Matsumoto A M, Bremner W J
Baillieres Clin Endocrinol Metab. 1987 Feb;1(1):71-87. doi: 10.1016/s0950-351x(87)80053-8.
The normal physiology of the hypothalamic-pituitary-testicular axis in man is reviewed. According to current concepts, LH plays an important role in the initiation and maintenance of spermatogenesis by stimulating Leydig cell production of high concentrations of T within the testes. FSH is thought to be important in spermatid maturation (spermiogenesis) during the initiation of spermatogenesis by stimulation of Sertoli cells. Studies of selective gonadotrophin replacement in experimentally-induced hypogonadotrophic hypogonadal men demonstrate that qualitatively normal sperm production can be achieved by replacement of either LH or FSH alone, but both LH and FSH are necessary to maintain quantitatively normal spermatogenesis. Studies of gonadotrophin replacement in spontaneously-occurring hypogonadotrophic men suggest that the requirement for FSH activity to stimulate sperm production is greatest during the initiation of sperm production at the time of puberty. The initiation of spermatogenesis in postpubertal men with acquired hypogonadotrophic hypogonadism and the maintenance of spermatogenesis after its initiation can often be achieved with LH activity alone.
本文综述了男性下丘脑-垂体-睾丸轴的正常生理学。根据目前的概念，促黄体生成素（LH）通过刺激睾丸内的睾丸间质细胞产生高浓度的睾酮（T），在精子发生的启动和维持中发挥重要作用。促卵泡生成素（FSH）被认为在精子发生启动过程中，通过刺激支持细胞，对精子细胞成熟（精子形成）很重要。对实验性诱导的低促性腺激素性性腺功能减退男性进行选择性促性腺激素替代治疗的研究表明，单独补充LH或FSH均可实现质量上正常的精子生成，但LH和FSH两者对于维持数量上正常的精子生成都是必需的。对自然发生的低促性腺激素男性进行促性腺激素替代治疗的研究表明，在青春期精子生成开始时，刺激精子产生对FSH活性的需求最大。青春期后获得性低促性腺激素性性腺功能减退男性的精子发生启动及其启动后的维持通常仅通过LH活性即可实现。
