Hudson R W
Division of Endocrinology and Metabolism, Queen's University and the Kingston General Hospital, Kingston, Ontario, Canada.
Fertil Steril. 1996 Aug;66(2):299-304.
To measure free T, free E2, and sex hormone-binding globulin (SHBG) levels in oligozoospermic men with varicoceles.
Retrospective study.
Sixty-four infertile patients with varicoceles.
A university-based tertiary care referral center.
Assessment of seminal cellular characteristics, gonadotropin responses to GnRH, total and free T, and E2 and SHBG levels before and after varicocele ligation.
Thirty-eight men had excessive preoperative gonadotropin responses to GnRH. These men had lower than normal levels of free T and higher than normal levels of free E2 and SHBG. Thirty men had improvements in seminal parameters, and sex steroid and SHBG values after surgery. Seven spontaneous pregnancies and three pregnancies through IUI occurred in their partners postoperatively. Twenty-six men had normal preoperative responses to GnRH and normal free T, E2 and SHBG levels. None had postoperative improvements in their semen analyses and no spontaneous pregnancies occurred in their partners. Three pregnancies occurred with IUI.
The men with excessive responses to GnRH had abnormal free sex steroid levels. The majority had improvements in semen analyses after varicocele repair and pregnancies occurred in their partners. The men with normal gonadotropin responces to GnRH had normal free sex steroid levels. Varicocele ligation had no effect on their semen parameters or fertility potential.
测量患有精索静脉曲张的少精子症男性的游离睾酮（free T）、游离雌二醇（free E2）和性激素结合球蛋白（SHBG）水平。
回顾性研究。
64例患有精索静脉曲张的不育患者。
一所大学附属的三级医疗转诊中心。
评估精索静脉曲张结扎术前和术后的精液细胞特征、促性腺激素对促性腺激素释放激素（GnRH）的反应、总睾酮和游离睾酮、雌二醇及SHBG水平。
38名男性术前促性腺激素对GnRH反应过度。这些男性的游离睾酮水平低于正常，游离雌二醇和SHBG水平高于正常。30名男性术后精液参数、性类固醇和SHBG值有所改善。其伴侣术后有7例自然受孕和3例通过宫腔内人工授精（IUI）受孕。26名男性术前对GnRH反应正常，游离睾酮、雌二醇和SHBG水平正常。他们术后精液分析均无改善，伴侣也未出现自然受孕情况。通过IUI有3例受孕。
对GnRH反应过度的男性游离性类固醇水平异常。大多数男性精索静脉曲张修复术后精液分析有所改善，其伴侣受孕。对GnRH促性腺激素反应正常的男性游离性类固醇水平正常。精索静脉曲张结扎术对其精液参数或生育潜力无影响。
