De Aloysio D, Fronticelli A, Venturoli S, Farello P, Nardi M, Flamigni C
Acta Eur Fertil. 1977 Mar;8(1):1-59.
Radioimmunological methods have been used to assay the plasma concentrations of gonadotropins, androgens (expressed as the sum of testosterone and dihydrotestosterone) and 17beta-oestradiol in 98 patients suffering from dysspermia of variable etiology, after stimulation with GnRH, Clomiphene, L-Dopa, Cyclophenyl, HCG in various dosage schemes, and HMG. Results show L-Dopa and HMG tests to be of little value in assessing the endocrine function in infertile men. They also confirm, in keeping with data found in the literature the usefulness of dynamic stimulation with GnRH, Clomiphene, and HCG for purposes of andrologic diagnosis. The GnRH proved useful for the distinction between primary and secondary hypogonadotropism as well as for assessing the therapeutic efficacy of releasing factors. The functional efficacy of the endocrine axis which is often impaired in patients with dysspermia can be evaluated by the Clomiphene test. In the small number of cases in which it was applied, Cyclophenyl brought about changes in gonadotropin concentration which require further study. The HCG tests, to be performed in patients with lower than normal testosterone plasma lavels, permits the discrimination between primary and secondary Leydig cell deficiencies as well as the assessment of interstitial tissue sensitivity to chorionic gonadotropin stimulation. Of the three dosage schemes (5000 IU, 7500 IU "step up", 10.000 IU) the last one is most suitable for clinical use.
采用放射免疫法测定了98例不同病因的精子异常患者在接受GnRH、克罗米芬、左旋多巴、环苯丙胺、不同剂量方案的HCG以及HMG刺激后血浆中促性腺激素、雄激素（以睾酮和二氢睾酮之和表示）和17β-雌二醇的浓度。结果显示，左旋多巴和HMG试验在评估不育男性内分泌功能方面价值不大。研究结果还证实，与文献中的数据一致，GnRH、克罗米芬和HCG动态刺激在男科诊断中具有实用性。GnRH被证明有助于区分原发性和继发性性腺功能减退，以及评估释放因子的治疗效果。克罗米芬试验可评估精子异常患者中常受损的内分泌轴的功能功效。在少数应用环苯丙胺的病例中，其导致促性腺激素浓度发生变化，这需要进一步研究。对于睾酮血浆水平低于正常的患者进行HCG试验，可区分原发性和继发性睾丸间质细胞缺陷，以及评估间质组织对绒毛膜促性腺激素刺激的敏感性。在三种剂量方案（5000 IU、7500 IU“逐步增加”、10000 IU）中，最后一种最适合临床使用。
