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Decrease in semen quality and Leydig cell function in infertile men: a longitudinal study
I A Olesen1,2, U N Joensen1,2, J H Petersen1,2,3
1University Department of Growth and Reproduction, Rigshospitalet section 5064, Blegdamsvej 9, Copenhagen Ø, Denmark.
Human Reproduction (Oxford, England)
|September 25, 2018
Summary
Infertile men with poor semen quality risk further testicular decline. Lower baseline sperm counts predict greater LH increases and testosterone/LH ratio decreases over 15 years.
Area of Science:
- Reproductive Endocrinology
- Male Infertility Research
- Spermatogenesis Studies
Background:
- Male factors contribute to up to 50% of infertility cases.
- Spermatogenic failure (SgF) is common, but its long-term impact on semen quality and testosterone is understudied.
Purpose of the Study:
- To investigate the long-term changes in semen quality and reproductive hormone levels in men with SgF.
- To assess the risk of further testicular function decline in infertile men with reduced semen quality.
Main Methods:
- A 15-year follow-up study of 137 men with SgF and 70 controls.
- Semen analysis and measurement of reproductive hormones (FSH, LH, testosterone, SHBG, estradiol, inhibin B) at baseline and follow-up.
Main Results:
- SgF men showed significantly lower Leydig cell capacity and semen quality at follow-up.
- Median sperm concentration decreased, and 10% developed azoospermia.
- Calculated free testosterone decreased annually, while LH increased, leading to reduced testosterone/LH ratios, more pronounced in men with lower baseline sperm counts.
Conclusions:
- Infertile men with reduced semen quality face a risk of progressive testicular function deterioration.
- Lower baseline sperm concentration is linked to more significant hormonal changes over time.
- Sperm cryopreservation or timely fertility treatment is advisable for men with impaired semen quality.
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