Gonadotropins,testosterone and prolactin in men with abnormal semen findings and an evaluation of the hormone profile

Over a 4-year period, 259 men were investigated regarding primary (86.5%) or secondary (13.5%) infertility. Men with azoospermia had significantly higher concentrations of FSH and LH and lower concentrations of testosterone than those with spermatozoa. High concentrations of FSH and LH in serum were found in case of low sperm density. Men with low testicular voluem had high concentrations of FSH and LH and low concentrations of testosterone. FSH was closely correlated with LH and also with total testicular volume. A negative correlation was found between both gonadotropins and testosterone. The correlation between LH and testosterone was stronger in azoospermic men than in those with spermatozoa in semen. Serum concentrations of prolactin were higher in men with high sperm motility than among men with low motility of spermatozoa. Otherwise, prolactin concentrations were not correlated either with sperm density or with the morphology of spermatozoa or total testicular volume. A ‘hormone profile’ of FSH, LH and testosterone concentrations is suggested useful in the routine investigation of the infertile man, as more information is given by this profile than by FSH concentrations alone.     

ALTERATION OF THE HYPOTHALAMUS-PITUITARY-TESTIS AXIS IN OLIGOZOOSPERMIC MEN WITH NORMAL GONADOTROPIN LEVELS

Background:
Serum basal hormone levels such as lutenizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone, which is important to regulate testicular function, do not necessarily indicate the normal integrity of the hypothalamic-pituitary-testicular axis and the static measurement is not enough to detect the endocrine disorder. The dynamic measurement of gonadal hormone by GnRH test is considered to be more helpful to understanding the endocrine regulation of spermatogenesis. In this study, we performed GnRH test in oligozoospermic patients with normal levels of LH and FSH to examine the subtle alteration of hypothalamic-pituitary-testis axis.
Methods:
GnRH test was performed in 41 patients with oligozoospermia and normal gonadal hormone levels.
Results:
The responses of LH and/or FSH were excessive in most patients in spite of their normal gonadotropin levels. The patients with sperm concentration < 10 ± 10⁶/ml had significantly higher peak levels of both LH and FSH than did those with sperm concentration > 10 ± 10⁶/ml. In the patients with normal peak levels of both LH and FSH, sperm concentration was significantly higher than those with exceeded peak levels of FSH and/or LH after GnRH test. No significant differences were observed in estradiol, testosterone, free testosterone, or prolactin (PRL) levels between patients with normal responses and abnormal responses of LH and/or FSH.
Conclusions:
The feedback control of gonadotropin release from testis was worse in more severely oligozoospermic patients, although the precise mechanism of feed back still remains unknown.     

The effect of streptozotocin-induced diabetes on the neuroendocrine-male reproductive tract axis of the adult rat

Studies in the streptozotocin rat model for diabetes mellitus suggest that sexual dysfunction in these animals may result from diabetes-induced alterations of the neuroendocrine-reproductive tract axis. Our investigation was performed to better define the effects of diabetes on the neuroendocrine sex accessory organ axis in the male rat. Rats were rendered diabetic, and were either left untreated or treated with insulin, testosterone or both. Diabetes resulted in decreased body and reproductive organ weights, as well as diminished sperm counts and motility and prostatic acid phosphatase. Seminal fructose was increased. A significant decrease in serum LH, FSH and testosterone was noted. Insulin treatment of the diabetic rats restored serum gonadotropins, reproductive organ weight, sperm counts and motility, and seminal fructose to control levels. Prostatic weight and prostatic acid phosphatase levels remained abnormal. Testosterone restored the above mentioned parameters to control levels, with the exception of LH. Treatment with insulin and testosterone had a synergistic effect on spermatogenesis. A GnRH stimulation test demonstrated that pituitaries of diabetic animals had a blunted response, with diminished LH and FSH secretion. In the diabetic animal, there are both pituitary and testicular abnormalities which may be responsible for reproductive dysfunction.     

