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Pituitary gonadal function in infertile men with varicocele
Andrologia
|January 1, 1983
Summary
Varicocele in infertile men is linked to impaired sperm quality and Leydig cell dysfunction, suggesting a causal role in infertility. Further research indicates hormonal imbalances and potential testicular damage with longer varicocele duration.
Area of Science:
- Reproductive Endocrinology
- Andrology
- Urology
Background:
- Varicocele is a common cause of male infertility.
- Idiopathic infertility affects a significant portion of the male population.
- Hormonal profiles and testicular function are crucial in male fertility.
Purpose of the Study:
- To investigate hormonal differences and testicular function in infertile men with varicocele compared to those with idiopathic infertility and controls.
- To assess the impact of varicocele on sperm parameters and gonadotropin-releasing hormone (GnRH) and thyrotropin-releasing hormone (TRH) stimulation tests.
- To explore the role of human chorionic gonadotropin (hCG) binding in testicular tissue of infertile men.
Main Methods:
- Radioimmunological plasma analyses of testosterone, FSH, LH, and PRL before and after LRH and TRH stimulation.
- Spermocytogram analysis for motility and normal forms.
- Intravenous LRH stimulation test.
- [125I]hCG binding assays on testicular biopsy tissue.
Main Results:
- Infertile men with varicocele or idiopathic infertility showed significantly lower sperm motility and normal forms than controls.
- Basal FSH and PRL levels were higher in the varicocele group compared to controls.
- LH, FSH, and PRL responses to LRH and TRH stimulation were generally higher in infertile men.
- Testosterone levels and FSH response to LRH were lower in the varicocele group than in the idiopathic infertility group.
- Age negatively correlated with sperm motility and testosterone in varicocele patients.
- [125I]hCG binding was present in all infertile men, with variable capacity in varicocele cases.
Conclusions:
- Varicocele may cause infertility through spermatogenesis and Leydig cell dysfunction, with compensatory pituitary hyperfunction.
- Prolonged varicocele duration is associated with worsening Leydig cell and tubular damage.
- No gross abnormalities in testicular hCG receptor binding were observed in varicocele patients, suggesting a causal role for varicocele in infertility.