Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Endocrine. 2019 Nov;66(2):381-385. doi: 10.1007/s12020-019-01983-0. Epub 2019 Jun 25.
A reduction of testicular volume (TV) represents an important clinical sign, which may hide sperm abnormalities and predispose to hypogonadism.
The primary purpose of this study was to evaluate the serum levels of total testosterone after treatment with urofollitropin in selected patients with male infertility and idiopathic mild reduction of testicular volume.
In this 1-year-long prospective design, patients with abnormal sperm parameters, mild reduction in TV (8-12 mL) and normal gonadotropin, and total testosterone (TT) serum levels were recruited in this study. Patients treated for 4 months with urofollitropin were included in group A, those treated with intracytoplasmatic sperm injection due to a female-factor infertility were included in group B. Hormone values, sperm parameters, and TV were detected at baseline (T0), after 4 (T1) and 12 months (T2) in group A and at T0 and T2 in group B.
Group A (n = 80) showed increased follicle-stimulating hormone (FSH) at T1 and sperm morphology at T1 and T2 compared to T0 (all p < 0.05). Group B (n = 50) had lower TT and higher FSH levels at T2 compared to T0 (all p < 0.05). At T2, TT, VT, total sperm count, progressive motility, total motility, and sperm morphology were higher in group A compared to group B (all p < 0.05).
Reduced TV may predispose to infertility and hypogonadism. FSH treatment may improve Sertoli and Leydig cell function and prevent the development of hypogonadism.
睾丸体积(TV)减少是一个重要的临床征象,可能隐藏精子异常并导致性腺功能减退。
本研究的主要目的是评估尿促卵泡素治疗后特发性轻度睾丸体积减少的男性不育患者的总睾酮血清水平。
在这项为期 1 年的前瞻性设计中,招募了精子参数异常、睾丸体积轻度减少(8-12mL)和正常促性腺激素及总睾酮(TT)血清水平的患者。接受尿促卵泡素治疗 4 个月的患者纳入 A 组,因女性因素不孕接受胞浆内精子注射治疗的患者纳入 B 组。在 A 组中,在基线(T0)、4 个月(T1)和 12 个月(T2)时检测激素值、精子参数和 TV,在 B 组中,仅在 T0 和 T2 时检测这些值。
A 组(n=80)在 T1 时 FSH 升高,T1 和 T2 时精子形态学升高,与 T0 相比均有统计学差异(均 p<0.05)。B 组(n=50)在 T2 时 TT 降低,FSH 升高,与 T0 相比均有统计学差异(均 p<0.05)。在 T2 时,A 组的 TT、VT、总精子计数、前向运动精子比例、总运动精子比例和精子形态学均高于 B 组(均 p<0.05)。
睾丸体积减少可能导致不孕和性腺功能减退。FSH 治疗可能改善 Sertoli 和 Leydig 细胞功能,预防性腺功能减退的发生。