男性不妊症に対する新しい内分泌治療

Abstract

We undertook a prospective trial to compare the efficacy and adverse effects of a gonadotropin releasing-hormone analogue (GnRHa) and clomiphene citrate therapy for idiopathic normogonadotropic oligoasthenozoospermia (INOA). Fifty-nine newly-diagnosed INOA patients were randomly allocated to treatment with GnRHa or clomiphene citrate. Efficacy was assessed by measuring changes in semen parameters prior to and after 3 months of treatment. Thirty-six INOA patients underwent GnRHa therapy with 15 microg of diluted buserelin acetate given once a day intranasally, and 23 INOA patients were treated with 50 mg of clomiphene citrate daily by oral administration. The mean sperm density in the GnRHa group increased from 13.7 x 10(6)/ml to 22.1 x 10(6)/ml (p < 0.01), while the mean sperm density did not change significantly in the group treated with clomiphene. Similarly, the mean sperm motility increased from 35.9% to 43.9% in the GnRHa group (p < 0.05), but did not significantly change in the clomiphene group. No adverse effects were observed in either group. This GnRHa treatment protocol can be administered on an outpatient basis and is hoped to be of benefit to INOA patients.