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Semen quality in patients with pituitary disease and adult-onset hypogonadotropic hypogonadism

OBJECTIVE: Gonadotropins (luteinizing hormone (LH) and follicle-stimulating hormone (FSH)) are released from the pituitary gland and stimulate Leydig cells to produce testosterone and initiates spermatogenesis. Little is known about how and when the deterioration of semen quality occurs in patients...

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Autores principales: Andreassen, Mikkel, Juul, Anders, Feldt-Rasmussen, Ulla, Jørgensen, Niels
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bioscientifica Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5881434/
https://www.ncbi.nlm.nih.gov/pubmed/29514896
http://dx.doi.org/10.1530/EC-18-0061
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author Andreassen, Mikkel
Juul, Anders
Feldt-Rasmussen, Ulla
Jørgensen, Niels
author_facet Andreassen, Mikkel
Juul, Anders
Feldt-Rasmussen, Ulla
Jørgensen, Niels
author_sort Andreassen, Mikkel
collection PubMed
description OBJECTIVE: Gonadotropins (luteinizing hormone (LH) and follicle-stimulating hormone (FSH)) are released from the pituitary gland and stimulate Leydig cells to produce testosterone and initiates spermatogenesis. Little is known about how and when the deterioration of semen quality occurs in patients with adult-onset gonadotropin insufficiency. DESIGN AND METHODS: A retrospective study comprising 20 testosterone-deficient men (median age, 29 years) with acquired pituitary disease who delivered semen for cryopreservation before initiation of testosterone therapy. Semen variables and hormone concentrations were compared to those of young healthy men (n = 340). RESULTS: Thirteen of 20 patients (65%) and 82% of controls had total sperm counts above 39 million and progressive motile spermatozoa above 32% (P = 0.05). For the individual semen variables, there were no significant differences in semen volume (median (intraquartile range) 3.0 (1.3–6.8) vs 3.2 (2.3–4.3) mL, P = 0.47), sperm concentration 41 (11–71) vs 43 (22–73) mill/mL (P = 0.56) or total sperm counts (P = 0.66). One patient had azoospermia. Patients vs controls had lower serum testosterone 5.4 (2.2–7.6) vs 19.7 (15.5–24.5) nmol/L (P = 0.001), calculated free testosterone (cfT) 145 (56–183) vs 464 (359–574) pmol/L (P < 0.001), LH 1.5 (1.1–2.1) vs 3.1 (2.3–4.0) U/L (P = 0.002) and inhibin b (P < 0.001). Levels of FSH were similar (P = 0.63). Testosterone/LH ratio and cfT/LH ratio were reduced in patients (both P < 0.001). CONCLUSIONS: Despite Leydig cell insufficiency in patients with acquired pituitary insufficiency, the majority presented with normal semen quality based on the determination of the number of progressively motile spermatozoa. In addition, the data suggest reduced LH bioactivity in patients with pituitary insufficiency.
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spelling pubmed-58814342018-04-05 Semen quality in patients with pituitary disease and adult-onset hypogonadotropic hypogonadism Andreassen, Mikkel Juul, Anders Feldt-Rasmussen, Ulla Jørgensen, Niels Endocr Connect Research OBJECTIVE: Gonadotropins (luteinizing hormone (LH) and follicle-stimulating hormone (FSH)) are released from the pituitary gland and stimulate Leydig cells to produce testosterone and initiates spermatogenesis. Little is known about how and when the deterioration of semen quality occurs in patients with adult-onset gonadotropin insufficiency. DESIGN AND METHODS: A retrospective study comprising 20 testosterone-deficient men (median age, 29 years) with acquired pituitary disease who delivered semen for cryopreservation before initiation of testosterone therapy. Semen variables and hormone concentrations were compared to those of young healthy men (n = 340). RESULTS: Thirteen of 20 patients (65%) and 82% of controls had total sperm counts above 39 million and progressive motile spermatozoa above 32% (P = 0.05). For the individual semen variables, there were no significant differences in semen volume (median (intraquartile range) 3.0 (1.3–6.8) vs 3.2 (2.3–4.3) mL, P = 0.47), sperm concentration 41 (11–71) vs 43 (22–73) mill/mL (P = 0.56) or total sperm counts (P = 0.66). One patient had azoospermia. Patients vs controls had lower serum testosterone 5.4 (2.2–7.6) vs 19.7 (15.5–24.5) nmol/L (P = 0.001), calculated free testosterone (cfT) 145 (56–183) vs 464 (359–574) pmol/L (P < 0.001), LH 1.5 (1.1–2.1) vs 3.1 (2.3–4.0) U/L (P = 0.002) and inhibin b (P < 0.001). Levels of FSH were similar (P = 0.63). Testosterone/LH ratio and cfT/LH ratio were reduced in patients (both P < 0.001). CONCLUSIONS: Despite Leydig cell insufficiency in patients with acquired pituitary insufficiency, the majority presented with normal semen quality based on the determination of the number of progressively motile spermatozoa. In addition, the data suggest reduced LH bioactivity in patients with pituitary insufficiency. Bioscientifica Ltd 2018-03-07 /pmc/articles/PMC5881434/ /pubmed/29514896 http://dx.doi.org/10.1530/EC-18-0061 Text en © 2018 The authors http://creativecommons.org/licenses/by-nc/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Research
Andreassen, Mikkel
Juul, Anders
Feldt-Rasmussen, Ulla
Jørgensen, Niels
Semen quality in patients with pituitary disease and adult-onset hypogonadotropic hypogonadism
title Semen quality in patients with pituitary disease and adult-onset hypogonadotropic hypogonadism
title_full Semen quality in patients with pituitary disease and adult-onset hypogonadotropic hypogonadism
title_fullStr Semen quality in patients with pituitary disease and adult-onset hypogonadotropic hypogonadism
title_full_unstemmed Semen quality in patients with pituitary disease and adult-onset hypogonadotropic hypogonadism
title_short Semen quality in patients with pituitary disease and adult-onset hypogonadotropic hypogonadism
title_sort semen quality in patients with pituitary disease and adult-onset hypogonadotropic hypogonadism
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5881434/
https://www.ncbi.nlm.nih.gov/pubmed/29514896
http://dx.doi.org/10.1530/EC-18-0061
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