睾丸下垂体系の研究

Abstract

The levels of plasma luteinizing hormone (LH), follicle stimulating hormone (FSH) and testosterone were measured in 48 males who complained of infertility (oligospermia and Klinefelter's syndrome). Correlations between the hormonal results and clinical, histological findings were studied and the testicular-hypophyseal relationship was discussed.The results were as follows.1) Synthetic luteinizing hormone-releasing hormone (LH-RH) of 100μg was administered to normal controls and to patients with infertility. The responses of gonadotropins to LH-RH in these patients were almost the same as controls. These findings might indicate that there was no abnormality in hypophyseal function on gonadotropin secretion in patients with primary testicular failure.2) In the cases of oligospermia, the mean plasma FSH concentration was significantly higher than that of the control group, but LH concentration was not significantly elevated. In the cases of azoospermia, plasma LH and FSH levels were significantly elevated.3) The relationships between serum gonadotropins and testicular weight were investigated. When the testis was lower than 17grs. in weight, FSH concentrations were always higher than normal levels. On the other hand, LH concentrations were ordinarily within the normal range and increased when the testicular weight fell below 12grs. in weight.4) Spermatogenic activity of germinal epithelium was evaluated by the methods of score count, germinal cell index and DNA synthesizing capacity of germinal epithelium. Good correlations were observed among serum LH, FSH and spermatogenic activity. It might be indicated that LH and FSH had a close relation to spermatogenesis.5) However, there were some differences between LH and FSH as to spermatogenesis. From an early stage of disturbaces of spermatogenesis, FSH levels were always elevated while LH concentrations remained normal. LH concentrations were significantly increased at the severely disturbed stage of spermatogenesis. It was considered from the above findings that the damage of testicular function might be initiated by a disturbance of spermatogenesis. The disturbance of Leydig cell function might not occur until the testicular damage had advanced severely.6) From the correlation of FSH concentration and germinal cell index, which was the ratio of germinal cell count to Sertoli cell count in seminiferous tubulus, it was considered that the stage of spermatogenesis affected by FSH in the testicular-hypophyseal relationship in man might be the stage of matured germ cell involving secondary spermatocytes and spermatids.7) As an index of the Leydig cell function, the authors culculated the Leydig cell index, which was the proportions of the interstitium to the areas of Leydig cells, and a good correlation was obtained between LH and Leydig cell index.