Seasonal effects on seminal quality, plasma hormone concentrations, and GnRH-induced LH response in fertile and subfertile stallions.

Seasonal effects on hormonal and seminal parameters in subfertile stallions have not been well documented and could provide information that is needed to understand the underlying endocrine mechanisms associated with testicular dysfunction. Such information may be useful in developing diagnostic tools to identify those stallions who are candidates for treatment. This investigation characterizes and compares the effects of season on endocrine function and seminal quality in fertile and subfertile stallions. Eight fertile and six subfertile stallions between the ages of 5 and 18 years were injected intravenously once every hour for 3 hours with either 1 mL saline on the first experimental day or 5 micrograms gonadotropin-releasing hormone in 1 mL saline on the second experimental day during the nonbreeding and breeding season. Heparinized blood samples were collected periodically through a jugular catheter before and after treatment for analysis of luteinizing hormone, follicle-stimulating hormone, testosterone, and estrogen conjugates by radioimmunoassay. Semen samples were collected twice, 1 hour apart, from all stallions in both seasons for analysis of volume, concentration, motility, pH, and morphology. A series of low intravenous doses (5 micrograms) of gonadotropin-releasing hormone induced a significant luteinizing hormone response (P less than 0.05) compared with saline treatment in both fertile and subfertile stallions. Fertile stallions had a twofold higher (P less than 0.05) net increase in plasma luteinizing hormone levels (peak levels minus baseline levels) in the breeding seasons than in the nonbreeding season. The magnitude of the luteinizing hormone response relative to baseline levels in fertile stallions, however, was one-and-one-half times greater (P less than 0.05) in the nonbreeding season than in the breeding season. In contrast, season did not have an effect on the net increase in plasma luteinizing hormone or the magnitude of the luteinizing hormone response relative to baseline levels in subfertile stallions. The net increase in plasma luteinizing hormone was similar between the two groups of stallions in both seasons. The magnitude of luteinizing hormone response relative to baseline levels, however, was lower (P less than 0.05) in subfertile stallions (141 +/- 14%) than in fertile stallions (235 +/- 46%) in the nonbreeding season; the two groups exhibited similar responses in the breeding season. Compared with fertile stallions, subfertile stallions had twofold to fourfold higher (P less than 0.05) plasma levels of gonadotropins and similar testosterone levels. The number of total progressively motile sperm was lower (P less than 0.05) in subfertile stallions in both seasons.(ABSTRACT TRUNCATED AT 400 WORDS)     

Pituitary and gonadal function in prepubertal boys with hypospadias

Luteinizing hormone releasing hormone and human chorionic gonadotropin tests were performed to examine the pituitary gonadal axis in 31 prepubertal boys with hypospadias. Luteinizing hormone and follicle stimulating hormone responses to luteinizing hormone releasing hormone in these boys with hypospadias were significantly higher than those in prepubertal control subjects (luteinizing hormone, p less than 0.01). follicle stimulating hormone, p less than 0.05). Prepubertal boys with hypospadias had remarkably reduced testosterone responses to human chorionic gonadotropin stimulation compared to controls (p less than 0.01). Hormonal milieus were further analyzed in the subtypes of hypospadias depending on their severity (distal vs. proximal). Nine of the 31 boys with hypospadias were classified as the proximal type. Basal luteinizing hormone levels in the proximal type were significantly higher than in the distal type (p less than 0.05). Luteinizing hormone and follicle stimulating hormone responses to luteinizing hormone releasing hormone and responses of testosterone to human chorionic gonadotropin were not significantly different in the 2 types. Seven of the 31 boys with hypospadias had a history of maternal progestin ingestion. Basal luteinizing hormone levels and responses of luteinizing hormone and follicle stimulating hormone to luteinizing hormone releasing hormone were also significantly higher in these subjects than in controls (p less than 0.005), though basal levels and responses of testosterone to human chorionic gonadotropin were not different from those of controls. Tests conducted to determine luteinizing hormone and follicle stimulating hormone and testosterone levels using luteinizing hormone releasing hormone and human chorionic gonadotropin stimulation revealed no statistical differences between the boys with hypospadias who had a history of maternal progestin ingestion and those without such a history. The majority of prepubertal boys with hypospadias had varying degrees of deficient testicular activity. The testicular function of these patients should be evaluated longitudinally at puberty and thereafter in order to insure the completion of secondary sexual development.     

