Yang Ronald M, Fefferman Richard A, Shapiro Charles E
Department of Urology, Kaiser Permanente Medical Center, Los Angeles, California 90027, USA.
Fertil Steril. 2005 Jan;83(1):223-5. doi: 10.1016/j.fertnstert.2004.08.018.
To report a case of an azoospermic man diagnosed with 21-hydroxylase deficiency congenital adrenal hyperplasia who successfully conceived with intrauterine insemination (IUI) after hormonal and clomiphene citrate (CC) treatment.
Case report.
Outpatient practice and academic hospital.
PATIENT(S): A 32-year-old azoospermic man who presented for evaluation of male factor infertility.
INTERVENTION(S): Semen analysis, ultrasonography, endocrinologic assays, hormonal treatment, CC, and IUI.
MAIN OUTCOME MEASURE(S): Semen analysis demonstrating increased sperm count and motility, ultrasonography demonstrating persistent nodules in bilateral testes, endocrinologic assays demonstrating elevated FSH and LH after CC treatment.
RESULT(S): Successful intrauterine pregnancy after IUI using the patient's sperm.
CONCLUSION(S): Clomiphene citrate treatment in addition to hormonal manipulation in azoospermic patients with congenital adrenal hyperplasia can be successful in improving sperm count and motility to allow for successful conception using IUI. The presumed adrenal rests in the testes may not involute after adrenal suppression.
报告一例被诊断为21-羟化酶缺乏先天性肾上腺皮质增生症的无精子症男性患者，在接受激素及枸橼酸氯米芬（CC）治疗后通过宫内人工授精（IUI）成功受孕的病例。
病例报告。
门诊及学术医院。
一名32岁的无精子症男性，因男性因素不孕症前来评估。
精液分析、超声检查、内分泌测定、激素治疗、CC及IUI。
精液分析显示精子数量及活力增加，超声检查显示双侧睾丸存在持续性结节，内分泌测定显示CC治疗后促卵泡生成素（FSH）及促黄体生成素（LH）升高。
使用患者精子经IUI后成功宫内妊娠。
对于先天性肾上腺皮质增生症的无精子症患者，除激素处理外，枸橼酸氯米芬治疗可成功提高精子数量及活力，从而通过IUI实现成功受孕。睾丸中推测的肾上腺残余组织在肾上腺抑制后可能不会消退。
Zotero 插件