Reversal of the toxic effects of cyclosporine on male reproduction and kidney function of rats by simultaneous administration of hCG + FSH

We have shown earlier that the administration of cyclosporine impairs testicular function and causes a decrease in sperm counts, sperm motility and fertility. In order to determine whether or not the deleterious effects of CsA could be reversed by hormonal therapy, we injected sexually mature male Sprague Dawley rats with cremaphor + saline or CsA (40 mg./kg./d) alone or in combination with human chorionic gonadotropin (hCG; five micrograms./d/rat) and follicle stimulating hormone (FSH; five micrograms./d/rat). The injections were given subcutaneously for 14 days. As expected, CsA administration decreased the body and reproductive organ weights, testicular and epididymal sperm counts, sperm motility and fertilizing ability. Serum levels of LH were elevated and testosterone was decreased. The administration of FSH + hCG to the CsA treated rats restored the body and reproductive organ weights, sperm counts and motility. Seventy five percent of gonadotropin treated males were fertile as compared to 25% in the CsA treated group. In the hormone treated group, the blood levels of CsA were 50% of that of CsA treated group. In order to verify whether or not the decline in the blood levels of CsA was the cause for the amelioration of CsA-induced changes in the reproductive function, we compared the CsA + hormone treated group with another group treated with five mg./kg./d CsA which had blood levels of CsA comparable to the former group. In the five mg./kg./d group the reproductive functions were significantly lower than the CsA + hormone treated group suggesting, therefore, that the restoration of reproductive functions in the CsA + hormone treated group is a result of hormonal treatment. Administration of CsA (40 mg./kg./d) reduced the kidney weight and increased the levels of serum creatinine: these changes were also ameliorated by the administration of hCG + FSH.     

Effects of Chronic Renal Failure on Hypothalamo-Pituitary-Testicular Axis Function and Fertility in Rats

Background: We evaluated the effects of chronic renal failure on hypothalamo-pituitary-testicular axis function in male Wistar rats.
Methods: Chronic renal failure was induced by five-sixths nephrectomy in male rats. Seven to 10 weeks after the surgery, serum urea and creatinine concentrations and hematocrits were evaluated, and human chorionic gonadotropin (hCG) and gonadotropin-releasing hormone (GnRH) tests, and prolactin stimulating antl suppression tests were performed. In addition, androgen-binding protein, epididymal sperm content, motility, ancl fertile potential were assessed.
Results: Basal serum testosterone concentrations and the response of testosterone to hCG were significantly lower in rats with chronic renal failure than in controls. Basal serum gonadotropin levels were elevated in rats with chronic renal failure, but the gonadotropin response to GnRH did not differ from that in controls. Serum protactin IeveIs responded appropriately to stimuIation and suppression tests. Androgen-binding protein levels, epididymal sperm content, motility, and fertile potential were significantly lower in uremic rats.
Conclusions: Chronic rend failure in rats interferes with endocrinologic mechanisms and testicular functions. Thus, uremic rats have a low fertile potential.     

Sperm concentration and normal sperm morphology decrease and follicle-stimulating hormone level increases with age

OBJECTIVE: To assess hormone levels, testicular volume, and semen characteristics of fertile men of various age groups. PATIENTS AND METHODS: The records of 889 men who sought a vasectomy between September 1999 and March 2003 were reviewed. Patients were divided into five groups by age; we evaluated semen volume, sperm concentration, motility, morphology and complex sperm motion variables. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone levels and both testicular volumes were compared. RESULTS: There were no differences among the groups in the levels of LH, testosterone, or right and left testicular volumes. There were differences among the five groups in FSH levels, semen volume, sperm concentration and motility. Normal morphology according to the World Health Organisation criteria was significantly lower in patients aged > 45 years. From a linear regression analysis, semen volume, sperm concentration and motility decreased by 0.01 mL, 2.1%, and 0.27%, respectively, per year, and the FSH level increased by 0.27%. CONCLUSIONS: Sperm concentration and motility decrease and FSH levels increase with age. Normal sperm morphology decreases from 45 years old. Thus, the ageing effect should be considered when proposing standard values for semen characteristics in routine semen analysis.     