子宫内膜异位症不孕患者血清泌乳素水平分析

目的:探讨子宫内膜异位症不孕患者与非子宫内膜异位症不孕患者血清卵泡刺激素、黄体生成素、雌二醇、睾酮、促甲状腺激素及泌乳素的差异。方法:选取2015~2016年907例子宫内膜异位症不孕患者(观察组),与1579例非子宫内膜异位症的不孕患者(对照组),对比分析两组患者激素水平。结果:两组卵泡刺激素、黄体生成素、雌二醇、睾酮、促甲状腺激素水平差异无统计学意义。观察组泌乳素水平[(17.8±8.8)ng/mL vs.(16.8±8.2)ng/mL]高于对照组,差异有统计学意义(P=0.005)。子宫内膜异位症卵巢型患者血清泌乳素水平为(17.1±7.1)ng/mL,腹膜型为(18.9±11.0)ng/mL,腹膜型高于卵巢型,差异有统计学意义(P=0.009)。结论:子宫内膜异位症不孕患者泌乳素水平升高,针对泌乳素的机制研究与干预可能有助于了解不孕症的发生机制、提高临床诊治效果。     

Kisspeptin and attributes of infertile males and females: A cross‐sectional study in a subset of Pakistani population

Kisspeptin, a peptide hormone, plays a pivotal role in fertility and neuroendocrine regulation of hypothalamo–pituitary–gonadal axis. Increased kisspeptin and reproductive hormones are responsible for fertility in male and females. This study aimed to explore the role of kisspeptin on hypothalamo–pituitary–gonadal axis by comparing the levels of kisspeptin in fertile and infertile subjects and identifying single nucleotide polymorphisms (SNPs) of KISS1 gene in exon 2 and exon 3 of infertile male and female cohorts. A cross‐sectional study was carried out on 80 males (44 infertile and 36 fertile) and 88 females (44 in each group). Significantly high levels of kisspeptin (KP), follicle‐stimulating hormone (FSH), luteinizing hormone and testosterone were observed in fertile male and female subjects except low FSH levels in comparison with infertile female subjects. One polymorphism in exon 2 (E1225K [G/A 3673]) and three in exon 3 (P1945A [C/G 5833]; Insertion of T at 6075; G2026G [C/G 6078]) in infertile group were detected, with low KP and hormonal levels. Male subjects had abnormal sperm parameters and unsuccessful attempt of intracytoplasmic sperm injection in females. Expression of SNP in exon 2 and exon 3 of KISS1 could be responsible for alteration in release of reproductive hormones and gonadal functions, hence causing infertility.     

Changes in serum levels of LH, FSH, prolactin, testosterone, and cortisol associated with season and mating in male pygmy goats

Four male pygmy goats were used in a study designed to determine the effects of season on serum hormone (luteinizing hormone, follicle stimulating hormone, prolactin, testosterone, and cortisol) levels, testis size and libido, and the effects of mating on serum hormone profiles. Seasonal peaks were observed for prolactin in July, luteinizing hormone and follicle stimulating hormone in September, and testosterone in October. Luteinizing hormone peak frequency was greatest in September and was increased by mating activity in the months immediately preceding the breeding season. Scrotal circumference did not vary with season and libido showed no consistent seasonal pattern. Mating appeared to raise all hormone levels except during the months when these hormones were seasonally elevated. When episodic releases of luteinizing hormone occurred, they were associated with subsequent rises in serum testosterone levels. On some mating days, when episodic releases of luteinizing hormone were absent, changes in testosterone levels were highly correlated with changes in cortisol levels. It was concluded that both season and mating influence reproductive hormone levels in male pygmy goats.     

