Orchiopexy: one procedure, two diagnoses - different male infertility outcomes.

Autor:	Newman NH; Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel.; Department of Pediatric Surgery, Soroka University Medical Center, Beer Sheva 84101, Israel., Farber I; Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel., Lunenfeld E; Adelson School of Medicine, Ariel University, Ariel 40700, Israel., Zeadna A; Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel.; IVF Unit, Diviation of Obstetrics and Gynecology, Soroka University Medical Center, Beer Sheva 84010, Israel., Vardi IH; Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel.; IVF Unit, Diviation of Obstetrics and Gynecology, Soroka University Medical Center, Beer Sheva 84010, Israel., Assi Z; Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel.; Department of Pediatric Surgery, Soroka University Medical Center, Beer Sheva 84101, Israel.
Jazyk:	angličtina
Zdroj:	Asian journal of andrology [Asian J Androl] 2024 Sep 01; Vol. 26 (5), pp. 472-478. Date of Electronic Publication: 2024 Apr 19.
DOI:	10.4103/aja202410
Abstrakt:	Abstract: Infertility, affecting one in six couples, is often related to the male partner's congenital and/or environmental conditions or complications postsurgery. This retrospective study examines the link between orchiopexy for undescended testicles (UDT) and testicular torsion (TT) in childhood and adult fertility as assessed through sperm analysis. The study involved the analysis of semen samples from 7743 patients collected at Soroka University Medical Center (Beer Sheva, Israel) between January 2009 and December 2017. Patients were classified into two groups based on sperm concentration: those with concentrations below 5 × 10 6 sperm per ml (AS group) and those above (MN group). Medical records and surgical histories were reviewed, categorizing orchiopexies by surgical approach. Among 140 individuals who had undergone pediatric surgery, 83 (59.3%) were placed in the MN group and 57 (40.7%) in the AS group. A higher likelihood of being in the MN group was observed in Jewish compared to Arab patients (75.9% vs 24.1%, P = 0.006). In cases of childhood UDT, 45 (78.9%) patients exhibited sperm concentrations below 5 × 10 6 sperm per ml ( P < 0.001), and 66 (76.7%) had undergone unilateral and 18 (20.9%) bilateral orchiopexy. Bilateral orchiopexy was significantly associated with lower sperm concentration, total motility, and progressive motility than unilateral cases ( P = 0.014, P = 0.001, and P = 0.031, respectively). Multivariate analysis identified UDT as a weak risk factor for low sperm concentration (odds ratio [OR]: 2.712, P = 0.078), with bilateral UDT further increasing this risk (OR: 6.314, P = 0.012). Jewish ethnicity and TT diagnosis were associated with a reduced risk of sperm concentrations below 5 × 10 6 sperm per ml. The findings indicate that initial diagnosis, surgical approach, and ethnicity markedly influence male fertility outcomes following pediatric orchiopexy. (Copyright © 2024 Copyright: ©The Author(s)(2024).)
Databáze:	MEDLINE
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