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Der Einfluss von Umweltfaktoren und Lebensstil auf die männliche Fertilität

The impact of environmental factors and lifestyle on male fertility

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Bei der Erfassung kausaler Faktoren männlicher Fertilitätsstörungen spielen Lebensstil und Umweltfaktoren eine wichtige Rolle. Das Wissen um die Wechselwirkungen zwischen derartigen Einflüssen und reproduktiven Funktionen des Mannes eröffnet zudem die Möglichkeit eines präventiven Ansatzes in der Andrologie. Relevante exogene Noxen sind Genussgifte, Pharmaka einschließlich Lifestyle-Medikamenten, Berufsstoffe, Umweltchemikalien sowie physikalische Faktoren. Reproduktionstoxische Effekte können sich prätestikulär, testikulär oder posttestikulär entfalten und neben einer Beeinträchtigung der Spermatogenese oder Spermienfunktion auch Hormon- und Sexualstörungen verursachen. Aufgrund der komplexen Regulation des männlichen Reproduktionssystems sowie der begrenzten Übertragbarkeit tierexperimenteller Befunde und In-vitro-Daten auf die Situation beim Menschen liegen allerdings nur für wenige Noxen gesicherte Erkenntnisse vor. In der andrologischen Sprechstunde sollten bei Erhebung der Anamnese potenzielle Expositionsrisiken erfasst und die Patienten über eine gesicherte oder mögliche Relevanz für ihre Fertilität aufgeklärt werden.

Abstract

The identification of potential environmental hazards may have clinical relevance for the diagnosis of male infertility. Knowledge about the interaction between these factors and male reproductive function opens up the possibility of a preventive approach in andrology. Apart from drugs or factors related to lifestyle, such as alcohol and tobacco smoke, various environmental and occupational agents both chemical and physical, may impair male reproductive functions. Reproductive toxicity may evolve at the hypothalamic-pituitary, testicular, or posttesticular level; endpoints comprise impairment of spermatogenesis and sperm function as well as endocrine disorders and sexual dysfunction. With respect to the complex regulation of the male reproductive system, the available information concerning single exogenous factors and their mechanisms of action in humans is limited. This is also due to the fact that extrapolation of results obtained from experimental animal and in vitro studies remains difficult. Nevertheless, the assessment of relevant exposures to reproductive toxicants should be carefully evaluated during diagnostic procedures for patients and elaborated during the andrological consultation.

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  1. Andrologicum München, München, Deutschland

    Frank-Michael Köhn

  2. Sektion Konservative Andrologie, Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie, Universitätsklinikum Gießen und Marburg GmbH – Standort Gießen, Justus-Liebig-Universität Gießen, Gaffkystr. 14, 35385, Gießen, Deutschland

    Hans-Christian Schuppe

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Aktualisierte Version der Originalpublikation von Schuppe HC, Köhn FM (2018) Einfluss von Lebensstil und Umweltfaktoren auf die reproduktive Gesundheit des Mannes. Hautarzt 69:996–1005. https://doi.org/10.1007/s00105-018-4307-2.

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Köhn, FM., Schuppe, HC. Der Einfluss von Umweltfaktoren und Lebensstil auf die männliche Fertilität. Gynäkologe 54, 260–272 (2021). https://doi.org/10.1007/s00129-020-04742-9

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