生殖激素检测在男性不育症诊断中的意义

本文报道了我院对３１５例男性不育症患者在第一次就诊时进行血清生殖激素ＦＳＨ、ＬＨ、Ｔ、ＰＲＬ、Ｅ２水平的检测，并进行详细的病史询问、常规体检和精液分析等检查。结果显示血清Ｔ值在不同的精子密度层次的男性不育症患者均呈正态分布。睾丸容积减少，ＦＳＨ、ＬＨ上升，Ｔ／ＬＨ下降，提示睾丸功能损害，并且Ｔ／ＬＨ的比值更能反映间质细胞的功能。血清ＰＲＬ和Ｅ２值在诊断高催乳素血症不育有意义，但在男性生育者和不生育者之间无明显差别。而且ＦＳＨ值在鉴别睾丸原发性与梗阻性无精子症是一项重要指标。作者讨论了血清生殖激素测定在不育症诊断中、在判定睾丸功能的损害程度中的意义。     

Effect of psychological stress on fertility hormones and seminal quality in male partners of infertile couples

The present study evaluated the effect of psychological stress on male fertility hormones and seminal quality in male partner of infertile couples. Seventy male partners of infertile couples were evaluated for level of psychological stress using Hospital Anxiety and Depression Score (HADS) questionnaire, serum total testosterone, luteinising hormone (LH) and follicle‐stimulating hormone (FSH) by electrochemiluminescence assay and serum GnRH by ELISA. Seminal analysis was performed as per WHO guideline. Nineteen (27%) of them had HADS anxiety and depression score ≥8 (abnormal HADS score). The persons having abnormal HADS had lower serum total testosterone, higher serum FSH and LH than those of persons having normal HADS. Serum total testosterone correlated negatively with HADS, but LH and FSH correlated positively. There was no change in GnRH with the change in stress or testosterone levels. Sperm count, motility and morphologically normal spermatozoa were lower in persons having abnormal HADS. Sperm count correlated positively with total testosterone and negatively with FSH and LH. Abnormal sperm motility and morphology were related to lower testosterone and higher LH and FSH levels. Psychological stress primarily lowers serum total testosterone level with secondary rise in serum LH and FSH levels altering seminal quality. Stress management is warranted for male infertility cases.     

精浆和血清生殖激素与精液质量的关系

目的为了评估精液质量不同的男性精浆和血清生殖激素的浓度与精子浓度及活动力的关系,探索精浆与血清生殖激素的关系。方法对301名男性进行精液检查,按照精液的质量参数将受试对象分成4组:精液正常组(n=176),弱精子症组(n=66),少精子症组(n=40)和非梗阻性无精子症组(n=19)。采用电化学发光免疫法测定各组受试对象血清卵泡刺激素(FSH)、黄体生成素(LH)、泌乳素(PRL)、孕酮(P)、睾酮(T)和雌二醇(E2)六项生殖激素和精浆PRL、T、P和E2四项生殖激素的浓度,比较组间差异并进行相关性分析。结果精液正常组和弱精子症组血清FSH和E2的浓度显著低于少精子症组和非梗阻性无精子症组(P0.05),精液正常组血清LH和P的浓度显著低于弱精子症、少精子症和非梗阻性无精子症的人群(P0.05);而精液正常、弱精子症和少精子症三组精浆PRL的浓度则高于非梗阻性无精子症组(P0.05)。除了非梗阻性无精子症组,受试者血清FSH的浓度与其精子浓度呈负相关(r分别为-0.350、-0.273和-0.448,P0.05)。精液正常组精浆PRL的浓度和精子的浓度之间呈正相关(r=0.269,P0.05);在少精子症组中,亦有相同趋势的相关性(r=0.432,P0.05)。结论精浆PRL及血清FSH的浓度能够反映精子浓度或活动力,在男性不育的病因分析中具有一定的指导价值。     

