Spermatogenesis improved by suppressing the high level of endogenous gonadotropins in idiopathic non-obstructive azoospermia: a case control pilot study

被引：27

作者：

Hu, Xuechun ^{[1
]}

Ding, Zheng ^{[2
]}

Hong, Zhiwei ^{[1
,3
]}

Zou, Zhichuan ^{[1
]}

Feng, Yuming ^{[1
]}

Zhu, Ruilou ^{[4
,5
]}

Ma, Jinzhao ^{[1
]}

Ge, Xie ^{[1
]}

Li, Chaojun ^{[4
,5
]}

Yao, Bing ^{[1
]}

机构：

[1] Nanjing Univ, Sch Med, Nanjing Jinling Hosp, Ctr Reprod Med, Nanjing 210002, Jiangsu, Peoples R China

[2] Nanjing Med Univ, Affiliated Jiangning Hosp, Nanjing Jiangning Hosp, Nanjing 210000, Jiangsu, Peoples R China

[3] Fujian Prov Hosp, Dept Urol, Fuzhou 350000, Fujian, Peoples R China

[4] Nanjing Univ, Natl Resource Ctr Mutant Mice, MOE Key Lab Model Anim Dis Study, Model Anim Res Ctr, Nanjing 210061, Jiangsu, Peoples R China

[5] Nanjing Univ, Natl Resource Ctr Mutant Mice, Sch Med, Nanjing 210061, Jiangsu, Peoples R China

来源：

REPRODUCTIVE BIOLOGY AND ENDOCRINOLOGY | 2018年 / 16卷

基金：

中国博士后科学基金;

关键词：

Gonadotropin reset; NOA; GnRH alpha; TESTICULAR SPERM EXTRACTION; FOLLICLE-STIMULATING-HORMONE; HUMAN CHORIONIC-GONADOTROPIN; SERTOLI-CELL; LUTEINIZING-HORMONE; INFERTILE MEN; RAT TESTIS; TIGHT JUNCTIONS; MOUSE TESTIS; INHIBIN-B;

D O I：

10.1186/s12958-018-0401-7

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Elevated plasma gonadotropins were associated with desensitization of Sertoli and Leydig cells in the male testis. Testis spermatogenesis ability would be improved via inhibiting high endogenous gonadotropin in patients with severe oligozoospermia. Whether it would be beneficial for non-obstructive azoospermia (NOA) patients was still unclear. Methods: Goserelin, a gonadotropin releasing hormone agonist (GnRH alpha) was used to suppress endogenous gonadotropin levels (gonadotropin reset) in the NOA patients, improving the sensitization of the Sertoli and Leydig cells. Then human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG) were injected to stimulate them to ameliorate the ability of testicular spermatogenesis. The main outcome measure was the existence of spermatozoa in the semen or by testicular sperm extraction (TESE). Elevation of inhibin B and/or ameliorative expression pattern of ZO-1 was the secondary objective. Results: A total of 35 NOA men who failed to retrieve sperm via TESE were enrolled. Among these, 10 patients without treatment were selected as control group and secondary TESE was performed 6 months later. Of the 25 treated men, inhibin B was elevated in 11 patients in the first 4 weeks (Response group), while only 5 patients had constant increase in the following 20 weeks (Response group 2). Of the 5 men, 2 men acquired sperm (Response group 2B), while 3 failed (Response group 2A). Immunofluorescence of mouse vasa homologue (MVH) and ZO-1 showed that both positive MVH signals and ZO-1 expression were significantly increased in the Response group 2, but only Response group 2B showed ameliorative ZO-1 distribution. Conclusions: Gonadotropin reset, a new therapeutic protocol with GnRH alpha, was able to improve the ability of testicular spermatogenesis in the NOA patients through restoring the sensitivity of Sertoli and Leydig cells, which were reflected by elevated inhibin B and ameliorative ZO-1 expression and distribution.

引用

页数：10

共 41 条

[1] EVIDENCE THAT SECRETION OF IMMUNOACTIVE INHIBIN BY SEMINIFEROUS TUBULES FROM THE ADULT-RAT TESTIS IS REGULATED BY SPECIFIC GERM-CELL TYPES - CORRELATION BETWEEN INVIVO AND INVITRO STUDIES [J].