甲状腺激素和性激素对男性生育能力的影响

Effects of thyroid hormones and sex hormones on male fertility

目的探讨甲状腺素和性激素对男性生育能力的影响。方法选取男性不育患者481例。对各组进行精液常规分析和生育力指数计算;检测精子DNA碎片率;采用化学发光法检测甲状腺激素[游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、促甲状腺激素(TSH)]和性激素[黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、泌乳素(PRL)、雌二醇(E2)];根据甲状腺激素水平分为低激素水平组(61例)、正常激素水平组(376例)和高激素水平组(44例)。分析甲状腺激素与性激素的相关性及T/E2、T/FSH、T/LH、T/PRL与精液参数、生育力指数的相关性。结果与正常水平激素组比较,低水平激素组前向运动率降低,高水平激素组前向运动率和生育力指数均降低,而畸形率升高(P<0.05)。患者FT3与PRL水平呈负相关,FT4与FSH、E2水平呈负相关,TSH与PRL水平呈正相关(P<0.05);T/E2与畸形率呈负相关,T/FSH与精子总数、精子浓度、前向运动率、生育力指数呈正相关,而与畸形率呈负相关(P<0.05),T/LH与精子总数、精子浓度呈正相关(P<0.01);T/PRL与畸形率呈负相关。结论甲状腺激素水平异常可影响男性生育能力,其水平升高时影响更加明显。

Objective To explore effects of thyroxine and sex hormone on male fertility.Methods A total of 481 male infertile patients were included in this study.Semen routine analysis and fertility index calculation were performed in each group.Sperm DNA fragmentation rate was detected.Chemiluminescence method was used to detect hyroid hormones[free triiodothy ronine(FT3),free tetraiodothyronine(FT4),thyrotropin(TSH)]and sex hormones[luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T),prolactin(PRL)andestradiol(E2)].According to thyroxine levels,patients were divided into the low hormone level group(61 cases),the normal hormone level group(376 cases)and the high hormone level group(44 cases).The correlation between thyroid hormone and sex hormone and the correlation between T/E2,T/FSH,T/LH,T/PRL,semen parameters and fertility index were analyzed.Results Compared with the normal hormone group,the forward motion rate was decreased in the low hormone group,the forward motion rate and fertility index were decreased in the high hormone group,and the malformation rate was increased(P<0.05).FT3 was negatively correlated with PRL level,FT4 was negatively correlated with FSH and E2 level,and TSH was positively correlated with PRL level(P<0.05).T/E2 was negatively correlated with the malformation rate,T/FSH was positively correlated with total sperm count,sperm concentration,forward motility rate and fertility index,but negatively correlated with the malformation rate(P<0.05).T/LH was positively correlated with total sperm count and sperm concentration(P<0.01).T/PRL was negatively correlated with the deformity rate.Conclusion Abnormal thyroid hormone levels can affect male fertility,and the effect is more pronounced at higher levels.