Relationships between serum hormone levels and semen quality among men from an infertility clinic
Relationships between serum hormone levels and semen quality among men from an infertility clinic
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DOI：
10.2164/jandrol.106.001545
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发表时间：
2007-05-01
影响因子：
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通讯作者：
Hauser, Russ
中科院分区：
文献类型：
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作者：
Meeker, John D.;Godfrey-Bailey, Linda;Hauser, Russ
关于精液质量的流行病学研究的参与率通常很低，这引发了人们对潜在的选择偏见的担忧。由于激素既启动并维持精子发生，它们在流行病学研究中可作为精液质量的替代物。为此，在本研究中，我们探讨了生殖激素和甲状腺激素对作为不育夫妇伴侣的男性精液质量的影响和预测能力。在1999至2003年间，388名男性从马萨诸塞州综合医院男科实验室招募，以进行生育状况的临床评估。对新鲜精液进行质量评价(浓度、活力和形态)，并测定血清激素水平，包括卵泡刺激素(FSH)、黄体生成素(LH)、抑制素B、性激素结合球蛋白(SHBG)、睾酮、游离雄激素指数、游离T-4、总T-3和促甲状腺激素(TSH)。多元Logistic回归显示，FSH升高的男性精子密度和形态低于参考值的几率增加，抑制素B升高的男性低于参考值的精子密度和活动率降低。当FSH和抑制素B被划分为五分位数时，与精子密度的关系显示出阈值的证据。然而，特异性卵泡刺激素(10IU/L)和/或抑制素B(80pg/mL)对精液质量的预测能力低于以往的报道。在多元线性回归分析中，FSH和LH值与精子密度、活动率和形态呈负相关。抑制素B和游离T-4与精子密度呈正相关，而睾酮与精子活力呈正相关。综上所述，我们发现FSH、LH、抑制素B、睾酮和游离T-4水平与人类精液参数有关。在由于后勤和/或志愿者费率限制而难以收集精液的表皮病学研究中，还应考虑将血清激素水平作为精液质量的替代指标。
Participation rates in epidemiologic studies on semen quality are generally very low, raising concerns as to the potential for selection bias. Since hormones both initiate and maintain spermatogenesis, they may serve as surrogates of semen quality in epidemiologic studies. For this reason, in the present study, we explored the influence and predictive ability of reproductive and thyroid hormones on semen quality among men who were partners in an infertile couple. Between 1999 and 2003, 388 men were recruited from Massachusetts General Hospital Andrology Laboratory for clinical evaluation of fertility status. Fresh semen samples were assessed for quality (concentration, motility and morphology) and the serum levels of hormones, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), inhibin B, sex hormone-binding globulin (SHBG), testosterone, free androgen index, free T-4, total T-3, and thyroid-stimulating hormone (TSH), were measured. Multiple logistic regression revealed increased odds for below-reference sperm concentration and morphology in men with increased FSH, and decreased odds for below-reference sperm concentration and motility in men with increased inhibin B. When FSH and inhibin B were divided into quintiles, the relationships with sperm concentration showed evidence of a threshold value. However, the ability of specific FSH (10 IU/L) and/or inhibin B (80 pg/mL) cutoff values to predict semen quality was lower than in previous reports. In multiple linear regression analysis, FSH and LH were inversely associated with sperm concentration, motility, and morphology. Inhibin B and free T-4 were positively associated with sperm concentration, while there was a suggestive positive association between testosterone and sperm motility. In conclusion, we have found that FSH, LH, inhibin B, testosterone and free T-4 levels are associated with human semen parameters. Additional consideration should be given to the utility of serum hormone levels as a surrogate for semen quality in epidermiologic studies in which the collection of semen is difficult due to logistical and/or volunteer rate constraints.