| Objective By measuring the bilateral testicular volume of azoospermia and normal individuals with reproductive age, we tend to investigate the clinical value of diagnostic classification in obstructive azoospermia(OA) group and non-obstructive azoospermia(NOA) group. Related assessments includes testing the size of bilateral testicular volume and the relationship between reproductive hormones, Digit ratios. The study is aim to provide basis for azoospermia etiology and accurate diagnosis classification, thus improving the overall efficiency of diagnosis and treatment of azoospermia.Methods As experimental group, 109 patients diagnosed as azoospermia in the Center for Reproductive Medicine of General Hospital at Ningxia Medical University during the period of Jul.2013~Dec.2014 were chosen for further research. Whereas, 87 male outpatients received at the same time with normal semen were chosen as control group. We used LOGIQ P3 ultrasound to measure left and right testicular volume, chemiluminescence serum reproductive hormone levels, PCR to detect Y chromosome microdeletions(AZF), and electronic calipers to measure the lengthof fingers.Statistical analysis was carried out using the SPSS 17.0 software,with measurement data treated by t-test, enumeration data treated withχ2-test and the correlation test was carried out with pearson correlation analysis. ROC curve and AUC was used to optimized the testicular volume and reproductive hormone level, which helps decide the the optimal cut-off value and judge monitoring value.Results(1) The right side of testis volume control group was significantly greater than the left(15.06±2.37 vs. 13.79±2.34, p<0.05), the left and right side testicular volume study group was significantly less than the control group(9.30±4.25 vs. 13.79±2.34,10.49±4.81 vs. 15.06±2.37, both p <0.05).(2) Research Group LH, FSH was significantly higher(6.58±4.65 vs. 3.55±1.57, 13.43±11.32 vs. 4.59±3.42, both p <0.05), and T, T/LH, T/E2 values were significantly lower(455.04±196.74 vs. 529.35±174.14,114.59±110.46 vs. 171.46 ±100.42, 13.02±5.93 vs. 15.65±6.84, all p <0.05).(3)NOA serum LH and FSH was significantly higher than OA group(7.69± 5.17 vs. 3.38 ±2.21 and 16.41±12.38 vs. 7.49±5.18, both p <0.05), and T, T/LH, T/E2 belower than the OA group(403.93±189.87 vs. 554.16±172.58,83.92±77.96 vs. 175.05 ±138.32,11.74±5.64 vs.15.62±5.71, both p <0.05).(4) The left side of testicular volume and LH, FSH was negatively correlated(p <0.01), and T, T/LH, T/E2 values were positively correlated(p<0.01).(5) Research group karyotype abnormality and AZF deletion was significantly higher(13.76% vs. 0% and 3.67% vs. 0%).(6) For the experimental group,the left hand 2D:3D, 2D:4D was significantly lower than the control group(t =-0.2663,-2.454, both p <0.05). NOA and OA groups about finger length ratio were not statistically different(all p> 0.05).(7) The occurrence of ED in experimental group is higher than that of the control group(22.02% vs. 5.75%, p <0.05).Conclusions(1)Normal male reproductive right testis volume was significantly larger than the left testicle, there are physiological differences. NOA group testicular volume can be smaller than OA group.(2) It is of great significance for the anticipation of NOA if the volume of the left and right testis is smaller than 9.27 ml and 10.55 ml, respectively.(3)Serum FSH, LH, T, T/LH, T/E2 levels help diagnose NOA.(4)The occurrence of azoospermia karyotype abnormality and AZF positive rate was significantly increased(13.76% vs. 0% and 3.67% vs. 0%), suggesting that genetic factors are one of the important factor of azoospermia.(5) Left hand 2D:3D, 2D:4D is probably one of the reference index for azoospermia early screening.(6) Azoospermia may have erectile dysfunction, should be cured with sex counseling and intervention, prompting assisted reproductive technology treatment. |
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