氰戊菊酯对大鼠精子及生殖激素的影响

目的探讨氰戊菊酯(Fen)对雄性大鼠精子计数、活力以及生殖激素的影响。方法成年雄性SD大鼠,分别以0、20、40、80mg/kg剂量的Fen连续灌胃染毒15和30d,按常规方法进行精子计数和精子活力检测,应用放射免疫法和化学发光免疫法测定大鼠血清卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)、雌二醇(E2)和睾丸匀浆中T、E2水平。结果Fen染毒15d时,与0mg/kg组相比,40mg/kg剂量组精子数量明显减少(P<0.01),20和40mg/kg组睾丸匀浆中T水平显著降低(P<0.01,P<0.05),血清LH、FSH水平随染毒剂量的增加而升高,且FSH水平和染毒剂量有显著的剂量-效应关系(P<0.05);Fen染毒至30d时,各组间精子数量差异不显著,与0mg/kg组相比,40mg/kg剂量组(a+b)级精子活力显著降低(P<0.05),血清LH、FSH水平随染毒剂量的增加而升高,但差异不显著。结论Fen对雄性大鼠有明显的生殖毒性作用,能够改变血清和睾丸中的生殖激素水平。     

Correlation of seminal parameters with serum lipid profile and sex hormones

The phospholipids and fatty acid composition of sperm are altered under the influence of serum lipids on impaired seminal parameters in infertile men. We studied the correlation of the serum lipid profile and sex hormone results of a group of infertile men with sperm characteristics of 18 infertile men. Semen samples were collected and analyzed. Serum fasted and post-meal glucose levels, insulin, total cholesterol, HDL, LDL, VLDL, triglyceride, FSH, LH, and testosterone measurements were performed. The increased serum VLDL, total triglyceride, and testosterone values were significantly correlated with decreased sperm motility. Serum FSH values were also inversely correlated with normal sperm morphology. The increased VLDL impaired seminal parameters; additionally, increased triglycerides may have deleterious effects on spermatogenesis. Deterioration is related with increased serum VLDL and triglyceride levels.     

Effect of sodium arsenite on spermatogenesis,plasma gonadotrophins and testosterone in rats

To investigate the effect of arsenic on spermatogenesis. Methods: Mature (4 months old) Wistar rats were intraperitoneally administered sodium arsenite at doses of 4, 5 or 6 mg-kg^-day1 for 26 days. Different varieties of germ cells at stage VII seminiferous epithelium cycle, namely, type A spermatogonia (ASg), preleptotene spermatocytes (pLSc), midpachytene spermatocytes (mPSc) and step 7 spermatids (7Sd) were quantitatively evaluated, along with radioimmunoassay of plasma follicle-stimulating hormone (FSH), lutuneizing hormone (LH), testosterone and assessment of the epididymal sperm count. Results: In the 5 and 6 mg/kg groups, there were significant dose-dependent decreases in the accessory sex organ weights, epididymal sperm count and plasma concentrations of LH, FSH and testosterone with massive degeneration of all the germ cells at stage VII. The changes were insignificant in the 4 mg/kg group. Conclusion: Arsenite has a suppressive influence on spermatogenesis and gonadotrophin and testosterone r     

Testicular Function in Varicocele

Testicular testosterone concentration, serum testosterone, LH and FSH, sperm count and testicular histology were evaluated in 17 patients with varicocele. Testicular testosterone was either normal or high (mean 906 ± 723 ng/g of tissue), and serum testosterone was within the normal range in most patients. Serum LH was elevated in half of the patients. The degree of testicular damage observed was extremely variable and correlated with sperm analysis. Testicular testosterone tended to be higher in patients with severe microscopic lesions of the testis.
It is concluded that even though Leydig cell function is partially altered, this deficiency is compensated by LH stimulation and therefore, failure of spermatogenesis is not secondary to low testosterone levels.,     

Risperidone induced reproductive toxicity in male rats targeting leydig cells and hypothalamic–pituitary–gonadal axis by inducing oxidative stress

