男人不育怎样治疗

男人不育如何治疗配图，仅供参考

Hormonal treatments
Enthusiasm for hormonal treatments has waned in recent years but their use is still widespread,as they are the least invasive and the most convenient initial treatment. Hormonal treatments can be targeted to the specific cause of the infertility if the underlying pathology is known,and can also be used to treat idiopathic infertility.
Targeted therapy
Targeted hormonal therapies are available for patients whose infertility is due to altered levels of androgens,prolactin,or TSH. Treatment has two goals. The first goal is to restore virilization and normal sexual function,using testosterone. The second is to initiate spermatogenesis with pulsatile GnRH treatment at 2,500–3,000 U every other day and FSH at 75–150 U every other day. Alternatively,patients can be treated with human chorionic gonadotropin (hCG) (3,000 IU every other day) and adding human menopausal gonadotropin (hMG) after spermatogenesis has been initiated. In patients with hyperprolactinemia,treatment depends on the need for surgical treatment of an underlying pituitary tumor. If a macroadenoma is not present and surgery is not indicated,treatment with the somatostatin analogs bromocriptine (2.5–10 mg daily) or,more commonly,cabergoline (0.5–1.0 mg twice a week) is indicated.
Hormonal treatment of patients using steroids
The first step in treating patients who are using testosterone products is to discontinue their use. Spermatogenesis usually returns,but full recovery can take over a year and may not return to pretreatment levels. In addition,many patients will still need some form of testosterone supplementation,as their endogenous testosterone production has been suppressed. For these patients,multiple hormonal agents have been used,including hCG,clomiphene citrate,or aromatase inhibitors. The choice and dose of potential treatments should be based on each patient’s hormone profile. If their testosterone:estradiol ratio is normal (15:1),hCG (3,000 U every other day),clomiphene citrate (25 mg daily),or tamoxifen (10 mg twice daily) can be used. If the ratio is abnormal,then anastrozole (1 mg daily) can be used to block the aromatization of testosterone to estradiol.
Gonadotropins
The use of gonadotropins in the treatment of idiopathic infertility in men is based on the age-old credo that “if a little bit is good,a lot will be better”,and thus gonadotropins are often used in extremely high doses. The use of hCG is becoming increasingly prevalent,as hCG administration can increase intratesticular testosterone to normal levels. Since many combinations of gonadotropins and dosages have been used,determining their true efficacy is difficult. In an attempt to clarify these results,a Cochrane analysis has been carried out,focusing only on the randomized,controlled studies. It concluded that pregnancy rates increased following 3 months of gonadotropin treatment. However,the analysis lacked adequate statistical power,and thus this conclusion must be viewed with some skepticism.
Oxytocin
Though best known for its role in promoting lactation,oxytocin is also produced in the reproductive tract. This hormone promotes sperm progression,increases sperm retrieval (seen in a small single-blinded study with oligospermic men) and also increases the conversion of testosterone to dihydrotestosterone (DHT),a more potent form of testosterone,which cannot be converted to estradiol by aromatase. The only trial of oxytocin to date showed no change in sperm count,ejaculate volume or sperm motility when used once before collection.","department":"