生殖激素检测在男性不育症诊断中的意义

本文报道了我院对３１５例男性不育症患者在第一次就诊时进行血清生殖激素ＦＳＨ、ＬＨ、Ｔ、ＰＲＬ、Ｅ２水平的检测，并进行详细的病史询问、常规体检和精液分析等检查。结果显示血清Ｔ值在不同的精子密度层次的男性不育症患者均呈正态分布。睾丸容积减少，ＦＳＨ、ＬＨ上升，Ｔ／ＬＨ下降，提示睾丸功能损害，并且Ｔ／ＬＨ的比值更能反映间质细胞的功能。血清ＰＲＬ和Ｅ２值在诊断高催乳素血症不育有意义，但在男性生育者和不生育者之间无明显差别。而且ＦＳＨ值在鉴别睾丸原发性与梗阻性无精子症是一项重要指标。作者讨论了血清生殖激素测定在不育症诊断中、在判定睾丸功能的损害程度中的意义。     

生殖激素检测在男性不育症诊断中的意义

本文报道了我院对３１５例男性不育症患者在第一次就诊时进行血清生殖激素ＦＳＨ、ＬＨ、Ｔ、ＰＲＬ、Ｅ２水平的检测，并进行详细的病史询问、常规体检测和精液分析等。结果显示血清Ｔ值在不同的精了密度层次的男性不育症患者均呈正态分布。     

男性不育患者精浆免疫球蛋白的测定与临床意义

对114例男性不育(包括前列腺炎、无精子症和抗精子抗体阳性者等)患者进行精浆免疫球蛋白IgG、HgA、IgM含量的测定,并与12例正常人对照,结果发现前列腺炎组的IgG值明显增高;IgG值增高与前列腺炎呈明显的正相关。表明此种检测可作为诊断前列腺炎的一个指标。     

Evaluation of serum level of Osteocalcin hormone in male infertility

The suggested concept of “bone as an endocrine organ” had shed the light on the role of osteocalcin, an osteoblast secreted hormone, in regulation of testosterone production. This study aimed to assess the association between the active undercarboxylated form of osteocalcin (ucOC) and semen parameters and hormonal levels in infertile male patients. The study was carried on 34 infertile male patients and 20 fertile healthy control males. Semen analysis and serum level of testosterone, LH and FSH were performed in addition to serum level of ucOC in cases and controls. The results revealed significant differences between cases and controls in all measured semen and hormonal parameters. In addition, significant higher level of ucOC in cases than control group (p = .019). On the other hand, ucOC was not related significantly to any of the measured hormones or semen parameters. There was no significant correlation between ucOC and sperm concentration, total motility, morphology (p = .594, .640, .940 respectively) and similarly between ucOC and testosterone level or LH level (p = .275, .954 respectively). The significant higher level of ucOC in infertile cases cannot be used as a predictor of male reproductive parameters.     

不育男性内分泌激素测定与精子密度相关研究

目的：探讨不育男性５项内分泌激素与精子密度的相关关系。方法：采取放免法（ＲＩＡ）对１１０例男性不育症进行卵泡刺激素（ＦＳＨ）、黄体生成素（ＬＨ）、催乳素（ＰＲＬ）、雌二醇（Ｅ２）、睾酮（Ｔ）的测定,实验值与同期检测的精子密度进行统计学相关分析。结果：＜４．６μｇ／Ｌ的Ｔ值与精子密度的等级相关系数ｒ＝０．７６０７（Ｐ＜０．００１）;＞１０Ｕ／Ｌ的ＦＳＨ、ＬＨ值与精子密度的等级相关系数分别是ｒ＝－０．５２８３（Ｐ＜０．００１）、ｒ＝－０．４５３１（Ｐ＜０．００５）。结论：低于正常的Ｔ值与精子密度呈正相关;高于正常的ＦＳＨ、ＬＨ值与精子密度呈负相关。     

217例男性不育症精子顶体酶检测与分析

目的　研究人精子顶体酶与男性不育之间的关系。　方法　 2 1 7例不育男性 ,年龄 2 4～ 43岁 ,根据精液常规检查结果分为不育 A、B两组 ;46例生育男性为对照组。手淫留取精液标本 ,常规洗涤后孵育 ,采用固定明胶底膜法检测精子顶体酶。　结果　正常生育组的精子顶体酶活性阳性率为 86.5% ,酶活性亮区直径为 42 .9μm。不育 A组酶活性阳性率为 57.0 % ,酶活性亮区直径为 3 8.5μm。不育 B组酶活性阳性率为3 5.2 % ,酶活性亮区直径为 2 7.5μm。经统计学处理 ,生育组与不育组之间精子顶体酶阳性率差异有显著性 ( P<0 .0 1 )。　结论　顶体酶阳性率和活力低下是男性不育的一个重要原因 ,精子顶体酶是受精过程中的关键酶     

性激素负反馈作用在男性不育诊疗中的应用

下丘脑-垂体-睾丸轴对男性的生殖功能起着关键性作用,下丘脑和垂体共同参与调控睾丸的甾体激素合成与精子发生;复杂的刺激和反馈机制通过神经腺成分来控制激素的合成和分泌。下丘脑和垂体均有大量雄、雌激素的受体,同时受睾酮及其芳香化产物(包括雌激素)的负反馈调节。利用男性生殖内分泌轴系中的负反馈作用,通过给予抗雌激素药物或芳香化酶抑制剂,可减弱睾酮及其芳香化产物的持续负反馈调节作用,增加内源性促性腺激素的分泌,而且还能去除雌激素对生精的副作用,恢复生精或提高精液质量。     