Hormonal environment and antiandrogenic treatment in benign prostatic hypertrophy

The plasma luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, testosterone and human growth hormone (HGH) response to insulin-induced hypoglycemia in patients with benign prostatic hypertrophy and age-matched control patients were not different. Although all 6 drugs used were effective for treating these benign prostatic hypertrophy patients the 3 drugs, chlormadinone acetate, oxendrone and allylestrenol, were especially recommended.     

实验性水上漂浮和高强度运动对大鼠下丘脑-垂体-睾丸轴功能的影响

目的:探讨大鼠在经历水上漂浮和高强度运动后血清T、皮质酮(CORT)、LH、FSH的变化规律。方法:将大鼠随机分为对照组(C组)、水上漂浮组(A组)、水上漂浮并高强度运动组(B组)3组,每组12只,实验分为3个阶段:第一阶段为适应性训练阶段,3d,每天10min,对模拟水上漂浮装置和大鼠跑台进行适应性训练;第二阶段为水上漂浮阶段,共3h;第三阶段为水上漂浮并高强度运动阶段,共2h。A组大鼠和B组大鼠分别经历第一、二阶段和第一、二、三阶段。实验结束后测定血清T、CORT、LH、FSH水平。结果:血清T(呈非正态分布,经对数转换后分析)A组为0.17±0.07,B组-1.11±0.35,与C组0.67±0.26相比均显著下降(P<0.05);LHB组为(3.97±1.57)mIU/ml,与C组(6.49±1.56)mIU/ml相比显著下降(P<0.05);FSH无显著变化;CORTB组为(977.22±207.36)ng/ml,与C组(434.58±110.45)ng/ml相比明显上升(P<0.05)。结论:在水上漂浮阶段,大鼠血清T出现明显下降,说明严重的心理应激会抑制下丘脑-垂体-睾丸轴的功能。随着应激原的增多和应激强度的增加,LH明显下降,T进行性下降,说明下丘脑-垂体-睾丸轴功能受到进一步抑制。     

正常促性腺激素妇女垂体降调节后晚卵泡期黄体生成素浓度对体外受精结局的影响

目的 :探讨正常促性腺激素妇女超促排卵时晚卵泡期黄体生成素 (LH)水平对体外受精 (IVF)结局的影响。　方法 :正常促性腺激素妇女 4 32个周期 ,于黄体中期开始采用促性腺激素释放激素激动剂 (GnRHa)行垂体降调节后 ,应用卵泡刺激素 (FSH)刺激卵巢的促排卵方案。当卵泡直径达 1 4mm时 ,添加hMG(FSH +hMG组 ) ,对照组不添加hMG(FSH组 )。hCG注射日测定血LH和雌二醇 (E2 )浓度。按照LH浓度 ,将FSH +hMG组分为 4个亚组。　结果 :FSH +hMG组的hCG注射日E2 浓度高于FSH组 [(3435 .5 1± 2 0 2 9.0 1 )pg/ml和 2 6 2 0 .6 2± 1 6 0 4 .80 )pg/ml,P<0 .0 5 ],胚胎移植数少于后者 [(2 .77± 0 .4 5 )个和 (2 .2 2± 0 .4 6 )个 ,P <0 .0 0 1 ]。两组受精率、胚胎种植率和临床妊娠率无统计学差异 (77.5 2 %和 78.31 %,4 1 .4 2 %和 4 1 .6 8%,6 4 .5 6 %和 6 2 .6 4 %,P均 >0 .0 5 ) ;FSH +hMG组的 4个亚组的受精率、胚胎种植率和临床妊娠率也无统计学差异 (P >0 .0 5 )。　结论 :正常促性腺激素妇女超促排卵时 ,晚卵泡期血清LH在生理范围内以及在晚卵泡期适量添加LH ,不会对IVF结局产生负面影响。     

