庚酸睾酮诱导的无及少精子症者生殖激素和精子功能指标变化的观察

Dynamic changes fn hormonal profile and sperm functions in testosterone enanthate induced azoo-oligozoospermic men

本文报道两组接受庚酸睾酮(TE200mg/周16个月)正常育龄男子的精液分析、血清生殖激素、精子特殊功能的动态变化。结果:第一组(8名)血清 FSH、LH 和 T 给药前平均自身对照值分别为2.7、6.2IU/L和16.5nmol/L,注射后3、6、9、12个月 FSH 下降了63％;LH 下降了69.4～72.6％;T 升高176％～198％。平均经117.5±2.87天治疗后全部受试者均达到无精症,连续给药1年的女方无妊娠。3种激素在停药3个月后恢复到给药前水平,精子计数10～12个月恢复到正常范围。第二组(16名)在给药第一个月后精子计数开始下降的同时3种精子特殊功能均有显著下降,而同期精子活动率(a+b)却无显著改变。我们的结果表明:(1)同一剂量和疗程的 TE 导致中国人的无精于发生率远高于白种人,(2)这一激素方法是有效、可靠和可逆的男性避孕措施,(3)TE 的避孕机理除抑制精子发生外,似还有精子功能的早期损伤的抗生育效应。这一机理不同于 GnRH 拮抗剂(Nal-glu),后者仅降低精子计数和活动率,而无精子多元运动速度指标的任何改变。

This paper reports the dynamic changes of semen analysis,hormonal profile and sperm functions before and during weekly intramuscular injection of testos- terone enanthate(TE),200mg for 16 months.In the first 8 subjects the mean serum FSH,LH,and T levels before injection of TE were 2.4,6.2 IU/L and 16.5 nmol/L respectively.FSH decreased by 32.0～35.0% and LH by 27～29% of baseline levels,while T in- creased to 189～202% of baseline measured at 3,6,9, 12 months during injection of TE.The mean duration required for achieving azoospermia was 117.5 4±2.87 days.No pregnancy occurred during 12 months of TE administration with no other contraceptive method. After cessation of treatment in all azoospermic men the three reproductive hormones returned to pretreatment values in 3 months,while full recovery of sperm counts required 10～12 months. In another group of 16 volunteers treated with the same steroid regimen,sperm concentrations started to decrease in the 4th week with no change of mean motil- ity(grade a+b).Sperm motion multiparameters (SMP),zona free hamster oocyte penetration(HOP) and sperm-cervical mucous interaction(SCMI) were seriously impaired in the first month after treatment, as compared to the controls. Our results demonstrated that TE induced a- zoospermia in Chinese men was much higher than that in Caucasians.This hormonal regimen has proven to be an effective,reliable and reversible male contracep- tive.Regarding to the contraception mechanism of TE in addition to suppression of spermatogenesis,there seems to be an additional independent antifertility ef- fect of detective sperm functions,which is different from that with GnRH antagonist plus TE that causes only decrease of sperm count and motility but did not change the SMP.