남성불임증에서의 내분비술과 정액과당의 상호관계

Abstract

In order to ascertain possible correlationship between levels of plasma FSH, LH, testosterone and seminal fructose and male infertility, the following clinical studies were carried out on 50 subjects. These were divided into the following 4 groups: Group I (control group), 20 cases of normospermia; Group 2. 10 cases of obstructive post-testicular azcospermias Group 3, 13 cases of non-obstructive testicular azoo spermias; and Group 4, 7 cases of Klinefelter's syn drome. Parameters investigated were semen analyses, measurements of seminal fructose, plasma FSH, LH. and testosterone by radioimmunoassays, and testicular biopsy besides the routine laboratory works. Results are summarized as follows: I. Testis biopsy: Group 2, normal sperrnatogenesi with obstructive pattern; group 3, hyposperrnatogenesi or spermatogenic arrest at various levels; and grou 4, severe seminiferous tubular atrophy and/or hyalin ization. 2. Spermiogramme: Group I, liquefaction time, 2 minutes; pH, 7.5; volume, 2. 8ml; count, 110 million ml; motility, 65%; and normal morphology, 95%. 3. Levels of hormone and fructose: Group 1, plasm FSH. 12.1mlU/ml; LH, 9.2mlU/ml; testosterone, . 630. 4ng/dl; and seminal fructose. 301.: mg/dl. Grou ·2, FSH, 3.2mlU/ml; LH, 4.2mlU/ml; testosterone'l 540.0ng/dl; and seminal fructose. 315.2mg/dJ. Group 3, FSH, 6.6mlU/ml; LH. 7.3mlU/ml; testosterone. 518.8ng/dl; and seminal fructose. 257.2mg/dJ. Group 4, FSH, 29.9 mlU/ml; LH. 12.1mIU/ml; testosterone 422.0ng/dJ. 4. Values of high plasma FSH (p<0.05) and LH (p>O.O, but low testosterone (p<O.Ol) are consis· tent in group 4, even though severe Leydig cell hyperplasia exists in all the cases. 5. No statistical correlations are found between plasma testosterone levels in the ranges of 292~ l,060ng/dl and seminal fructose levels in the ranges .of 120~485mg/dl. (r=0.190, p>O.l) ,6. The seminal fructose levels in the normal ranges ((l20~485mg/dl) are not influenced by the concen. tration of plasma FSH 0. 0~20. OmlU/ml) and LH ·(0. 5~15. 9mlU/ml). 7. Low plasma testosterone levels in spite of severe Leydig cell hyperplasia in group 4 suggests perplexity .of Leydig cell responsiveness to the LH.