Erkek hipogonadotropik hipogonadizm tanılı hastaların fertilizasyon oranlarının belirlenmesi ve fertilizasyonu etkileyen faktörlerin değerlendirilmesi

Year 2019, Volume: 29 Issue: 4, 157 - 162, 01.12.2019

Ferhat Bacaksız Faruk Kılınç Zafer Pekkolay Alpaslan Kemal Tuzcu

Abstract

Amaç: Hipogonadotropik hipogonadizm tanısıyla takip edilen hastaları retrospektif olarak tarayıp, bu hastalardaki fertilizasyon oranlarını, hormonal profili ve fertilizasyon düzeyini etkileyen faktörleri araştırmayı amaçladık.Gereç ve Yöntem: 2009-2015 yılları arasında Endokrinoloji polikliniğine başvurmuş olan erkek hipogonadizmi tanılı hastalar retrospektif olarak incelendi. 18 yaşından büyük 55 erkek hasta çalışmaya alındı.Hasta dosyalarından hastaların yaşı, boyu, ağırlığı ve testosteron düzeyleri incelendi. Tedavi öncesi TÖ ve tedavi sonrası TS testosteron,spermiogram parametreleri ve skrotal ultrasonografideki testis volümleri karşılaştırıldı.Bulgular: Ortalama testosteron seviyesiTÖ: 0.88±1,3 ng/ml , TS: 5.98±2.96 ng/ml olup, artış istatistiksel olarak anlamlıydı p

Keywords

Hipogonadotropik hipogonadizm, testosteron, testis volümü, spermiogram

References

• Shlomommed L, Kleinberg D. Hypogonadotropic Hypo- gonadism. In: Larsen R,Kronenberg HM, Melmed S (eds), Williams Text Book of Endocrinology (10nd ed) Saunder- s,Philadelphia 2003; 177-279.
• Jockenhövel F, Male Hypogonadısm, First Edition, UNI- MED Verlag AG, Bremen 2004;12-118.
• Burris AS, Rodbard HW, Winters SJ, et al. Gonadotropin therapy in men with isolatedhypogonadotropic hypogona- dism: The response to human chorionic gonadotropin is predictedby initial testicular size. J Clin Endocrinol Metab 1988; 66: 1144-9.
• Hani Hosseinifar, Marjan Sabbaghian, Mohammad Cheh- razi, et al. Assessment of Deoxyribonucleic Acid Fragmen- tation Index, Testicular Volume, Semen Parameters, and Hormone Profile in Gonadotropin-treated Men With Hy- pogonadotropic Hypogonadism. Infertility Urology 2013; 82: 1291-5.
• Pasquali R, Patton L, Gambineri A. Obesity and infertility. Curr Opin Endocrinol. Diabetes Obes 2007; 14: 482-7.
• Corona G, Rastrelli G, Morelli A, et al. Hypogonadism and metabolic syndrome. J Endocrinol Invest 2011; 34: 557-67.
• Corona G, Monami M, Rastrelli G, et al. Type 2 diabetes mellitus and testosterone: a metaanalysis study. Int J Androl 2011; 34: 528-40.
• Corona G, Monami M, Rastrelli G, et al. Testosterone and metabolic syndrome: a metaanalysis study. J Sex Med 2011; 8: 272-83.
• Corona G, Mannucci E, Forti G, Maggi M. Following the common association between testosterone deficiency and diabetes mellitus, can testosterone be regarded as a new therapy for diabetes? Int J Androl 2009; 32: 431-41.
• Saad F, Aversa A, Isidori AM, et al. Onset of effects of testos- terone treatment and time span until maximum effects are achieved. Eur J Endocrinol 2011; 165:675-85.
• A.A. Mac Donald, A.W. Stewart, and C.M. Farquhar. Body mass index in relation to semen quality and reproductive hormones in New Zeland men: a cross-sectional study in fertility clinics. Hum Reprod 2013; 28: 3178-87.
• Sermondade N, Faure C, Fezeu L, Shayeb AG, Bonde JP, Jensen TK, Van Wely M, Cao J, Martini AC, Eskandar M et al. BMI in relation to sperm count: an updated systematic review and collaborative meta-analysis. Hum Reprod Up- date 2012; 19: 1-11.
• Ishikawa T, Ooba T, Kondo Y, et al. Assessment of gonadot- ropin therapy in male hypogonadotropic hypogonadism. Fertil Steril. 2007; 88: 1697-9. 61.
• Farhat R, Al-zidjali F, Alzahrani AS. Outcome of gonadot- ropin therapy for male infertility due to hypogonadotrophic hypogonadism. Pituitary 2010; 13: 105-10.
• Miyagawa Y, Tsujimura A, Matsumiya K, et al. Outcome of gonadotropin therapy for male hypogonadotropic hypogo- nadism at university affiliated male infertility centers: a 30- year retrospective study. J Urol 2005; 173: 2072-5.
• Liu PY, Gebski VJ, Turner L, et al. Predicting pregnancy and spermatogenesis by survival analysis during gonadotrophin treatment of gonadotrophin-deficient infertile men. Hum Reprod 2002; 17: 625-33.
• David W. Warne, Genevieve Decosterd, Hiroshi Okada, et al. A combined analysis of data to identify predictive factors for spermatogenesis in men with hypogonadotropic hypo- gonadism treated with recombinant human follicle-stimu- lating hormone and human chorionic gonadotropin. Fertil Steril 2009; 92: 594-604.
• Liu PY, Gebski VJ, Turner L, et al. Predicting pregnancy and spermatogenesis by survival analysis during gonadotrophin treatment of gonadotrophin-deficient infertile men. Hum Reprod 2002; 17: 625-33.
• Burris AS, Rodbard HW, Winters SJ, Sherins RJ. Gonadot- ropin therapy in men with isolated hypogonadotropic hy- pogonadism: the response to human chorionic gonadotro- pin is predicted by initial testicular size. J Clin Endocrinol Metab 1988; 66: 1144-51.
• Jones TH, Darne JF. Self-administered subcutaneous hu- man menopausal gonadotrophin for the stimulation of testicular growth and the initiation of spermatogenesis in hypogonadotrophic hypogonadism. Clin Endocrinol (Oxf) 1993; 38: 203–8.
• Buchter D, Behre HM, Kliesch S, Nieschlag E. Pulsatile GnRH or human chorionic gonadotropin/human menopa- usal gonadotropin as effective treatment for men with hy- pogonadotropic hypogonadism: a review of42 cases. Eur J Endocrinol 1998; 139:298– 303.
• Dwyer AA. Best Practice 92 &Research Clinical Endocri- nology&Metabolism 2015; 29: 91-103.
• Peter Y. Liu, H. W. Gordon Baker, Veena Jayadev, et al. In- duction of Spermatogenesis and Fertility during Gonadot- ropin Treatment of Gonadotropin-Deficient Infertile Men: Predictors of Fertility Outcome. J ClinEndocrinol Metab 2009; 94: 801-8.
• Russell LD, Ren HP, SinhaHikim I, Schulze W, SinhaHikim AP. A comparative study in twelve mammalian species of volume densities, volumes, and numerical densities of se- lected testis components, emphasizing those related to the Sertoli cell. Am J Anat 1990; 188: 21-30.
• Corona G, Rastrelli G, Vignozzi L, Mannucci E &Maggi M. How to recognizelate-onset hypogonadism in men with sexual dysfunction. Asian J Androl 2012; 14: 251-9.