ENDOCRINE STUDIES ON MALE INFERTILITY
1981 Volume 72 Issue 5 Pages 544-558
Details
1981 Volume 72 Issue 5 Pages 544-558
Endocrine studies were performed on two hundred and nineteen cases of male infertility. Forty normal adult men and thirty-three cases of Klinefelter's syndrome were also studied for comparison. Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testoterone, prolactin (PRL), thyroid-stimulating hormone (TSH), thyroxine (T4) and triiodotllyronine (T3) were determined and correlations between these hormone levels and sperm concentrations as well as histological indexes on testicular biopsy specimens investigated. Stimulation tests for these hormones using LH-RH, TRH, or hCG were also added in some cases.
Serum gonadotropin levels (particularly FSH levels) were found to be increased in patients with azoospermia and severe oligozoospermia (sperm concentrations lower than 10×106/ml), the mean values for LH and FSH being significantly elevated from those in normal men (p<0.05). Serum levels of PRL, TSH, T4 and T3 and their responses to TRH stinnulatiotn were within normal ranges for men. Pituitary reserve function for secreting gonadotropins in response to synthetic LH-RH has been found to be almost normal in the majority of cases of male infertility showing adequate increases of LH and FSH. On the other hand, some alterations or hypofunctiori of the Leydig cell reserve capacity to secrete testosterone in response to hCG have been suggested to exist in certain cases of disordered spermatogenesis.
Analyses of correlations between testicular biopsy score count and endocrine parameters suggested the possibility that cases of spermatogenetic failure with given biopsy scores are mixed up with those with different etiologic factors, i. e., at least one with primary testicular failure and another with secondary testicular failure due to hypothalamo-pituitary dysfunction to secrete gonadotropins appropriately. These endocrine pictures are discussed in analogy to those in certain types of eunuchoidism, and spermatogenetic failure may reasonably be considered as milder forms of male hypogonadism.
