男子不妊症の臨床統計

Abstract

1976～1981年までに広島大学医学部附属病院泌尿器科不妊外来を受診した794例について集計した.1)不妊外来患者は男子外来患者に対して9.9%であり, 年齢分布では25～34歳が全体の76%を占めていた.不妊期間は結婚後2～5年が多く, これらで全体の約57%を占めていた.2)精液検査では無精子症が32.4%, 乏精子症(50×106 /ml以下)が47.7%で, この両者が全体の約80%であった.3)睾丸生検ではhypospermatogenesisが45.4%, Sertoli cell onlyが28.8%で, この両者で全体の84.2%であった.4)睾丸容積の減少にともなって血中gonadotropin (LH, FSH)は上昇したが, testosteroneは変化なかった.睾丸容積が12 ml以下ではほとんどの症例が無精子症であり, 睾丸容積の減少は高度の精細管機能障害が疑われた

A statistical analysis was performed on infertile male patients who visited our urological clinic between Jan. 1976 and Dec. 1981. The incidence of infertile male was 9.9% of the total male out-patients. Age distribution of most of the patients ranged from 25 to 34 years old. Infertile period was most commonly within 5 years after they had married. In semen analysis, the cases of azoospermia and oligozoospermia (less than 50 x 10(6)/ml) accounted for 80% of all the infertile males. Testicular histology showed hypospermatogenesis or "Sertoli cell only" in most patients (more than 84.2%) who received testicular biopsy. Decrease in testicular volume was accompanied by an increase in the serum levels of luteinizing hormone and follicle stimulating hormone, but there was no relationship between testicular volume and testosterone. Most of the patients with a testicular volume of less than 12 ml were azoospermic. This suggests that there may be a suppression of spermatogenesis in small testes.