Endocrine studies of azoospermia, II. Serum steroid levels in obstructive azoospermia

Abstract

Serum estrone, estradiol, estriol, progesterone, 17 a-hydroxyprogesterone, and testosterone were determined in the sera of 25 normal males and 25 patients with obstructive azoospermia. An increase in testosterone and estriol levels, and a decrease in other hormones were demonstrated in patients with obstructive azoospermia. These long-term effects of obstruction of the vas apparently also occur in comparable situations, for example, after vasectomy.Key Words: Azoosperrnia; Estrogens; Progesterones; Androgens. INTRODUCTIONInterest in the effects of prolonged obstruction of the vas on the spermatogenic and hormonal function of the testes is growing, particularly with vasectomy being performed as part of contraceptive programs implemented by many developing countries. Infertile males with obstructive azoospermia are expected to develop comparable effects. The available literature on this subject is characterized by contradiction and inconsistency. While some investigators have reported no significant changes [3, 181, others have demonstrated alterations in the hormonal function of the testes apparently related to the duration andor level of obstruction [6].This study was carried out to determine the serum levels of estrogens, progesterones, and androgens in obstructive azoospermia and to find out whether the levels are different from those in a normal control group. MATERIALS AND METHODSA group of 25 patients (26-44 yr of age) with obstructive azoospermia were selected randomly from the male infertility clinic. Their diagnosis was based on repeated semen analyses and a testicular biopsy showing active spermatogenesis. All were sexually potent and in good general health. A control group of 25 fertile males (21-40 yr of age), sexually potent and in good general health, was also included in the study. Their fertility was proved by repeated semen analyses. All had sperm counts of over 40 millionlCulm1, average motility, less than 15% abnormal forms, and ejaculate volume ranging from 1.2 to 6.7 Cu/ml. All the subjects participating in the study RESULTSThe mean values f SE for the serum levels of each of esterone, estradiol, and estriol are presented in Fig. 1, and those for serum progesterone, 17a-hydroxyprogesterone, testosterone, and dihydrotestosterone are shown in Fig. 2. In comparison to the normal group, the obstructive azoospermic group had significantly (p < 0.001) lower levels of estrone, estradiol, progesterone, 17a-hydroxyprogesterone, and dihydrotestosterone and significantly (p < 0.001) higher levels of estriol and testosterone. DISCUSSIONThe rise in total androgens and the fall in total estrogens and progesterones observed in the present study are inconsistent with the results of short-term studies reported by other investigators, which indicated insignificant changes in these hormones in vasectomized patients [3, 181. This inconsistency might be attributable to the duration and level of obstruction. In their report, Smith et al. demonstrated differential changes in the hormonal levels between the first a...

Quantification of telomerase activity, porphobilinogen deaminase and human telomerase reverse transcriptase mRNA in testicular tissue – new parameters for a molecular diagnostic classification of spermatogenesis disorders

“…(1999) describing activation of telomerase by 17β‐estradiol via direct and indirect effects on the hTERT promoter with consecutive up‐regulation of hTERT mRNA expression. It would thus be conceivable that the different oestrogen level found, for example, in patients with SCOS (Abdalla et al ., 1979) contribute to the reduced hTERT expression in telomerase positive cells of patients with spermatogenesis defects. It is also possible that, besides this some other endocrine factors that are important for spermatogenesis (Berruti, 1998), may also play a role in the regulation of hTERT expression.…”

Serum Progesterone Patterns in Male Subfertility

“…The results are restricted to progesterone patterns in cases of obstructive azoospermia compared with fertile men. A significant decrease of progesterone in patients with obstructive azoospermia was found (Abdalla et al -1979). Purvis et al (1975) included the group of severe oligozoospermia to their investigations and found elevated progesterone levels in azoospermic and oligozoospermic men.…”

“…The few available clinical data about affections of plasma progesterone levels at impaired male fertility are contradictive and restricted to reports on azoospermia and oligozoospermia. Abdalla et al (1979) reported decreased levels or progesterone in 25 patients with obstructive azoospermia. Purvis et al (1975) found significantly higher plasma progesterone levels in eleven oligozoospermic and ten azoospermic men in comparison to a normozoospermic control group.…”