性激素负反馈作用在男性不育诊疗中的应用

摘要

Hypothalamo-pituitary-testicular axis plays a crucial role in male reproduction.Hypothalamus and pituitary regulate the biosynthesis of steroid hormones as well as spermatogenesis in testis.Complex stimulation and feedback mechanism manage the biosynthesis and secretion of hormone through neural components.There are lots of androgen receptor and estrogen receptor in hypothalamus and pituitary,which are regulated by negative feedback of testosterone and its aromatization products including estrogen.Administration of anti-estrogen drugs or aromatase inhibitors can minimize the continuous negative feedback regulation of testosterone and its aromatic products and increase the secretion of endogenous gonadotropin,by though the negative feedback of male hypothalamic-pituitary-gonadal axis,which may also limit the side effect of estrogen on spermatogenesis,and restore spermatogenesis or improve semen quality.%下丘脑-垂体-睾丸轴对男性的生殖功能起着关键性作用,下丘脑和垂体共同参与调控睾丸的甾体激素合成与精子发生;复杂的刺激和反馈机制通过神经腺成分来控制激素的合成和分泌.下丘脑和垂体均有大量雄、雌激素的受体,同时受睾酮及其芳香化产物(包括雌激素)的负反馈调节.利用男性生殖内分泌轴系中的负反馈作用,通过给予抗雌激素药物或芳香化酶抑制剂,可减弱睾酮及其芳香化产物的持续负反馈调节作用,增加内源性促性腺激素的分泌,而且还能去除雌激素对生精的副作用,恢复生精或提高精液质量.