Raised plasma oestrogens in infertile men with elevated levels of FSH

In twenty oligospermic or azoospermic patients with elevated plasma FSH, the mean concentrations of plasma oestrone sulphate (843 +/- 233 pg/ml), oestrone (54 +/- 10.4 pg/ml) and oestradiol (46.6 +/- 12.6 pg/ml) were found to be significantly higher than in twenty-one normal fertile men of comparable age (593 +/- 220 pg/ml, 40.6 +/- 8.8 pg/ml and 33.1 +/- 10.9 pg/ml respectively). SHBG binding capacity was elevated in the infertile group (infertile 3.35 +/- 0.82 x 10(-8) M/l v. normal 2.76 +/- 0.89 x 10(-8) M/l) but the total plasma testosterone concentrations were comparable (infertile 5435 +/- 1578 pg/ml v. normal 5046 +/- 1102 pg/ml). Evidence was cited to support the view that Sertoli cells, in response to an unphysiological FSH stimulation, are a likely source of excessive oestrogen production. The possible significance of increased intra-testicular and circulating oestrogen in the altered state of testicular steroidogenic function in men with primary seminiferous tubular defects was discussed.