[Current aspects of hormone diagnosis in andrology--predictive values for the preservation of spermatogenesis]

The occurrence of hormonal disorders in 1.4 to 9.7% of the patients of andrology units justify a corresponding hormone analysis. Besides helping to make the differential-diagnosis of a disease hormone results are important for the description of preservation of spermatogenesis in cases of aspermia or azoospermia. Indications of a rest-spermatogenesis or a spermatozoon-pool could be crucial for assisted reproduction. Spermatological and testis-histological data of 2 independent collectives (n1 = 138; n2 = 110) were correlated with basal levels of FSH, LH, PRL, T, free T, and E2. Serum FSH appears with a sensitivity of 88.8% and a specification of 94.1% as good, but not absolutely certain discriminator of preserved or disturbed spermatogenesis. The inclusion of testis volume improves the diagnostic reliability only negligibly--the critical size is 16 ml. Because of its low diagnostic sensitivity the serum LH alone gives not much information but it can indicate together with serum testosterone causally relevant disorders in androgen metabolism (i.e. androgen resistance syndrome. Klinefelter-syndrome). PRL, T, free T, and E2 gave no conclusion of occurrence of disturbed or preserved spermatogenesis. For indication of performing testis biopsy because of diagnosis and therapeutic considerations further factors of spermatogenesis are required.