单精子卵胞浆内穿刺术治疗男性不育症的探讨(附23例报告)

目的：探讨单精子卵胞浆内穿刺椁（ＩＣＳＩ）治疗严重粗液异常和梗生无精子症所致不育的疗产。方法;对２３例严重精液异常和梗阻性无精子症患者施行ＩＣＳＩ,妇方行常规超促排卵以获取卵子并选择成熟的终卵细胞,同时采用手淫法、经皮附睾穿刺术（ＰＥＳＡ）和睾丸精子获取术（ＴＥＳＥ）以获得精液、附睾及睾丸精子行ＩＣＳＩ。结果：２３例２３个治疗周期共获卵３３２个,其中３００个成熟卵母细胞进行了ＩＣＳＩ,１９３（６４     

Genetic causes of male infertility

Summary.  Male infertility has often been ascribed to infections, immunologic factors, chemical insults or malformations. About 10% of infertile males have severe defects in sperm production. Lately, research has focused on possible genetic aetiologies. In this review genetic causes of male infertility are discussed. For pragmatic reasons three groups have been defined. In the first group, disorders of sexual differentiation associated with male infertility are considered. In the second group, male infertility is discussed in a context of some genetic diseases. In the third group, genetic causes for isolated defects of sperm production and function are reported.     

Redefining abnormal follicle-stimulating hormone in the male infertility population

Study Type – Diagnostic (validating cohort) Level of Evidence 2a What's known on the subject? and What does the study add? FSH is a hormone released by the anterior pituitary gland via stimulation from gonadotrophin‐releasing hormone and potentially other factors. FSH reflects the status of spermatogenesis (i.e. the ability to produce sperm) as a result of the feedback between the testis and hypothalamus/pituitary glands. An elevated FSH level is indicative of abnormal spermatogenesis and may indicate primary testicular failure. The range for ‘normal’ FSH varies somewhat between institutions but has been defined by the Strong Memorial Hospital (Rochester, NY, USA) clinical laboratory as 1.4–18.1 IU/L based on the ADVIA Centaur (Siemens Medical Solutions, Tarrytown, NY, USA) FSH assay. The findings obtained in the present study could be helpful for predicting male factor infertility in patients with a borderline high FSH level (≈4.5 IU/L) and a low testosterone level compared to someone with a borderline high FSH level and a normal testosterone level. Although the ‘normal’ range for FSH is qualified as a value in the range 1.4–18.1 IU/L, the present study shows that an FSH level >4.5 IU/L was associated with abnormal semen analysis in terms of morphology and sperm concentration in the present patient population. Therefore, these findings suggest that FSH values lower than those currently considered normal may be associated with abnormal semen analysis, and that the ‘normal’ range for FSH used in clinical settings may need to be reconsidered.

OBJECTIVE

• ? To examine the correlation between follicle‐stimulating hormone (FSH) and testosterone/FSH levels with semen analysis parameters to evaluate whether the range for judging normal FSH levels should be reconsidered.

PATIENTS AND METHODS

• ? The present study included 610 male infertility patients from a single urology infertility clinic between 2004 and 2008.
• ? Patients (n = 153) were excluded for obstructive azoospermia, hypogonadotrophic hypogonadism, steroid use or failure to complete testing.
• ? Abnormal semen analysis values were based on the WHO 1999 criteria.
• ? We performed t‐tests, anova , chi‐squared tests and logistic regression to statistically examine the association between the FSH (or testosterone/FSH ratio) level and semen parameters.

RESULTS

• ? The FSH level showed statistically significant associations, as well as evidence of a dose response, with abnormal sperm concentration and morphology but not with semen volume.
• ? In men with FSH levels >7.5 IU/L, the risk of abnormal semen quality was five‐ to thirteen‐fold higher than that of men with FSH levels <2.8 IU/L depending on the specific semen parameter.
• ? Similarly, semen parameters were had a greater probability of being abnormal with decreasing testosterone/FSH ratios.

CONCLUSION

• ? A significantly increased risk of abnormal semen analyses among men with FSH levels >4.5 IU/L and decreasing testosterone/FSH ratios suggests that redefining normal FSH in infertile men would be valuable.

     

男子不育症患者无精子因子检测的临床意义

本文对30例非梗阻性无精子症或严重少精子症患者及20例正常有生育能力的男子进行了AZF因子（AZFa、ZAFb和AZFc）检测,发现病人组中有4例患者存在着AZF因子不同区域片段的缺失,发生率为13．3％,而20例对照组男子均未发现相应部位的缺失。由此可见,精子发生与AZF因子存在有关。     

病毒感染与男性不育关系的研究进展

近年来研究发现病毒感染与不孕不育存在一定的联系,人类免疫缺陷病毒、乙肝病毒等感染不仅损伤生殖系统的功能、影响生育能力,而且也能够通过性接触传播而导致不育,病毒的遗传物质可通过干扰精卵正常受精或影响胚胎的正常着床导致不孕。在男性不育方面,病毒主要通过损伤睾丸功能和影响精子浓度、活力、形态以及DNA完整性使精子质量降低,影响正常精卵结合,进而导致男性生育能力下降甚至不育。本文就相关病毒感染与男性不育的关系做一综述。     

男性不育209例病因分析

本文报告了对２０９例男性不育患者进行遗传学、生殖内分泌、感染性疾病和抗精子免疫等４种导致不育病因研究的结果。并对４种主要病因检测的意义、睾丸不同发育状况与不同类型染色体异常的生殖激素水平变化的特点、解脲支原体感染与抗精子抗体产生的关系以及其它相关问题进行了分析。