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用绒毛膜促性腺激素治疗隐睾后的生育能力(作者译)

[Fertility after treatment with HCG for undescended testes (author's tranls)].

作者信息

Richter W, Pröschold M, Butenandt O, Knorr D

出版信息

Klin Wochenschr. 1976 May 15;54(10):467-73. doi: 10.1007/BF01469047.

Abstract

151 out of 212 adolescents having had been treated by human chorionic gonadotrophin (HCG) before puberty because of undescended testes, were re-examined 7 to 12 years later at an individual age of at least 17 years. In 121 of them a semen specimen for sperm counts could be obtained. In 10 patients, however, no ejaculate could be collected because of their hypogonadism. 78 of these 121 patients examined by sperm count had a sufficient testicular descensus after HCG treatment. In 43 adolescents HCG therapy failed, therefore subsequent orchidopexy was performed. A normal sperm count was seen in only 39 per cent of the 121 patients. After unilateral testicular maldescensus 18%, after bilateral maldescensus 43% of the patients had to be evaluated as prospectively infertile. Maier and Spann reported sperm counts below 10(6)/ml in 9 out of 17 patients with bilateral maldescensus who had been treated by surgery alone. In the present study, however, only 9 out of 35 individuals treated for bilateral maldescensus by HCG alone showed sperm counts below 10(6)/ml. Plasma LH and FSH concentrations were determined in 93 patients, 6 out of which showed hypergonadotrophic values of FSH and sperm counts below 10(7)/ml. Subsequently, 3 cases of Klinefelter's syndrome could be diagnosed among the total group of 121 patients. The etiology of testicular maldescensus is by no means uniform since anatomical, endocrine and/or chromosomal factors are involved.

摘要

212名因隐睾在青春期前接受过人类绒毛膜促性腺激素(HCG)治疗的青少年中,有151名在7至12年后、个体年龄至少为17岁时接受了复查。其中121名可以获得精液样本进行精子计数。然而,有10名患者由于性腺功能减退无法收集到射精样本。在这121名接受精子计数检查的患者中,78名在HCG治疗后睾丸下降充分。43名青少年的HCG治疗失败,因此随后进行了睾丸固定术。121名患者中只有39%的精子计数正常。单侧睾丸下降不全的患者中,18%、双侧睾丸下降不全的患者中,43%被评估为预期不育。迈尔和施潘报告,17名单独接受手术治疗的双侧睾丸下降不全患者中有9名精子计数低于10⁶/ml。然而,在本研究中,仅接受HCG治疗双侧睾丸下降不全的35名个体中只有9名精子计数低于10⁶/ml。对93名患者测定了血浆促黄体生成素(LH)和促卵泡生成素(FSH)浓度,其中6名患者FSH呈高促性腺激素值且精子计数低于10⁷/ml。随后,在121名患者的总群体中诊断出3例克兰费尔特综合征。隐睾的病因绝非单一,因为涉及解剖、内分泌和/或染色体因素。

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