Frequency of androgen insensitivity in infertile phenotypically normal men

In 1979 Aiman and associates reported on a group of phenotypically normal men with severe oligospermia or azoospermia and androgen receptor deficiency. They calculated an androgen insensitivity index (ng./ml. serum testosterone times mIU/ml. serum luteinizing hormone) to identify these men and found the mean to be 233. We calculated the androgen insensitivity index in 144 infertile male patients in our fertility clinic. Of these patients 86 had azoospermia or severe oligospermia (mean sperm concentration 3 million per ml.). In this group 11.6 per cent had an androgen insensitivity index of more than 200, suggesting androgen insensitivity. These patients were compared to a control group with known fertility (16 semen donors) and to 34 men with idiopathic infertility (mean sperm concentration 47 million per ml.) treated with clomiphene citrate. The androgen insensitivity index may help to identify a group of 10 per cent or more of azoospermic or oligospermic men who are not amenable to therapy.