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十一酸睾酮作为特发性少精子症患者绝经后促性腺激素或枸橼酸他莫昔芬补充治疗的内分泌效应

Endocrine effects of testosterone undecanoate as a supplementary treatment to menopausal gonadotropins or tamoxifen citrate in idiopathic oligozoospermia.

作者信息

Adamopoulos D A, Nicopoulou S, Kapolla N, Vassilopoulos P, Karamertzanis M, Kontogeorgos L

机构信息

Endocrine Department, Elena's Hospital, Athens, Greece.

出版信息

Fertil Steril. 1995 Oct;64(4):818-24. doi: 10.1016/s0015-0282(16)57860-1.

DOI:10.1016/s0015-0282(16)57860-1
PMID:7672156
Abstract

OBJECTIVE

To evaluate the effects of T undecanoate given as a supplementary treatment with tamoxifen citrate (TAM) or hMG on pituitary and Leydig cell function in men with idiopathic oligozoospermia.

DESIGN

A total of 48 normogonadotropic men with idiopathic oligozoospermia were allocated in to six groups (n = 8 per group) treated with placebo, 40 mg T undecanoate three times per day, 10 mg TAM two times per day, T undecanoate and TAM, 75 IU/d hMG, and T undecanoate and hMG. All groups were evaluated with standard GnRH, thyrotropin-releasing hormone, and hCG tests before and on the final day of 3 months on treatment with measurements of FSH, LH, thyroid-stimulating hormone (TSH), PRL, T, E2, 17-hydroxyprogesterone, sex hormone-binding globulin, and seminal analyses (at least twice each time).

RESULTS

Basal and stimulated concentrations and incremental FSH and LH values showed no differences among TAM or hMG and TAM + T undecanoate or hMG + T undecanoate treated groups. Basal, stimulated, and incremental values for TSH and PRL were elevated markedly during treatment in most groups in comparison to placebo. Basal, stimulated, and incremental T and E2 values were similar in active treatment groups except that higher T concentration was found in TAM + T undecanoate as compared with T undecanoate only treated men. Finally, significant improvements were noted in important seminal parameters and particularly in the functional sperm fraction of the TAM + T undecanoate group as compared with single treatment with TAM.

CONCLUSION

These results indicate that T undecanoate in combination with TAM or hMG not only had no adverse effects on pituitary and Leydig cell activity but also seemed to improve important seminal parameters and signify that androgens may be tried as a supplementary treatment to conventional regimes in idiopathic oligozoospermia.

摘要

目的

评估癸酸睾酮作为枸橼酸他莫昔芬(TAM)或人绝经期促性腺激素(hMG)的辅助治疗药物,对特发性少精子症男性垂体和睾丸间质细胞功能的影响。

设计

将48名患有特发性少精子症的促性腺激素水平正常的男性分为六组(每组n = 8),分别接受安慰剂、每日三次40mg癸酸睾酮、每日两次10mg TAM、癸酸睾酮和TAM、每日75IU hMG以及癸酸睾酮和hMG治疗。在治疗前及治疗3个月的最后一天,所有组均接受标准促性腺激素释放激素、促甲状腺激素释放激素和人绒毛膜促性腺激素试验,测定卵泡刺激素(FSH)、黄体生成素(LH)、促甲状腺激素(TSH)、催乳素(PRL)、睾酮(T)、雌二醇(E2)、17-羟孕酮、性激素结合球蛋白,并进行精液分析(每次至少两次)。

结果

在接受TAM或hMG以及TAM + 癸酸睾酮或hMG + 癸酸睾酮治疗的组之间,基础和刺激状态下的浓度以及FSH和LH的增加值无差异。与安慰剂相比,大多数组在治疗期间TSH和PRL的基础、刺激状态下的值以及增加值均显著升高。活性治疗组中T和E2的基础、刺激状态下的值以及增加值相似,但与仅接受癸酸睾酮治疗的男性相比,TAM + 癸酸睾酮组的T浓度更高。最后,与单独使用TAM治疗相比,TAM + 癸酸睾酮组的重要精液参数,尤其是功能性精子比例有显著改善。

结论

这些结果表明,癸酸睾酮联合TAM或hMG不仅对垂体和睾丸间质细胞活性无不良影响,而且似乎能改善重要的精液参数,这意味着雄激素可作为特发性少精子症传统治疗方案的辅助治疗药物进行尝试。

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