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Fertil Steril:雄激素缺乏生育力低下男性接受阿那曲唑 结局有何改善?

2017-04-14 选题审校:顾歆纯 编辑:吴刚 环球医学编写

2017年3月,发表在《Fertil Steril》的一项由美国科学家进行的研究考察了阿那曲唑在少精症雄激素缺乏生育力低下男性中的结局。

2017年3月,发表在《Fertil Steril》的一项由美国科学家进行的研究考察了阿那曲唑在少精症雄激素缺乏生育力低下男性中的结局。

目的:旨在确定阿那曲唑治疗的雄激素缺乏生育力低下男性中,精子参数的改变是否与对治疗具有应答的男性的睾酮(T)与雌激素比值的增加幅度相关。

设计:回顾性研究。

设置:男性生育诊所。

患者:研究组由86名T与雌二醇(E2)比值较低的雄激素缺乏生育力低下的男性(78人)或之前对枸橼酸氯米芬具有负面反应的男性(8人)组成。

干预:所有患者每天都接受阿那曲唑1mg口服给药治疗。

主要结局测量:研究人员在治疗前和治疗后进行了激素分析和精子分析。激素分析包括总T、E2、性激素结合球蛋白、白蛋白、FSH、LH的测量,并计算了生物可利用的T。从精子分析中计算活动精子总数。

结果:总共95.3%的患者在阿那曲唑治疗后血清T增加,血清E2降低。阿那曲唑治疗的21名少精症雄激素缺乏生育力低下男性中的18人,其精子浓度和活动精子总数改善。这些男性中,活动精子总数的增加幅度与T/E2比的改变显着相关。表现为无精症、隐匿精子症或精子量正常的男性,其精子参数无改善。

结论:将近95%的雄激素缺乏男性,其内分泌参数改善,少精症男性的子集(约所有患者的25%),其精子参数显着改善。在该患者子集中,精子参数的增加与T/E2比值的改变相关,指出了治疗的生理效应。

原始出处:Shoshany O,et al.Outcomes of anastrozole in oligozoospermic hypoandrogenic subfertile men.Fertil Steril. 2017 Mar;107(3):589-594. doi: 10.1016/j.fertnstert.2016.11.021. Epub 2017 Jan 6.


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