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Decrease in semen quality and Leydig cell function in infertile men: a longitudinal study.

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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.

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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.