HCG、FSH联合治疗低促性腺激素性性腺功能减退症29例报告

目的 探讨人绒毛膜促性腺激素(HCG)和促卵泡激素(FSH)联合治疗男性低促性腺激素性性腺功能减退症的有效性和安全性.方法 29例男性低促性腺激素性性腺功能减退症23例,Kallmann综合征6例.治疗方案:采用联合HCG 2000 IU,2次/周;FSH 75 IU,3次/周,肌肉注射,连续用药至少3个月. 结果治疗后所有患者体力改善,体质增强;22例患者出现胡须、阴毛和(或)腋毛.睾丸体积治疗前(2.68±1.44)ml,治疗后(8.93±3.24)ml(P<0.01);促卵泡激素(FSH)、促黄体激素(LH)和睾酮(T)水平有所提高(P<0.05);12例患者出现遗精现象,8例有精子生成.结论 对男性低促性腺激素性性腺功能减退症,用HCG和FSH治疗能促进青春期第二性征发育,并可使部分睾丸恢复产生雄激素和生成精子功能.     

Fertility of men following inguinal hernia repair

Among 8500 patients attending the fertility clinic due to infertility, 565 men (6.65%) reported an incidence of inguinal hernioplasty with or without subsequent atrophy of the testis. Semen quality (sperm concentrations, motility, and morphology) of these patients was markedly reduced in comparison to that of fertile men. In cases where hernioplasty was followed by atrophy of the testis, damage to sperm characteristics and Sertoli cell function was found to be far greater. This was also reflected in significant serum follicle stimulating hormone elevation (P less than 0.0025). No changes in luteinizing hormone and testosterone were found. No correlation was found between age of hernioplasty and semen quality following operation. The reasons for testicular damage may be due to ischaemic orchitis or immunological reactions.     

Sirolimus Impairs Gonadal Function in Heart Transplant Recipients

The impact of sirolimus on hormone levels involved in the hypothalamus-pituitary-gonad axis in male heart transplant recipients was investigated. A pair-matched analysis with 132 male heart transplant recipients on either sirolimus based- or calcineurin inhibitor-based immunosuppression was performed. Matching criteria were age, years after transplantation and creatinine levels. Measured parameters were testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), sexual hormone-binding globulin (SHBG) and free androgen index (FAI). Mean testosterone was 3.86 +/- 1.41 ng/mL in the sirolimus group and 4.55 +/- 1.94 ng/mL in the controls (p = 0.025). Serum LH was 12.82 +/- 11.19 mlU/mL in the sirolimus patients and 6.2 +/- 5.25 mlU/mL in the controls (p = 0.015). Follicle stimulating hormone levels were 13.31 +/- 18.4 mlU/mL vs. 7.32 +/- 5.53 mlU/mL, respectively (p = 0.015). The analysis revealed a significant decrease in testosterone and a significant increase in FSH and LH in the sirolimus group. The duration of sirolimus treatment correlated positively with SHBG (p < 0.01), LH (p < 0.05) and FSH (p < 0.05) and negative with the FAI (p < 0.05). Sirolimus trough levels correlated with LH and FSH levels (p < 0.01). Heart transplant recipients treated with sirolimus revealed significantly lower testosterone levels and a significant increase in gonadotropic hormones. These effects were trough-level dependent. All candidates awaiting organ transplantation should be informed about these adverse effects.     

Routine screening for classical azoospermia factor deletions of the Y chromosome in azoospermic patients with Klinefelter syndrome

