Matsumoto A M, Karpas A E, Bremner W J
J Clin Endocrinol Metab. 1986 Jun;62(6):1184-92. doi: 10.1210/jcem-62-6-1184.
The role of FSH in the maintenance of spermatogenesis in man is poorly understood. To determine whether normal serum levels of FSH are necessary for the maintenance of quantitatively normal spermatogenesis, we first studied the effect on sperm production of selective FSH deficiency induced by chronic administration of hCG in normal men. Then, we determined the effect of FSH replacement in some of these men. After a 3-month control period, eight normal men (aged 30-39 yr) received 5000 IU hCG, im, twice weekly for 7 months. Then while continuing the same dosage of hCG, subjects simultaneously received 200 mg testosterone enanthate (T), im, weekly for an additional 6 months. hCG administration alone resulted in partial suppression of the mean sperm concentration from 88 +/- 24 (+/-SEM) million/ml during the control period to 22 +/- 7 million/ml during the last 4 months of hCG treatment (P less than 0.001 compared to control values). With the addition of T to hCG, sperm counts remained suppressed to the same degree. Except for one man who became azoospermic while receiving hCG plus T, sperm motilities and morphologies remained normal in all subjects throughout the entire study. During both the hCG alone and hCG plus T periods, serum FSH levels were undetectable (less than 25 ng/ml), and urinary FSH levels were comparable to those in prepubertal children and hypogonadotropic hypogonadal adults. We replaced FSH activity in four of the eight men in whom prolonged selective FSH deficiency and partial suppression of sperm production were induced by hCG administration. Immediately after the period of hCG plus T administration, T was stopped in four men who continued to receive hCG alone (5000 IU, im, twice weekly) for 3 months. Then, while continuing the same dosage of hCG, these men received 100 IU human FSH, sc, daily (n = 2) or 75 IU human menopausal gonadotropin, sc, daily (n = 2) for 5-8 months. During the second period of hCG administration alone, serum FSH levels were undetectable (less than 25 ng/ml), and sperm concentrations were suppressed (34 +/- 13 million/ml) compared to the control values for these four men (125 +/- 39 million/ml; P less than 0.001). With the addition of FSH to hCG, FSH levels increased (213 +/- 72 ng/ml) and sperm concentrations rose significantly, reaching a mean of 103 +/- 30 million/ml (P less than 0.03 compared to hCG alone).(ABSTRACT TRUNCATED AT 400 WORDS)
促卵泡激素（FSH）在维持男性精子发生过程中的作用目前仍知之甚少。为了确定正常血清水平的FSH对于维持定量正常的精子发生是否必要，我们首先研究了在正常男性中通过长期注射人绒毛膜促性腺激素（hCG）诱导选择性FSH缺乏对精子产生的影响。然后，我们测定了其中一些男性补充FSH后的效果。在3个月的对照期后，8名正常男性（年龄30 - 39岁）每周两次肌肉注射5000 IU hCG，共7个月。之后，在继续使用相同剂量hCG的同时，受试者每周一次肌肉注射200 mg庚酸睾酮（T），持续6个月。单独给予hCG导致平均精子浓度从对照期的88±24（±SEM）百万/ml部分抑制至hCG治疗最后4个月的22±7百万/ml（与对照值相比，P<0.001）。在hCG中添加T后，精子计数仍被抑制至相同程度。除了一名在接受hCG加T治疗时变为无精子症的男性外，所有受试者在整个研究过程中精子活力和形态均保持正常。在单独使用hCG和hCG加T的时期，血清FSH水平均检测不到（<25 ng/ml），尿FSH水平与青春期前儿童和低促性腺激素性性腺功能减退的成年人相当。我们对8名男性中的4名进行了FSH活性补充，这4名男性因注射hCG导致长期选择性FSH缺乏和精子产生部分抑制。在hCG加T给药期结束后，4名男性停止使用T，继续单独接受hCG（每周两次肌肉注射5000 IU）3个月。然后，在继续使用相同剂量hCG的同时，这些男性每天皮下注射100 IU人FSH（n = 2）或75 IU人绝经期促性腺激素（n = 2），持续5 - 8个月。在单独使用hCG的第二个时期，血清FSH水平检测不到（<25 ng/ml），与这4名男性的对照值（125±39百万/ml；P<0.001）相比，精子浓度被抑制（34±13百万/ml）。在hCG中添加FSH后，FSH水平升高（213±72 ng/ml），精子浓度显著上升，平均达到103±30百万/ml（与单独使用hCG相比P<0.03）。（摘要截断于400字）
