Ebisu Tsuji Clinic, 1-14-10 Ebisu-minami, Shibuya-ku, Tokyo, 150-0022, Japan.
CEN Case Rep. 2024 Dec;13(6):479-483. doi: 10.1007/s13730-024-00874-2. Epub 2024 Apr 8.
Autosomal-dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disease characterized by the formation of numerous cysts in organs other than the kidneys. Although female patients with ADPKD do not have direct fertility problems, infertility in male patients may arise following the formation of cystic lesions in the lower seminal tract, which impair the function of spermatozoa. Generally, the treatment strategy for necrospermia depends on the severity of sperm viability, and intracytoplasmic sperm injection may be offered to patients with necrospermia. We report two cases of secondary infertility in men with ADPKD. These men experienced an inability to reproduce naturally after the previous birth of a child, suggesting a progressive deterioration of semen quality. Semen analysis showed necrospermia in both patients, and transrectal ultrasound revealed marked dilatation of the seminal vesicles bilaterally. The main cause of secondary infertility in male patients with ADPKD is sperm death resulting from progressive dilatation of seminal vesicles. Further research is needed on the appropriate follow-up schedule for men with ADPKD who desire to reproduce naturally.
常染色体显性遗传多囊肾病（ADPKD）是最常见的遗传性肾脏疾病，其特征是除肾脏外的其他器官形成大量囊肿。虽然 ADPKD 女性患者没有直接的生育问题，但男性患者在下生殖道形成囊状病变后可能会出现不育，这会损害精子的功能。一般来说，对于死精子症的治疗策略取决于精子活力的严重程度，对于死精子症患者可能会提供胞浆内精子注射。我们报告了两例 ADPKD 男性的继发性不孕病例。这两名男性在之前生育一个孩子后自然生育能力丧失，表明精液质量逐渐恶化。精液分析显示两名患者均为死精子症，直肠超声显示双侧精囊明显扩张。ADPKD 男性患者继发性不孕的主要原因是由于精囊进行性扩张导致精子死亡。对于希望自然生育的 ADPKD 男性，需要进一步研究适当的随访时间表。