Aim： To evaluate the occurrence of classical azoospermia factor （AZF） deletions of the Y chromosome as a routine examination in azoospermic subjects with Klinefelter syndrome （KS）. Methods： Blood samples were collected from 95 azoospermic subjects with KS （91 subjects had a 47,XXY karyotype and four subjects had a mosaic 47,XXY/46, XY karyotype） and a control group of 93 fertile men. The values of testosterone, follicle stimulating hormone （FSH） and luteinizing hormone （LH） were measured. To determine the presence of Y chromosome microdeletions, polymerase chain reaction （PCR） of five sequence-tagged site primers （sY84, sY 129, sY 134, sY254, sY255） spanning the AZF region, was performed on isolated genomic DNA. Results： Y chromosome microdeletions were not found in any of the 95 azoosperrnic subjects with KS. In addition, using similar conditions of PCR, no microdeletions were observed in the 93 fertile men evaluated. The level of FSH in KS subjects was higher than that in fertile men （38.2 ± 10.3 mIU/mL vs. 5.4 ±2.9 mIU/mL, P 〈 0.001） and the testosterone level was lower than that in the control group （1.7 ±0.3 ng/mL vs. 4.3 ± 1.3 ng/mL, P 〈 0.001）. Conclusion： Our data and review of the published literature suggest that classical AZF deletions might not play a role in predisposing genetic background for the phenotype of azoospermic KS subjects with a 47,XXY karyotype. In addition, routine screening for the classical AZF deletions might not be required for these subjects. Further studies including partial AZFc deletions （e.g. gr/gr or b2/b3） are necessary to establish other mechanism underlying severe spermatogenesis impairment in KS.     

Detection of testicular endocrine abnormalities and their correlation with serum antisperm antibodies in men following vasectomy

We measured the serum gonadotropin response to gonadotropin-releasing hormone in 25 men who underwent vasectomy 2 to 64 months before the study. Ten age-matched fertile men were used as controls. Baseline serum follicle-stimulating hormone, luteinizing hormone and testosterone levels were not significantly different between vasectomized men and controls. However, mean serum follicle-stimulating and luteinizing hormone responses to an intravenous bolus injection of 100 mcg. gonadotropin-releasing hormone were significantly greater in the vasectomy group (p equals 0.008 and 0.003, respectively). There was no correlation between these responses and the interval after vasectomy. Serum antisperm antibodies were present in 13 vasectomized men (52 per cent) using enzyme-linked immunosorbent assay and microagglutination techniques. A significant correlation (p equals 0.003) was found between the presence of serum antisperm antibodies and a normal follicle-stimulating hormone response to gonadotropin-releasing hormone stimulation. Of 13 patients with demonstrable antisperm antibody titers 9 (69 per cent) had normal follicle-stimulating hormone responses, compared to only 1 of 12 (8 per cent) without identifiable antisperm antibody titers. Our data suggest that certain men following vasectomy have abnormalities in seminiferous tubule and Leydig cell functions of the testes. These abnormalities are unrelated to the interval after vasectomy and are not identifiable with routine static hormonal measurements. In addition, serum antisperm antibodies are most likely to be present in men who demonstrate normal seminiferous tubular activity after vasectomy.     

Serum levels of dimeric and monomeric inhibins and the degree of seminal alteration in infertile men with varicocele

The aim of the present study was to establish the serum levels of inhibins and their relationship with the degree of seminal alteration in infertile men. Thirty-six patients with varicocele (Va) and seven non-obstructive azoospermic men (Az) were included. The Va group was divided into two subgroups: Va I (sperm concentration: >20 x 106; n = 21) and Va II (sperm concentration: < 20 x 106; n = 15). Twelve fertile men were included as a control group (Co). Semen analysis and serum follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), inhibin B and Pro-alphaC levels were determined. Serum inhibin B and T levels were significantly lower and FSH and LH significantly higher in group Az when compared with the Co. Inhibin B was unable to differentiate Va I from Va II groups. However, in Va II an increase in FSH levels was observed. An inverse correlation between inhibin B and FSH, a direct correlation between inhibin B and testosterone, sperm concentration, motility and morphology were found. No such correlations were seen when only the Va group was analysed. The lack of correlation between serum levels of inhibin B, gonadotrophins, sperm concentration and seminal parameters observed in Va, adds other factor to the complex pathophysiology of varicocele. Finally, further studies are needed to elucidate if oligozoospermic patients with varicocele have also an impaired negative feed-back mechanism that regulates FSH synthesis and secretion.     