Risperidone (RIS), a commonly used drug during a lifetime for the treatment of schizophrenia, causes some adverse effects in the male reproductive system; however, there is no comprehensive reproductive toxicity study of RIS. For this purpose, male rats were administered orally for 1.25, 2.5 and 3 mg/kg RIS for 28 days and the sperm count, motility, morphology, DNA damage and the histological changes in testicular tissue were evaluated. Follicle-stimulating hormone (FSH), luteinising hormone (LH) and serum levels of testosterone, which are the main hormonal regulators of reproduction, and testicular glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) and malondialdehyde (MDA) levels as the indicators of oxidative stress were determined. Normal sperm morphology was decreased in RIS groups and histopathological degeneration occurred in testis tissue dose-dependently. Serum LH levels were not altered; however, FSH and testosterone levels decreased in the high-dose group. Histopathologic examination showed RIS toxicity targeted Leydig cells, which might be associated with impairment of the hypothalamic–pituitary–gonadal (HPG) axis. GSH levels were decreased and MDA levels were increased in the high-dose group which was evaluated as indicators of oxidative stress. In conclusion, RIS caused reproductive toxicity in male rats by inducing oxidative stress and disrupting hormonal regulation.     

Relationships between serum hormone levels and semen quality among men from an infertility clinic

Participation rates in epidemiologic studies on semen quality are generally very low, raising concerns as to the potential for selection bias. Since hormones both initiate and maintain spermatogenesis, they may serve as surrogates of semen quality in epidemiologic studies. For this reason, in the present study, we explored the influence and predictive ability of reproductive and thyroid hormones on semen quality among men who were partners in an infertile couple. Between 1999 and 2003, 388 men were recruited from Massachusetts General Hospital Andrology Laboratory for clinical evaluation of fertility status. Fresh semen samples were assessed for quality (concentration, motility and morphology) and the serum levels of hormones, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), inhibin B, sex hormone-binding globulin (SHBG), testosterone, free androgen index, free T4, total T3, and thyroid-stimulating hormone (TSH), were measured. Multiple logistic regression revealed increased odds for below-reference sperm concentration and morphology in men with increased FSH, and decreased odds for below-reference sperm concentration and motility in men with increased inhibin B. When FSH and inhibin B were divided into quintiles, the relationships with sperm concentration showed evidence of a threshold value. However, the ability of specific FSH (10 IU/L) and/or inhibin B (80 pg/mL) cutoff values to predict semen quality was lower than in previous reports. In multiple linear regression analysis, FSH and LH were inversely associated with sperm concentration, motility, and morphology. Inhibin B and free T4 were positively associated with sperm concentration, while there was a suggestive positive association between testosterone and sperm motility. In conclusion, we have found that FSH, LH, inhibin B, testosterone and free T4 levels are associated with human semen parameters. Additional consideration should be given to the utility of serum hormone levels as a surrogate for semen quality in epidemiologic studies in which the collection of semen is difficult due to logistical and/or volunteer rate constraints.     

Testicular function in varicocele

Testicular testosterone concentration serum testosterone, LH and FSH, sperm count and testicular histology were evaluated in 17 patients with varicocele. Testicular testosterone was either normal or high (mean 906 +/- 723 ng/g of tissue), and serum testosterone was within the normal range in most patients. Serum LH was elevated in half of the patients. The degree of testicular damage observed was extremely variable and correlated with sperm analysis. Testicular testosterone tended to be higher in patients with severe microscopic lesions of the testis. It is concluded that even though Leydig cell function is partially altered, this deficiency is compensated by LH stimulation and therefore, failure of spermatogenesis is not secondary to low testosterone levels.     

