Buvat J
Association pour l'Etude de l'Appareil Reproducteur et de la Psychosomatique, Lille.
J Gynecol Obstet Biol Reprod (Paris). 1996;25(3):223-32.
Many hormonal treatments have been tried in idiopathic oligospermia because of the physiologic roles of the hormones FSH and testosterone in regulation of spermatogenesis, the possibility of increasing spermatogenesis in normal monkeys by increasing their serum FSH up to supraphysiologic levels, and of several hormone abnormalities reported in this condition (abnormal pulsatile release of LH and thus probably of LHRH, abnormal bioactivity of FSH, compensated hyperestrogenism). None of these treatments proved to be effective until now, though a modest beneficial effect cannot be totally excluded for some of them, because of the poor discriminating power of most of the trials. Many methodological difficulties do indeed hamper the objective assessment of male infertility treatments. Pulsatile administration of LHRH, human menopausal gonadotropins, androgens, bromocriptine, and angiotensin-converting enzyme inhibitors are definitely uneffective or without practical interest. A beneficial effect of the anti-estrogens clomifene and tamoxifene cannot be excluded. It would be modest, increasing the annual pregnancy rate from 18 to 30%, only in case of normogonadotropic oligospermia. The possibility of increasing the vitro fertilization success rate by treating the oligospermic males with purified FSH needs confirmation. Whatever the benefit, it would not reach the success rate of intracytoplasmic injection of spermatozoa.
由于促卵泡激素（FSH）和睾酮在精子发生调节中的生理作用、将正常猴子血清FSH水平提高到超生理水平可增加精子发生的可能性，以及在特发性少精子症中报告的几种激素异常情况（促黄体生成素（LH）脉冲式释放异常，因此促性腺激素释放激素（LHRH）可能也异常、FSH生物活性异常、代偿性高雌激素血症），人们已经在特发性少精子症中尝试了多种激素治疗方法。到目前为止，这些治疗方法均未被证明有效，不过由于大多数试验的鉴别力较差，其中一些治疗方法的适度有益效果也不能完全排除。许多方法学上的困难确实阻碍了对男性不育治疗的客观评估。脉冲式给予LHRH、人绝经期促性腺激素、雄激素、溴隐亭和血管紧张素转换酶抑制剂肯定无效或没有实际意义。抗雌激素药物克罗米芬和他莫昔芬的有益效果不能排除。只有在促性腺激素正常的少精子症患者中，其效果才会适度，将年妊娠率从18%提高到30%。用纯化的FSH治疗少精子症男性以提高体外受精成功率的可能性需要得到证实。无论有何益处，都无法达到胞浆内单精子注射的成功率。
