在一名患有严重少精子症的男性先天性肾上腺皮质增生症患者中，通过更换类固醇改善精液参数。
Improvement in semen parameters by switching steroids in a male congenital adrenal hyperplasia patient with severe oligozoospermia.
作者信息
Onishi Atsushi, Okada Keisuke, Sato Katsuya, Kaku Yasuhiro, Chiba Koji, Fujisawa Masato
机构信息
Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 6500017, Japan.
出版信息
Urol Case Rep. 2023 Mar 1;47:102368. doi: 10.1016/j.eucr.2023.102368. eCollection 2023 Mar.
Congenital adrenal hyperplasia (CAH) causes hypogonadotropic hypogonadism due to the excessive production of adrenal androgens, which results in hypospermatogenesis in some male patients. We herein present a CAH case with hypogonadotropic hypogonadism and male infertility. A 26-year-old male receiving steroid therapy for 21 hydroxylase deficiency was diagnosed with low gonadotropin levels, an elevated ACTH level, and severe oligozoospermia. The switching from hydrocortisone to dexamethasone resulted in the normalization of gonadotropin levels and semen findings. The couple underwent ICSI-ET, resulting in a live birth. In cases of CAH with hypospermatogenesis, the continuous suppression of ACTH by dexamethasone may restore spermatogenesis.
先天性肾上腺皮质增生症（CAH）由于肾上腺雄激素分泌过多导致低促性腺激素性性腺功能减退，这在一些男性患者中会导致精子发生减少。我们在此报告一例患有低促性腺激素性性腺功能减退和男性不育症的CAH病例。一名因21-羟化酶缺乏接受类固醇治疗的26岁男性被诊断为促性腺激素水平低、促肾上腺皮质激素（ACTH）水平升高和严重少精子症。从氢化可的松换用地塞米松后，促性腺激素水平和精液检查结果恢复正常。这对夫妇接受了卵胞浆内单精子注射-胚胎移植（ICSI-ET），并成功分娩。在患有精子发生减少的CAH病例中，地塞米松持续抑制ACTH可能会恢复精子发生。
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