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DOI: 10.1055/s-2001-11905
Georg Thieme Verlag Stuttgart · New York
Behandlung der idiopathischen männlichen Infertilität mit rekombinantem FSH: Ergebnisse einer kontrollierten Studie
Recombinant Follicle-Stimulating Hormone for Treatment of Idiopathic Male InfertilityPublication History
Publication Date:
31 December 2001 (online)
Zusammenfassung
Fragestellung
Ziel der vorliegenden Studie war es, den Einfluss von rekombinantem FSH auf die Ejakulatparameter idiopathisch infertiler Männer mit normogonadotroper Oligoasthenoteratozoospermie (OAT-Syndrom) zu untersuchen.
Patienten und Methoden
44 idiopathisch infertile Männer mit der Diagnose eines OAT-Syndroms (Einschlusskriterien: Spermienkonzentration < 20 Mio./ml; progressive Motilität < 50 %; Normalformen < 30 %) wurden über einen Zeitraum von 6 Wochen mit 75 IE recFSH (Gonal-F ®, Serono) behandelt. Etwa 2 Wochen nach Beendigung der Behandlung erfolgte eine erneute Ejakulatanalyse zur Überprüfung des Therapieeffektes. Als Kontrollgruppe dienten 44 Patienten der andrologischen Sprechstunde, die im Rahmen der Erstuntersuchung ein OAT-Syndrom aufwiesen und sich innerhalb von 6 - 8 Wochen einer Kontrolluntersuchung unterzogen, ohne dass zwischenzeitlich eine Behandlung erfolgte.
Ergebnisse
Die Dauer des Kinderwunsches wurde in der Behandlungsgruppe mit M = 57 Monaten (Spanne 12 - 193) und in der Kontrollgruppe mit M = 61 Monaten (Spanne 29 - 118) angegeben. Zu Beginn der Untersuchung gab es keine signifikanten Unterschiede bezüglich der durchschnittlichen Spermienkonzentration (M = 5,5 Mio. vs. 5,1 Mio. Spermatozoen/ml), der Progressivmotilität (M = 19,6 % vs. 30,8 %) bzw. des Anteils morphologischer Normalformen (M = 8,9 % vs. 15 %) zwischen der Behandlungs- und der Kontrollgruppe. In der Kontrolluntersuchung zeigte sich ein Anstieg der durchschnittlichen Spermienkonzentration sowohl in der Behandlungs- als auch in der Kontrollgruppe (M = 9,1 Mio. vs. 10,7 Mio. Spermatozoen/ml). Alle anderen Parameter blieben unverändert.
Schlussfolgerung
Die Behandlung des normogonadotropen OAT-Syndroms mit rekombinantem FSH mit einer Dosis von 75 IE täglich über 6 Wochen hat keinen Effekt auf die konventionellen Ejakulatparameter.
Summary
Objective
We prospectively studied the effect of recombinant follicle-stimulating hormone (FSH) in men with normogonadotropic oligoasthenoteratospermia.
Methods
A total of 44 men with idiopathic oligoasthenoteratospermia (sperm concentration < 20 × 106/mL, progressive motility < 50 %, normal forms < 30 %) received 75 IU of recombinant FSH daily for 6 weeks. Semen analysis was performed 2 weeks after the completion of treatment. The treated men were compared with 44 men with idiopathic oligoasthenoteratospermia who were observed without treatment for 6 - 8 weeks after initial diagnosis. The mean duration of infertility was 57 months (range, 12 - 193) in the treatment group and 61 months (range, 29 - 118) in the control group. At baseline there were no significant differences between the two groups in mean sperm concentration (5.5 × 106 vs. 5.1 × 106/mL, respectively), progressive motility (20 % vs. 31 %, respectively), or normal morphology (8.9 % vs. 15 %).
Results
Sperm concentration increased both in the treatment and in the control group (9.1 × 106 and 10.7 × 106/mL). The other parameters were unchanged.
Conclusion
Treatment of normogonadotropic oligoasthenoteratospermia with FSH at a dose of 75 IU/day for 6 weeks did not influence semen parameters.
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Priv.-Doz. Dr. C. Keck
Universitäts-Frauenklinik
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Email: CKECK@FRK.ukl.uni-freiburg.de