Department of Endocrinology 2132, Rigshospitalet, Faculty of Health Science, University of Copenhagen, Blegdamsvej 3, Copenhagen, Denmark.
Department of Growth and Reproduction 5064, Rigshospitalet, Faculty of Health Science, University of Copenhagen, 5064, Copenhagen, Denmark.
Pituitary. 2020 Apr;23(2):160-166. doi: 10.1007/s11102-019-01018-x.
Growth hormone (GH) activity might be implicated in male reproductive function. One previous study has suggested significantly reduced semen quality in untreated acromegalic patients due to both reduced sperm counts and sperm motility.
A retrospective study comprising ten uncontrolled hypogonadal acromegalic patients (median age 29 years) who delivered semen for cryopreservation before initiation of testosterone therapy. Semen variables and hormone concentrations were compared to those of ten non-acromegalic hypogonadal men with pituitary disease (age 31 years) and those of young healthy men.
Acromegalic patients vs. non-acromegalic patients had a higher percentage of progressive motile spermatozoa (62 vs. 47%, p = 0.04). Eight of ten acromegalic patients and 82% of controls had total sperm counts above 39 million and progressive motile spermatozoa above 32% (p = 0.55), corresponding to the WHO 2010 reference levels for expected normal fertility for these variables. Non-acromegalic patients vs. healthy controls had reduced percentage of progressive motile spermatozoa (47 vs. 57%, p = 0.02) and only five of ten patients had semen quality above the WHO reference level, which was significantly lower than observed in healthy controls (p = 0.022). Total sperm counts were similar between both patient groups and controls. There were no differences in reproductive hormone levels between acromegalic patients vs. non-acromegalic patients (p-values between 0.10 and 0.61). Compared to healthy controls both patient groups had severely reduced serum testosterone, calculated free testosterone.
Despite severe hypoandrogenism acromegalic patients had semen quality similar to healthy controls based on determination of the number of progressively motile spermatozoa. By contrast non-acromegalic pituitary patients had reduced sperm motility. Our data do not support reduced semen quality in acromegaly.
生长激素（GH）的活性可能与男性生殖功能有关。此前的一项研究表明，未经治疗的肢端肥大症患者由于精子数量和精子活力均降低，精液质量显著下降。
一项回顾性研究纳入了 10 例未经治疗的性腺功能减退性肢端肥大症患者（中位年龄 29 岁），他们在开始睾酮治疗前为冷冻保存精液而提供精液。比较了肢端肥大症患者与 10 例患有垂体疾病的非肢端肥大症性腺功能减退男性（年龄 31 岁）和年轻健康男性的精液变量和激素浓度。
肢端肥大症患者与非肢端肥大症患者的前向运动精子百分比更高（62% vs. 47%，p=0.04）。10 例肢端肥大症患者中有 8 例和 82%的对照组的总精子数超过 3900 万，前向运动精子数超过 32%（p=0.55），这与这些变量的世卫组织 2010 年预期正常生育力的参考水平相符。非肢端肥大症患者与健康对照组相比，前向运动精子百分比较低（47% vs. 57%，p=0.02），只有 10 例患者中的 5 例精液质量超过世卫组织参考水平，显著低于健康对照组（p=0.022）。两组患者和对照组的总精子数相似。肢端肥大症患者与非肢端肥大症患者之间的生殖激素水平无差异（p 值在 0.10 至 0.61 之间）。与健康对照组相比，两组患者的血清睾酮和计算的游离睾酮水平均严重降低。
尽管存在严重的性腺功能减退症，肢端肥大症患者的精子质量与健康对照组相似，依据是前向运动精子数的测定。相比之下，非肢端肥大症的垂体患者精子活力降低。我们的数据不支持肢端肥大症患者的精液质量降低。
