Mouzannar A, Narasimman M, Patel P, Ramasamy R
Department of Urology, University of Miami Miller School of Medicine Miami, FL.
Northwestern University Evanston, IL.
Rev Urol. 2019;21(4):180-182.
Exogenous testosterone administration decreases intratesticular testosterone (ITT) significantly, an essential hormone for spermatogenesis. Therefore, treatment of patients with hypogonadotropic hypogonadism (HH) who desire infertility can be challenging. These patients are treated with recombinant follicle-stimulating hormone (FSH), clomiphene citrate, and human chorionic gonadotropin (hCG) to increase their ITT. However, there is no approved serum biomarker for ITT and it can only be measured via invasive testicular biopsy or aspiration. Previous authors have speculated that serum 17-hydroxyprogestrone (17-OHP) can be used as serum biomarker for ITT. In our case report, we demonstrate increase in 17-OHP associated with spermatogenesis after commencing treatment for infertility in patient with HH.
外源性睾酮给药会显著降低睾丸内睾酮(ITT)水平,而睾酮是精子发生所必需的激素。因此,对于有不育意愿的低促性腺激素性性腺功能减退(HH)患者进行治疗可能具有挑战性。这些患者接受重组促卵泡激素(FSH)、枸橼酸氯米芬和人绒毛膜促性腺激素(hCG)治疗以提高其ITT水平。然而,目前尚无经批准的用于检测ITT的血清生物标志物,且只能通过侵入性睾丸活检或抽吸来测量。此前有作者推测血清17-羟孕酮(17-OHP)可作为ITT的血清生物标志物。在我们的病例报告中,我们展示了一名HH患者开始不育治疗后,随着精子发生,其17-OHP水平升高。