Factors predicting the outcome of varicocele repair for subfertility: the value of the luteinizing hormone-releasing hormone test

The mechanism by which varicocele caused infertility is not yet clear. Endocrine factors have been suggested to explain impaired spermatogenesis in patients with varicocele. We conducted a prospective study on testosterone and gonadotropin levels and their response to the luteinizing hormone-releasing hormone test to determine the possible role of a hormonal defect in subfertility. Luteinizing hormone-releasing hormone tests were performed on 11 subfertile men with varicocele preoperatively and 3 months postoperatively. The differences in the luteinizing hormone response were statistically significant. The maximal luteinizing hormone levels also were significantly lower in patients whose spermiogram changed postoperatively. No significant changes were noted in testosterone and other gonadotropin levels postoperatively. A prognostic correlation between the change in response of luteinizing hormone to luteinizing hormone-releasing hormone (preoperatively and postoperatively) and improvement in fertility (pregnancy success) was found. We suggest that the luteinizing hormone-releasing hormone test should be considered to estimate the hormonal derangement and also the prognosis of an operation in subfertile men with varicocele.     

Treatment of prostatic cancer with slow-release formulation of luteinizing hormone releasing hormone (LH-RH) analog

A slow-release formulation of the luteinizing hormone releasing hormone (LH-RH)analog(TAP-144-SR) was administered in 6 cases of prostatic cancer. Five were untreated cases, 3 of moderately-differentiated and 2 of poorly-differentiated cancers (four D2 and one C, NX), the other (D2) was under control by another LH-RH analog. The plasma level of luteinizing hormone and follicle stimulating hormone fell below normal, and the plasma testosterone was less than 1 ng/ml by four weeks after start of treatment. According to the National Prostatic Cancer Project Criteria, 2 of the untreated cases showed a partial response and 3 of the untreated ones showed a stable response, one of which underwent transurethral resection later. The pretreated case still continued controlled more than 4 months. No side effect was noticed.     

Pituitary-testicular function of prostatic cancer patients during treatment with a gonadotropin-releasing hormone agonist analog. I. Circulating hormone levels

Eight patients with advanced prostatic carcinoma (ages 59 to 78 years) were treated with a potent gonadotropin-releasing hormone (GnRH) agonist analog (buserelin, Hoechst; 600 micrograms intranasally, 3 times daily) and orchiectomized after 6 months of treatment. Endocrine responses were followed by serum hormone measurements during agonist treatment and for 3 months after orchiectomy. Six other patients (65 to 86 years) with advanced prostatic cancer had been orchiectomized as the first therapeutic measure and their blood samples were used as controls. In the GnRH agonist-treated patients, serum immunoreactive luteinizing hormone (LH) and follicle stimulating hormone (FSH) decreased after initial stimulation by 70 to 80%, within 1 to 3 weeks (P less than 0.01). FSH partly recovered (P less than 0.05) after the first month of treatment. Serum prolactin (PRL) displayed a slight tendency to decline during buserelin treatment (P less than 0.05). Serum total and free testosterone (T) of the buserelin-treated patients decreased to the castrate range within 3 to 4 weeks after an initial 5-day increase (P less than 0.01). Serum progesterone and 17-hydroxyprogesterone (17-OHP-4) decreased to the castrate range (by 50 to 70%) in 1 week. Only minor changes were observed in sex hormone binding globulin (SHBG). Significant, acute elevations of LH, FSH, T, and 17-OHP-4 were observed only on day 1 after an injection of buserelin (500 microgram i.m.) and not when assessed between day 7 and month 6 of treatment. After 6 months of buserelin treatment, orchiectomy did not affect the serum steroids measured. After orchiectomy, immediate increases in serum LH, and somewhat later in FSH, were seen in the control patients.(ABSTRACT TRUNCATED AT 250 WORDS)     

Efficacy of anastrozole in the treatment of hypogonadal,subfertile men with body mass index ≥25 kg/m2

