Zusammenfassung Ergebnisse der Behandlung mit Tamoxifen bei Oligozoospermie 15 Männer im Alter zwischen 32 und 42 Jahren mit normo‐ bzw. hypogonadotroper Oligozoospermie wurden über 6 Monate mit tgl. 2 times 10 mg Tamoxifen oral behandelt. Veränderungen der seminalen und hormonalen Parameter werden diskutiert. Eine signifikante Verbesserung der Spermatozoendichte wurde nur bei sog. „Respondern” gefunden, während bei Männern mit einer hypergonadotropen Ausgangslage kein Effekt nachgewiesen werden konnte. Die Veränderungen der Plasmawerte von Testosteron, 17‐ß‐Östradiol und den Gonadotropinen zeigten während der Tamoxifenbehandlung weder bei „Respondern” noch bei den „Nicht‐Respondern” auffällige Unterschiede. Die Therapie mit Tamoxifen verursachte keinerlei Effekte hinsichtlich Änderung des Sexualverhaltens oder Entwicklung einer Gynäkomastie.
A group of 20 patients with torsion was investigated. The study indicated that immediate surgical intervention with a period of torsion of the testis of less than 6 h will prevent impairment of testicle function. The histology of testicular biopsies taken from such patients revealed only interstitial oedema and, at the most, partial necrosis. If torsion time exceeded 6 h testicular histology revealed severe alterations, and surgical correction could not prevent atrophy of the testis. Patients with pathological spermiograms showed FSH values over or at the upper limit of the normal range. As far as can be concluded from one single basal hormone determination, the testosterone secretion remained unaltered. Libido, potency and virilization remained normal.
Eighteen boys with either unilateral or bilateral cryptorchidism were treated with a synthetic LH-RH analogue ("D-Leu 6, Des-Gly-10 LH-RH ethylamide") intranasally. The peptide was dissolved in aqueous solution (25 micrograms in 0,2 ml) and administered in the form of nasal drops. The patients were divided in two groups: in group A, 50 micrograms of the synthetic LH-RH analogue were administered intranasally every 48 h for 36 days; in group B same dose was given every 24 h. Additionally, in 4 cases a LH-RH test prior the trial was performed with the same peptide. The nasal administration resulted in a fivefold increase of LH and of FSH plasma concentration in 30 min and in 60 min, respectively. The endocrine profiles for T, LH and FSH were studied in each group over the treatment period and in group B (same dose was given every 24 h) a significant decrease of the LH and FSH plasma levels could be found. The clinical effect of treatment was same in the both groups. In the whole material 44% had either unilateral or bilateral descent of the testis after the therapy.
The effects of a combination of medroxyprogesterone acetate and testosterone enanthate, on the exocrine and endocrine testicular function were examined in adult men. The treatment was carried out with 2 different regimens and lasted for 8 months. Group I received an initial injection of 1000 mg medroxyprogesterone acetate and 500 mg testosterone enanthate followed by monthly maintenance dose of 150 mg medroxyprogesterone acetate and 500 mg testosterone enanthate. In group II, after an initial high dose of 1000 mg medroxyprogesterone acetate and 250 mg testosterone enanthate treatment was given as biweekly injections of 75 mg medroxyprogesterone acetate and 250 mg testosterone enanthate. Complete spermatogenic arrest of variable duration was achieved in all 9 subjects enrolled. Restoration of spermatogenesis occurred in both groups, in a few cases during the treatment, and there was a delay of full recovery of sperm counts up to 5 months after cessation of therapy. None of the subjects enrolled in this study complained of decrease in libido or change in sexual behaviour. Clinical evaluation and measurements of various urine and serum components revealed no significant changes during the treatment period. The dosage and the different administration schedule of the hormone combination described here was inadequate to maintain azoospermia in all subjects during treatment.
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