PDF(Pubmed)
Abstract：
Isolated follicle-stimulating hormone (FSH) deficiency is a rare cause of infertility in both sexes, and only a few cases have been reported in Japan. This is a case report of a young male patient with isolated FSH deficiency and azoospermia who was successfully treated with human menopausal gonadotropin (hMG). A 28-year-old male patient was referred for azoospermia. The delivery at his birth was uneventful and a family history of infertility or hypogonadism was not observed. The testes volume was 22/24 mL (right/left). No varicocele was observed in the ultrasound, and no sign or symptom of hypogonadism was found. In the semen analysis, however, the sperm concentration was as low as 2.5×106/mL and the motility was less than 1%. The endocrine panel revealed luteinizing hormone (LH) (2.1 mUI/mL, normal values 0.8-5.7 mUI/mL) and testosterone (6.57 ng/ml, normal values 1.42-9.23 ng/mL) were normal, while the FSH level was very low (0.6 mUI/mL, normal values 2.0-8.3 mIU/mL). The odor and the karyotype 46, XY, were normal. The brain MRI scans showed no abnormal findings. Genitalia and potency were normal. The diagnosis was made of isolated FSH with severe oligoastenozoospermia clinically. FSH replacement therapy was employed. The patient self-injected 150 units of hMG three times a week. After 3 months of the treatment, the sperm concentration and motility went up to 264×106/mL and 12%, respectively. At 5 months, the patient\'s spouse conceived naturally, and at 7 months the treatment was terminated. During the treatment, FSH rose to the normal range, while other test items showed no change. The patient\'s health condition was uneventful. The spouse delivered a healthy boy. In conclusion, for isolated FSH with severe oligoastenozoospermia, hMG can be as effective as recombinant human FSH (rh-FSH), although the dosage remains a matter of discussion.
摘要：
孤立的卵泡刺激素（FSH）缺乏是男女不育的罕见原因，日本只报道了几例。这是一例年轻男性患者的病例报告，该患者患有孤立的FSH缺乏症和无精子症，并成功地用人绝经促性腺激素（hMG）治疗。一名28岁男性患者因无精子症转诊。出生时分娩顺利，未观察到不育或性腺功能减退的家族史。睾丸体积为22/24mL(右/左)。超声检查未观察到精索静脉曲张,没有发现性腺机能减退的迹象或症状。在精液分析中，然而,精子浓度低至2.5×106/mL，运动性小于1％。内分泌面板显示黄体生成素（LH）（2.1mUI/mL，正常值0.8-5.7mUI/mL）和睾酮（6.57ng/ml，正常值1.42-9.23ng/mL）正常，而FSH水平非常低(0.6mUI/mL，正常值2.0-8.3mIU/mL)。气味和核型46，XY，是正常的。脑部MRI扫描显示没有异常发现。生殖器和效力正常。临床诊断为分离的FSH伴严重的少精子症。采用FSH替代疗法。患者每周三次自我注射150单位的hMG。经过3个月的治疗，精子浓度和活力达到264×106/mL和12%，分别。5个月时,病人的配偶自然怀孕，在7个月时终止治疗。在治疗过程中,FSH升至正常范围,其他检测项目无变化。病人的健康状况是平静的。配偶生了一个健康的男孩。总之,对于分离的FSH患有严重的少缩精子症，hMG可以与重组人FSH（rh-FSH）一样有效，虽然剂量仍然是一个讨论的问题。
