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Therapieversuche bei idiopathischer Infertilität

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Andrologie

Zusammenfassung

Hinter der Sammeldiagnose idiopathische Infertilität verbergen sich wahrscheinlich eine Vielzahl von unterschiedlichen pathogenetischen Mechanismen, die aufzuklären eine der wichtigsten und spannendsten Aufgaben der Andrologie ist, um schließlich die verursachenden Störungen durch rationale Theapie beheben zu können. Neue Ansätze sind vorwiegend aus der Forschung über die molekulargenetische und parakrine Steuerung der Spermatogenese, die Wirkung der Gonadotropine und Sexualhormone auf molekularer Ebene und die Biologie der Gameten zu erwarten (z. B. Hans-son et al.1996; Stefanini et al.1998). Als Beispiele für derartige Forschungsergebnisse seien die Mikrodeletionen auf dem Y-Chromosom, die CFTR-Mutationen bei kongenitaler beidseitiger Aplasie der Samenleiter (CBAVD) und die Pathologie des Androgenrezeptors erwähnt.

Die idiopathische infertilität steiit eine Ausschiußdiagnose dar ind darf erst nach Ausschluß anderer fertilitätsstörender Ursachen gesteiit werden. Die Seminaiparametern können subnormal sein und eine Erhöhung des FSH kann einen Hinweis auf eine Spermatogeneseseörung geben. Die Hodenbiopsie erbringt allerdings keine weiterführenden diagnostischen Erkenntnisse. Histologisch findert sich häfig ein inkompietter Spermatogene searrest oder ein parttieiies SCO-Syndrom. Diesa Patienten bilden die größte Gruppe der die Fertilltätssprechstunde aufsuchenden Männer (in unserem institut etwa ein Drittel).

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  1. E. Nieschlag
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  1. Institut für Reproduktionsmedizin, Westfälischen Wilhelms-Universität, Domagkstr. 11, D-48129, Münster, Deutschland

    Eberhard Nieschlag FRCP

  2. Zentrum für Frauenheilkunde, Westfälischen Wilhelms-Universität, Albert-Schweitzer-Str. 33, D-48129, Münster, Deutschland

    Hermann M. Behre

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Nieschlag, E. (2000). Therapieversuche bei idiopathischer Infertilität. In: Nieschlag, E., Behre, H.M. (eds) Andrologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-05739-1_16

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  • DOI: https://doi.org/10.1007/978-3-662-05739-1_16

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