Liu Si-Tian, Gui You-Lun, Lin Cui-Hong, He Chang-Hai
Fudan University, Shanghai, China.
Asian J Androl. 2004 Mar;6(1):41-6.
To explore the causes of the difference in spermatogenic suppression between responders and non-responders in Chinese men treated with levonorgestrel (LNG) implants plus testosterone undecanoate (TU) injectable.
The 16 Chinese volunteers treated were divided into two groups in regard to the sperm count during the treatment period, 7 men in the responder group (Group R), including 6 azoospermia and one severe oligozoospermia, and the remaining 9 in the non-responder group (Group N), including 4 oligozoospermia and 5 with sperm counts greater than 20 x 10(6)/mL. The differences in serum profiles of FSH, LH, T, LNG and T/LH ratio were compared between the two groups and the correlation between the seminal fluid parameters and serum reproductive hormones was analyzed.
The serum FSH level was lower in Group R than that in Group N (P<0.05), while the serum LH and LNG levels were higher in Group R than those in Group N (P<0.05). The sperm density (P<0.01, r=0.235), motility(P<0.01, r=0.326) and vitality (P<0.01, r=0.219) showed significantly positive correlation with the serum FSH level.
The blood LNG and T levels, the degree of FSH inhibition and/or the sensitivity of the pituitary-testis axis to exogenous steroids, as well as the individual spermatogenetic potential and the functional status of the Leydig cells may be factors bringing about individual differences in spermatogenic suppression in Chinese men treated with LNG and TU.
探讨左炔诺孕酮（LNG）皮下埋植联合十一酸睾酮（TU）注射治疗中国男性时，反应者与无反应者生精抑制差异的原因。
16名接受治疗的中国志愿者根据治疗期间的精子计数分为两组，反应者组（R组）7人，包括6例无精子症和1例严重少精子症；其余9人为无反应者组（N组），包括4例少精子症和5例精子计数大于20×10⁶/mL者。比较两组血清卵泡刺激素（FSH）、黄体生成素（LH）、睾酮（T）、LNG及T/LH比值的差异，并分析精液参数与血清生殖激素之间的相关性。
R组血清FSH水平低于N组（P<0.05），而R组血清LH和LNG水平高于N组（P<0.05）。精子密度（P<0.01，r=0.235）、活力（P<0.01，r=0.326）和活率（P<0.01，r=0.219）与血清FSH水平呈显著正相关。
血液中LNG和T水平、FSH抑制程度和/或垂体-睾丸轴对外源性类固醇的敏感性，以及个体生精潜能和睾丸间质细胞的功能状态，可能是导致LNG和TU治疗中国男性生精抑制个体差异的因素。
