Testicular Steroids in Spermatic and Peripheral Veins After Single Injection of Hcg in Patients With Varicocele

Takeyama, Masami; Honjoh, Michio; Kodama, Masaya; Sakaguchi, Hideki; Koh, Eitetsu; Kondoh, Nobuyuki; Fujioka, Hideki; Nakamura, Masayoshi; Namiki, Mikio; Okuyama, Äkïhïko; Matsumoto, Kenji; Sonoda, T

doi:10.3109/01485019008986881

Cited by 17 publications

(9 citation statements)

References 24 publications

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“…The mechanism by which testosterone synthesis is affected is not yet clear. Possible mechanisms include reduced activity of 17,20‐desmolase and 17‐alpha‐hydroxylase enzymes as a result of testicular hyperthermia [31] and impaired Leydig cell response to gonadotrophin stimulation [32,33].…”

Section: Discussionmentioning

confidence: 99%

Impact of Varicocelectomy on Gonadal and Erectile Functions in Men with Hypogonadism and Infertility

Zohdy

Ghazi

Arafa

2011

The Journal of Sexual Medicine

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Introduction Previous reports linked varicocele in infertile males with Leydig cell dysfunction and hypogonadism. Aim The aim of this study was to determine the impact of varicocelectomy on serum total testosterone (TT) level and erectile function in men with infertility and clinical varicocele. Methods This study included 141 heterosexual infertile men diagnosed to have clinical varicocele. They were divided into two groups: group 1 (103 men), who had microsurgical varicocelectomy, and group 2 (38 patients), who decided to pursue assisted reproduction procedures. All participants completed the International Index of Erectile Function (IIEF)-5 questionnaire and underwent semen analysis. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and TT were measured both at recruitment time and 6 months later. Main Outcome Measure Changes in serum TT and IIEF-5 following varicocelectomy. Results In group 1, the mean TT level increased significantly post-varicocelectomy (379.1 ± 205.8 to 450.1 ± 170.2 ng/dL, P < 0.0001). No similar change was found in group 2. Out of the 49 patients in group 1 with hypogonadism at baseline assessment (TT < 300 ng/dL), 37 (75.5%) exhibited a postoperative normalization of TT. However, only 3/15 hypogonadal men (20%) in group 2 had normal testosterone levels at the second visit. IIEF-5 scores improved significantly postoperatively in patients with hypogonadism (17.1 ± 2.6 to 19.7 ± 1.8, P < 0.001). Neither operating vein diameter 3.6 ± 0.57 mm nor testicular size 10.46 ± 3.3 mL correlated with the mean change in TT (71.1 ± 101.2 ng/dL) (r = 0.162, P = 0.183 and r = −0.077, P = 0.536, respectively). Conclusions Varicocele is associated with hypogonadism in some infertile patients. Varicocelectomy significantly improves serum testosterone in infertile men, especially those with hypogonadism. This improvement in TT level may be reflected in the IIEF score.

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Section: Discussionmentioning

confidence: 99%

Impact of Varicocelectomy on Gonadal and Erectile Functions in Men with Hypogonadism and Infertility

Zohdy

Ghazi

Arafa

2011

The Journal of Sexual Medicine

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“…The mechanism by which testosterone synthesis is affected is not yet clear. Possible mechanisms include reduced activity of 17,20-desmolase and 17-alpha-hydroxylase enzymes as a result of testicular hyperthermia [27] and impaired Leydig cell response to gonadotrophin stimulation [28, 29]. …”

Section: Discussionmentioning

confidence: 99%

Does Varicocelectomy Improve Gonadal Function in Men with Hypogonadism and Infertility? Analysis of a Prospective Study

Srini

Veerachari

2011

International Journal of Endocrinology

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Varicocele in infertile males is associated with Leydig cell dysfunction and hypogonadism. The effect of varicocelectomy on serum testosterone level is not yet established. We analysed 200 heterosexual infertile men diagnosed to have clinical varicocele they were divided into two groups: group 1 (100 men) had microsurgical varicocelectomy, and group 2 (100 patients) underwent assisted reproduction procedures. All participants had semen analysis, serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and total testosterone (TT), measured both at recruitment time and 6 months later. In group 1, the mean TT level increased significantly after varicocelectomy (1.644 ± 0.029 to 2.461 ± 0.0198 ng/dL, P < 0.0001) and testicular size correlated with the mean change in TT (P = 0.001). No similar change was found in group 2. Out of the 100 patients in group 1, 78 had postoperative normalization of TT unlike only 16 men in group 2.

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“…Defective testosterone synthesis has been reported to be associated with varicocele [1,15]. This is probably through intratesticular hyperthermia, which inhibits 17alpha-hydroxyprogesterone aldolase, an enzyme responsible for the conversion of 17alpha-hydroxyprogesterone to testosterone.…”

Section: Discussionmentioning

confidence: 99%

Varicocele Ligation on Free Testosterone Levels in Infertile Men With Varicocele

Ishikawa¹,

Fujisawa²

2004

Archives of Andrology

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We have analyzed the effects of varicocele ligation on free testosterone levels, and investigated the interrelationships between free testosterone and fertility. The records were retrospectively evaluated for 42 infertile patients who underwent varicocele ligation, with serum free testosterone levels, follicle stimulating hormone (FSH), lutenizing hormone (LH), testosterone, estradiol, prolactin, ejaculated volume, sperm concentration and motility before and after surgery. Serum free testosterone levels increased from 12.97 AE 4.16 to 13.59 AE 3.93 pg=mL, but the difference was insignificant. The differences before and after surgery of patients in sperm concentration and motility were also insignificant. However, in free testosterone increasing group, the sperm concentration and motility increased significantly, from 4.05 AE 4.35 to 7.90 AE 8.19 million=mL (P ¼ 0.01) and from 30.64 AE 21.87% to 41.00 AE 22.00%, respectively (P ¼ 0.03). The increase in serum free testosterone level by varicocele ligation results in a significant improvement in sperm concentration and motility.

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Testicular Steroids in Spermatic and Peripheral Veins After Single Injection of Hcg in Patients With Varicocele

Cited by 17 publications

References 24 publications

Impact of Varicocelectomy on Gonadal and Erectile Functions in Men with Hypogonadism and Infertility

Impact of Varicocelectomy on Gonadal and Erectile Functions in Men with Hypogonadism and Infertility

Does Varicocelectomy Improve Gonadal Function in Men with Hypogonadism and Infertility? Analysis of a Prospective Study

Varicocele Ligation on Free Testosterone Levels in Infertile Men With Varicocele

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