EYES2023 ESE Young Endocrinologists and Scientists (EYES) 2023 Oral communication 5: Reproductive Endocrinology (9 abstracts)
Testosterone serum levels in idiopathic male infertility: An epidemiological insight with pathophysiological and clinical consequences
Francesco Costantino 1 , Giorgia Spaggiari 2 , Leonardo Dalla Valentina 3 , Marilina Romeo 3 , Laura Roli 4 , Maria Cristina De Santis 4 , Tommaso Trenti 4 , Antonio Granata 2 , Manuela Simoni 3 & Daniele Santi 3
1Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy; Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Italy; 2Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Italy, Unit of Andrology and Sexual Medicine of the Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Italy; 3Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy, Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Italy; 4Department of Laboratory Medicine and Pathology, Azienda Usl of Modena, Italy.
Background: Despite male idiopathic infertility is characterized by semen analysis alteration with gonadotropins within reference ranges, it is still considered a functional hypogonadotropic hypogonadism (FHH). This simple definition is fundamental to guide the empirical therapeutic approach of these men. However, the number of studies describing total testosterone serum levels (TT) in male idiopathic infertility is still limited.
Objective: To evaluate TT distribution in a cohort of men with idiopathic infertility.
Methods: A real-world study was conducted, enrolling all men evaluated for couple infertility. Each patient was evaluated by conventional semen analysis and hormones (i.e. follicle stimulating hormone [FSH], luteinising hormone [LH] and TT). When semen analysis alteration was detected and all known causes of male infertility excluded, the diagnosis of idiopathic infertility was reached. TT distribution was evaluated and the number of subjects with TT below than reference thresholds suggested by scientific societies (i.e. 3.5 ng/ml) was calculated.
Results: 254 men were enrolled (mean age 38.2±6.1 years), with an average infertility duration of 2.5±3.1 years. According to inclusion criteria, the average semen analysis parameters were below than decisional limits and gonadotropins within reference ranges (LH: 4.1±1.9 IU/l, FSH: 5.8±4.7 IU/l). TT was not normally distributed (P<0.001), with a positive asymmetric distribution (Curtosi 3.1, standard error 0.3), with mean 5.0±2.1 ng/ml (min 2.2, max 10.5 ng/ml), 5th centile 2.6 ng/ml and 95th centile 9.4 ng/ml. In the 19.4% of the cohort (58 patients) TT was lower than 3.5 ng/ml. Semen parameters and gonadotropins did not differ between patients with TT below or above 5th centile of distribution.
Conclusions: About the 20% of men with idiopathic infertility showed reduced TT, confirming the suggestion of FHH. However, this result confirmed the heterogeneity of this condition, excluding the FHH in the remnant 80% of cases.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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