Boucher D, Grizard G, Hermabessiere J, Gaillard G, Pays J
Andrologia. 1983 Jan-Feb;15(1):78-89. doi: 10.1111/j.1439-0272.1983.tb00120.x.
Infertile men with varicocele or idiopathic infertility were compared with a control group. Spermocytograms were taken and the following radioimmunological plasma analyses carried out: testosterone, FSH and LH before and after 50 micrograms LRH, Prolactin (PRL) before and after 200 micrograms TRH; in addition, 8 patients with varicoceles and 3 controls received LRH intravenously (0.4 microgram/min.) for 4 hours. The binding of [125I] human chorionic gonadotrophin (hCG) to testicular tissue obtained by biopsy from 10 infertile men was also investigated. Of the parameters studied, no differences were found between the unilateral or bilateral varicoceles. In the two groups of infertile men, sperm motility and percentage normal forms were similar and significantly lower than in controls. As compared to the controls, in the groups of infertile men, basal LH and testosterone levels were no different but basal FSH levels was increased, basal PRL was higher (p less than 0.05) in the varicocele group. Responses of the LH, FSH and PRL to LRH and TRH stimulations were generally higher in infertile men than in controls. As compared to the idiopathic infertile men, testosterone levels and responses of plasma FSH to LRH injection were lower in varicocele group. Moreover, in infertile men with varicocele, age was correlated negatively with sperm motility and testosterone level and it was correlated positively with LH response to LRH injection. For each patient, testicular tissue was able to specifically bind [125I]hCG, but in some cases of varicoceles, hCG binding capacity was different in the two testes and seemed higher than that observed in men with obstructive azoospermia. These results suggest: 1) dysfunction in both spermatogenesis and Leydig cells with a compensatory hyperfunction of the pituitary gland in infertile men with varicocele; 2) worsening in Leydig cells and tubular lesions with longer duration of varicocele; and 3) absence of any gross abnormality in hCG binding to its specific receptors in the testis of men with varicocele. These data suggest varicoceles may play a causal role in infertility.
将患有精索静脉曲张或特发性不育症的男性与对照组进行比较。采集精子细胞图，并进行以下放射免疫血浆分析：50微克促性腺激素释放激素（LRH）前后的睾酮、促卵泡激素（FSH）和促黄体生成素（LH），200微克促甲状腺激素释放激素（TRH）前后的催乳素（PRL）；此外，8例精索静脉曲张患者和3例对照者静脉注射LRH（0.4微克/分钟），持续4小时。还研究了从10例不育男性活检获得的睾丸组织对[125I]人绒毛膜促性腺激素（hCG）的结合情况。在所研究的参数中，单侧或双侧精索静脉曲张之间未发现差异。在两组不育男性中，精子活力和正常形态百分比相似，且显著低于对照组。与对照组相比，不育男性组的基础LH和睾酮水平无差异，但基础FSH水平升高，精索静脉曲张组的基础PRL更高（p<0.05）。不育男性中LH、FSH和PRL对LRH和TRH刺激的反应通常高于对照组。与特发性不育男性相比，精索静脉曲张组的睾酮水平和血浆FSH对LRH注射的反应较低。此外，在患有精索静脉曲张的不育男性中，年龄与精子活力和睾酮水平呈负相关，与LH对LRH注射的反应呈正相关。对于每位患者，睾丸组织能够特异性结合[125I]hCG，但在某些精索静脉曲张病例中，两个睾丸的hCG结合能力不同，且似乎高于梗阻性无精子症男性中观察到的结合能力。这些结果表明：1）精索静脉曲张不育男性的精子发生和睾丸间质细胞均存在功能障碍，垂体存在代偿性功能亢进；2）精索静脉曲张持续时间越长，睾丸间质细胞恶化和小管病变越严重；3）精索静脉曲张男性睾丸中hCG与其特异性受体结合未发现任何明显异常。这些数据表明精索静脉曲张可能在不育中起因果作用。
