Divisions of Endocrinology, Metabolism and Nutrition, University of Washington School of Medicine, Seattle, WA, US.
Men's Health Clinic, University of Washington School of Medicine, Seattle, WA, US.
J Clin Endocrinol Metab. 2020 Dec 1;105(12):e4194-207. doi: 10.1210/clinem/dgaa390.
Male infertility secondary to oligozoospermia is surprisingly common. Although a majority of cases are idiopathic, oligozoospermia can be caused by endocrine dysfunction, anatomic abnormalities, medications, or environmental exposures. The work-up includes excluding reversible factors such as hormonal deficiency, medication effects, and retrograde ejaculation and identifying any underlying genetic syndrome and treating reversible medical causes. If no reversible cause is found, appropriate referrals to urology and assisted reproductive technology should be initiated. Lastly, clinicians should be aware of and respond to the psychological and general health ramifications of a diagnosis of oligozoospermia as part of the comprehensive care of men and couples struggling with a diagnosis of infertility.
男性少精子症导致的不育症非常常见。虽然大多数病例是特发性的,但少精子症可能由内分泌功能障碍、解剖异常、药物或环境暴露引起。检查包括排除激素缺乏、药物作用和逆行射精等可逆因素,以及确定任何潜在的遗传综合征并治疗可逆转的医学原因。如果没有发现可逆的原因,应向泌尿科和辅助生殖技术适当转诊。最后,临床医生应该意识到并应对少精子症诊断带来的心理和整体健康影响,这是对与不育症作斗争的男性和夫妇进行全面护理的一部分。