Oehninger S, Pike I, Slotnick N
The Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk 23507, USA.
Obstet Gynecol. 1998 Oct;92(4 Pt 2):652-3. doi: 10.1016/s0029-7844(98)00082-9.
The clinical association of hemochromatosis and infertility is rare. Hemochromatosis may affect fertility through a variety of mechanisms.
A 44-year-old man and his 36-year-old wife presented with primary infertility of 7 years' duration. The husband was diagnosed as having idiopathic hemochromatosis, abnormal glucose tolerance, and hypogonadism accompanied by impotence, retrograde ejaculation, and azoospermia. Treatment consisted of phlebotomies followed by gonadotropins, which corrected retrograde ejaculation and improved semen characteristics. Concomitant pelvic factors in the woman were corrected endoscopically. After failure of pregnancy with ovulation stimulation and intrauterine inseminations, a singleton pregnancy was achieved by in vitro fertilization, augmented with intracytoplasmic sperm injection.
This case underscores the need to consider advanced reproductive technologies after the failure of specific, first-line therapeutic options in infertile couples.
血色素沉着症与不孕症的临床关联较为罕见。血色素沉着症可能通过多种机制影响生育能力。
一名44岁男性及其36岁妻子因原发性不孕前来就诊，病程长达7年。该男性被诊断为患有特发性血色素沉着症、糖耐量异常及性腺功能减退，伴有阳痿、逆行射精和无精子症。治疗方法包括放血疗法，随后使用促性腺激素，这纠正了逆行射精并改善了精液特征。同时，通过内镜纠正了女方的盆腔因素。在排卵刺激和宫腔内人工授精未能成功受孕后，通过体外受精并辅以卵胞浆内单精子注射实现了单胎妊娠。
本病例强调了在不孕夫妇一线特定治疗方案失败后，需要考虑采用先进生殖技术。