Bromocriptine for infertile males with mild hyperprolactinemia: hormonal and spermatogenic effects

To clarify the influence of hyperprolactinemia on spermatogenesis and steroidogenesis in infertile male patients, the serum prolactin (PRL), luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, and estradiol concentrations were and the effect of bromocriptine treatment on spermatogenesis was examined. A total of 1234 patients were evaluated and 147 men had hyperprolactinemia. Of these, only 30 had PRL concentrations more than twice the upper limit of normal and most of them had a little excess over the upper limit. For 10 of these 30, serum hormone concentrations were measured and semen was analyzed before and after bromocriptine administration. No relationship between the PRL and other hormone concentrations was found. No changes were noted in the LH, FSH, testosterone, or estradiol concentrations, or in the sperm density and motility after treatment. The mean PRL decreased from 26.5 +/- 4.5 to 1.4 +/- 1.8 ng/mL. In infertile men who are mildly hyperprolactinemic, bromocriptine administration does not improve semen analysis, although it does normalize the PRL.     

Gonadotropin Suppression in Normal Males and Males with 1° Hypogonadism: Evaluation of Four Androgens

Serum concentrations of FSH and LH have been evaluated during treatment with four commonly prescribed androgens. In the first study, five adult males with primary gonadal failure were treated for four weeks with each of four regimens: 17α-methyl testosterone [MT] (40 mg/day or 50 mg/day), fluoxymesterone [F] (50 mg/day), and testosterone cypionate [TC] (200 mg). LH was not suppressed by either dose of MT but was suppressed by F ( P < 0.02). Both FSH and LH were suppressed for up to 3 weeks ( P < 0.05) after a single injection of TC. In the second study, testosterone enanthate [TE] was evaluated as a contraceptive in 20 normal men. After two weeks (200 mg/week), the concentration of testosterone increased from 661 ± 29 ng/dl to approximately 1050 ng dl ( P < 0.001) and serum gonadotropins had fallen to very low or undetectable levels. After 12 weeks of this regimen, 11 men had ≤ 1 million sperm/ml of semen, but 3 had ≥ 10 million sperm/ml. When 200 mg of TE was given every 3 weeks, serum levels of FSH and LH normalized and sperm density increased.
These studies indicate that exogenous androgens can be used to suppress gonadotropins and spermatogenesis; however, each of these four available androgens has limitations. A more potent, longer acting androgen with low toxicity is needed if this approach to the development of a male contraceptive is to be pursued.     

它莫西芬对促性腺激素、睾酮及精液参数影响的研究

本文报告它莫西芬治疗特发性少精症对卵泡刺激素_(ESH)、黄体生成素_(LH)、睾酮(T)以及对精子数量、活力、精浆果糖等参数的影响。采用的双盲法对39例受试者分为实验组、实验对照组、安慰组。结果表明服用它莫西芬20mg/日3个月,可以明显增加血中FSH、LH、T水平,对精子活力,精浆果糖浓度无明显影响。对精子密度在3个月服药期间个体差异较大,均数无明显增加。从临床角度而言,它莫西治疗特发性少精症不育可能对配偶妊娠是有益的。     

Influence of chronic morphine exposure on serum LH, FSH, testosterone levels, and body and testicular weights in the developing male rat

Opiate abuse has been a matter of serious concern in male adolescents. This study investigates the effects of chronic morphine administration on serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone levels, testicular histology, and body and testes weight in developing male rats. Animals were subcutaneously injected with morphine (5 mg/kg) or saline (1 mL/kg) twice daily for 30 days. Body weight determinations and injections were carried out under light ether anesthesia. At the end of the experiments, the rats were decapitated and blood samples were collected. Serum levels of LH and FSH were measured. Chronic morphine administration significantly decreased decreased serum testosterone (p < .02) and LH (p < .01) levels, but not FSH release compared to controls. Morphine exposure reduced body weight (p < .01), but had no significant effect on the testicular weight. When the testicular tissue was histologically examined, structural features of the seminiferous tubules and Leydig cells were similar in both saline and morphine-treated animals. The results suggest that opiates affect testosterone release through the hypothalamo-hypophyseal-gonadal axis rather than by a local testicular mechanism. Chronic morphine exposure during sexual maturation may have long-term endocrine disturbances in male rats.