Serum luteinzing hormone pulsatility and intratesticular testosterone and oestradiol concentrations in idiopathic infertile men with high and normal fofficle stimulating hormone serum concentrations

Abstract

The purpose of the study was to evaluate pulsatile luteinizing hormone (LH) release and intratesticular concentrations of testosterone and oestradiol in infertile men, to determine if alterations in gonadotrophin secretion are associated with changes in the testicular concentrations of steroids. Patients with idiopathic oligo/azoospermia were divided into a high follicle stimulating hormone (FSH) group (n = 5) and a normal FSH group (n = 6). Blood samples were taken every 15 min for 6 h to determine LH, FSH, testosterone, oestradiol, sex hormone binding globulin, bioactive LH and bioavailable testosterone. The patients underwent a bilateral testicular biopsy for histological assessment and to determine testosterone and oestradiol concentrations. Serum measurements were compared with those of seven fertile men. The high FSH group had a higher concentration of serum LH and oestradiol than normal men (P < 0.01) and showed a lower frequency of LH pulses than the normal FSH group and control men (P < 0.01). Intratesticular oestradiol was higher in the high FSH group (P < 0.001), with a lower testosterone/oestradiol ratio (P < 0.01). Patients showed a negative correlation between the serum testosterone/LH ratio and FSH (r = -0.75; P < 0.01) and a positive correlation between the testicular oestradiol concentration and serum FSH (r = 0.86; P < 0.01). The histopathological examination only showed a smaller tube diameter in the high FSH group (P < 0.05). These data seem to indicate that a higher intratesticular concentration of oestradiol with a lower testosterone/oestradiol ratio in the high FSH group could have a deleterious effect on spermatogenesis.

Increased Testicular Steroid Concentrations in Patients With Idiopathic Infertility and Normal FSH Levels

“…From the bilateral biopsy performed in these infertile patients, even though no change in the spermatogenic score was recorded, a tremendous increase of endogenous levels of testosterone and estradiol was noticed, whereas in the control group they were in the normal range. Our results are in agreement with those published by Levalle et al [26], showing an increase of the intratesticular concentrations of testosterone in infertile men with normal FSH levels. There is large augmentation of endogenous estradiol levels; consequently, estradiol/testosterone ratio was higher and may account for the deleterious effect of estradiol on the late steps of spermatogenesis, which do require testosterone [32].…”

“…The patients included in the infertile group (n = 10, mean age 29.8 ± 3.3 years; range [26][27][28][29][30] were selected during the advisory service (infertility status ranged between 3 and 6 years). All of them had normal caryotype and androgenic development; the blood FSH levels were in the normal range but they were infertile.…”

Hormonal regulation of c-KIT receptor and its ligand: implications for human infertility?

“…It is also known that hyperestrogenism is a hormonal deregulation associated with some cases of male idiopathic infertility (Lardone et al, 2010;Levalle et al, 1994;Marie et al, 2001). These findings support the idea that the elevated concentrations of estrogens are the cause underlying male infertility due to their effects on the reduction of c-KIT expression.…”

Insulin-Like Growth Factor I Inhibits Aromatization Induced by Follicle-Stimulating Hormone in Rat Sertoli Cell Culture1

“…IGF-I may modulate this FSH-stimulated estrogen during testis development in the immature animal. Additionally, estradiol may inhibit spermatogenesis, as infertile men with elevated FSH have higher circulating estradiol [48]. Since IGF-I biologic activity is likely to be stimulated by FSH, one action of IGF-I may be to lower estrogen levels to augment testosterone-mediated action in the testis.…”