BackgroundAnastrozole is a non-steroidal fourth generation aromatase inhibitor that stops the conversion of testosterone to estradiol and has been used as empiric medical therapy for the treatment of male infertility in men with an abnormal testosterone-to-estradiol ratio <10 in order to increase endogenous testosterone levels. This study sought to evaluate the efficacy of anastrozole in the treatment of hypogonadal, subfertile men with body mass index greater than 25 mg/kg² with respect to hormonal profile, semen parameters and overall fertility status.MethodsRetrospective chart review was performed of hypogonadal, subfertile men with body mass index ≥25 kg/m² who were treated with anastrozole (1 mg daily). Hormonal measurements and semen analysis prior to and after treatment was analyzed in 30 men. Total motile count was calculated from semen analysis. Clinical pregnancy rates were recorded.ResultsMen treated with anastrozole had increases in follicle stimulating hormone (4.8 versus 7.6 IU/L, P<0.0001), luteinizing hormone (3.4 versus 5.4 IU/L, P<0.0001), testosterone (270.6 versus 412 ng/dL, P<0.0001) and testosterone-to-estradiol ratio (9 versus 26.5, P<0.0001) and decrease in estradiol level (32 versus 15.9 pg/mL, P<0.01) after 5 months of therapy. Increases in sperm concentration (7.8 versus 14.2 million/mL, P<0.001), total motile count (12.6 versus 17.7 million, P<0.01) and strict morphology (3.0% versus 3.5%, P<0.05) was appreciated. Clinical pregnancy rate for our cohort was 46.6% (14 of 30), with 71.4% (10 of 14) conceiving through in vitro fertilization, 14.2% (2 of 14) through intrauterine insemination and 14.2% (2 of 14) through natural intercourse.ConclusionsAnastrozole improves hormonal profiles and semen parameters in hypogonadal, subfertile men with body mass index over 25 kg/m² and may aid in achieving pregnancy especially in conjunction with assisted reproductive techniques.     

Bromocriptine therapy in oligozoospermic infertile men

A prospective, randomized double-blind study with crossover using bromocriptine and placebo was performed on a group of 17 infertile males with idiopathic oligozoospermia. Twelve patients completed the duration of this study of eight months by receiving 5 mg of bromocriptine per day for four months followed by four months of placebo or vice versa. Prior to treatment, the sperm count was 8.76 +/- 1.32 (10(6)/ml). The hormonal profile was performed prior to treatment and included estimation of prolactin, T3, T4, thyroid stimulating hormone (TSH), testosterone, follicle stimulating hormone (FSH), and plasma LH. Stimulation studies using LHRH and TRH were also performed. All hormonal estimations were within normal limits. Compared to placebo, bromocriptine had no significant effect on sperm analysis, or basic hormonal profile. The stimulation test with luteinizing hormone releasing hormone (LHRH) was unchanged except for the basic plasma testosterone, which increased. The prolactin decreased following the thyrotropin releasing hormone (TRH) stimulation. Two pregnancies were noted four to six weeks following the end of treatment. Bromocriptine did not seem to be more effective than placebo in the treatment of idiopathic oligozoospermia.     

Gonadal function in male heroin and methadone addicts

Gonadal function was elevated in 80 male heroin and/or methadone addicts by measuring basal plasma levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and testosterone. In 41 subjects semen analyses were also undertaken. Three groups were distinguished consisting of 15 heroin addicts, 42 undergoing methadone treatment but continuing to take heroin, and 23 taking only methadone. All patients had normal plasma levels of FSH, LH and testosterone. Prolactin levels were normal in all subjects except for the 15 heroin addicts, in whom they were significantly higher than in controls (P less than 0.025). Semen analyses from all of the heroin addicts and from the dual heroin-methadone users were abnormal, whereas only 10 out of 22 (45%) of the methadone takers were pathological. In all cases asthenospermia was one of the abnormalities (100%). Twenty-four per cent also showed teratospermia and hypospermia and 17% showed oligozoospermia. Such seminal pathology, especially of forward motility, even in combination with normal hormone levels, might be an early indication of heroin toxicity to the male reproductive tract.