Endocrine Abstracts

Objective: Growth hormone (GH) activity might be implicated in male reproductive function. One previous study has suggested significantly reduced semen quality in untreated acromegalic patients due to both reduced sperm counts and motility.

Design and methods: A retrospective study comprising 10 uncontrolled hypogonadal acromegalic patients (median age 29y) who delivered semen for cryopreservation before initiation of testosterone therapy. Semen variables and hormone concentrations were compared to those of 10 non-acromegalic hypogonadal men with pituitary disease (age 31 years) and those of young healthy men (n=340).

Results: 80 % of acromegalic patients vs 50% of non-acromegalic patients had total sperm counts above 39 million and progressive motile spermatozoa above 32% (P=0.18) (WHO criteria for normal semen quality based on sperm counts and motility). The corresponding number in healthy controls was 82%. The prevalence of normal semen quality in acromegalic patients vs healthy controls was 80% vs 82% (P=0.55) and in non-acromegalic patients vs healthy controls 50% vs 82% (P=0.022). Serum IGF-1 was higher in acromegalic patients vs non-acromegalic patients 1017 (421–1434) vs 211 (91–271) mg/l (P<0.001). For reproductive hormone levels there were no differences between acromegalic patients vs non-acromegalic patients (P-values between 0.10 and 0.61). Patients (n=20) vs healthy 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 145 (56–183) vs 464 (359–574) pmol/l (P<0.001), LH (P=0.002), and inhibin b (P<0.001). Levels of FSH were similar (P=0.63).

Conclusions: Despite severe Leydig cell insufficiency acromegalic patients had semen quality similar to healthy controls based on determination of the number of progressively motile spermatozoa. By contrast non-acromegalic patients had reduced semen quality. Our data do not support reduced semen quality in acromegaly.