Varicocele is a common disease in men. It means blood flow siltation caused by spermatic venous plexus plexiform expansion,tortuous,and variable length. The incidence of the disease in the general male population is about 2% -22.6%. According to WHO requirements,one couple have been unable to achieve pregnancy after one year of unprotected intercourse for the reasons of man,the diagnosis is male infertility. About 5.7% -41% in male infertility patients suffer from varying degrees of varicocele. At present,for the treatment of varicocele,surgery is the primarily method. But the efficacy of surgical treatment is still controversial. This article collected the 75 cases from April 2006 to April 2008 for treatment in our department and the clinical base of the Institute for Reproductive Medicine of Jilin Province,and they have accepted checkup and ultrasound examination to confirm that they are infertility varicocele patients. A follow-up of patients with pregnancy rate has been done,then compare the difference among levels due to varicocele infertile patients with differences in pregnancy rate.Objective:To observe the difference of pregnant rate between the patients with varicocele and infertile after varicoceletomy and the patients with out operation,compare the rate of pregnancy in the patients with different level varicocele。Then compare the semen quality after the operation in the pregnant and unpregnant patients. To comprehend the effect of surgical treatment.Method: A diagnosis of VC were made in the group with ligations through chief complaint,physical sign and ultrasound in 75 cases . Abnormal semens were found in all of these cases after 3 analysises of their specimens. A follow-up had been done with these 75 cases of patients with ligation,and a comparison were made between with operation and without cases. Then the patients with pregnancy were grouped by the level of VC,campare the pregnancy rate among these groups. Analyze the change among different stages in semen of the 10 cases of such patients who pregnant and 11 patients without pregnant in the past 9-month follow-up. Statictical analysis: All the numeration data were analyzed byχ2 test and the measurement data were analyzed by Student t tests. Software SPSS 17.0 was applied for analyzing the data. A value of P<0.05 was considered to be statistically significant.Results: 75 cases were followed up successfully. In these cases,there are 23 cases who's wife has had a baby,in the other side ,there are also 52 cases haven't have baby. The pregnancy rate is 30.67% in these patients after varicoceletomy. Then we followed up 20 cases who haven't receive an operation. There are also 1 case whoes'wife has pregnanted,The pregnancy rate is 5%. We do aχ2 test between the two groups,the difference of the pregnancy rate is significant(P<0.05). The pregnancy rate was low in the patients with level III VC(10%). The specimen of semen from 10 cases in the pregnancy group and 11 cases from unpregnancy group in several period were analysised. There is no statistically significanty in the semen analysis of 3 month after operation,except the sperm morphology. The statistically significanty was found in 6 month and 9 month semen analysis (P<0.05).Conclusion: The controlled trials of high spermatic veins can improve the semen quality and enhance the fertility of the infertile patients with varicocele. We have found that the pregnancy rate is high if the operation is done in the early and light period of VC. In the opposite,these patients with high level VC and a long course of disease should be treated with drug after the operation and oberserve the effect by semen analysis. If these patients haven't had a baby in the two years after operation,then we should consider that if there are other factors that cause infertility. |
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