Main Article Content
luteinizing hormone, follicle stimulating hormone, testosterone, semen quality, hormones
Background and Objective
Hormonal measurements play an important role in the evaluation of male fertility potential. In men without hypogonadism, the impact of androgen status on semen is rarely analyzed.
Material and Methods
We evaluated associations between parameters of the pituitary-gonadal axis: luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (T), free testosterone (FT), calculated testosterone (TC), bioavailable testosterone (TB), sex hormone-binding globulin (SHBG), free androgen index, and semen quality parameters in healthy young men.
In our study group, sperm concentration and sperm count were associated with FSH and FT. The percentage of immotile sperm was associated with LH and T. The percentage of vital sperm was negatively related to LH. We identified negative, independent associations between T and semen volume (p<0.026) and TC and semen volume (p<0.025). We observed negative, independent association between FSH, FT, and total sperm count (both P<0.002) and between FT and the percentage of normal forms (P<0.012). There were positive associations between LH and T and the percentage of immotile sperm (P<0.007 and P<0.034, respectively). There were no relationships between sperm morphology parameters and the parameters of the pituitary-gonadal axis.
In healthy eugonadal men, variations in FSH, LH, T, and FT (within normal limits) are reflected in semen characteristics but not in sperm morphology features.
2. O'Donnell L, Stanton P, de Kretser DM. Endocrinology of the Male Reproductive System and Spermatogenesis. In: LJ De Groot, G Chrousos, K Dungan, KR Feingold, A Grossman, JM Hershman et al. (eds.), Endotext [Internet]. South Dartmouth, MA;MDText.com, Inc.; 2000. Available from http://www.ncbi.nlm.nih.gov/books/ NBK279031/. PubMed PMID: 25905260.
3. Stewart TM, Liu DY, Garrett C, Jorgensen N, Brown EH, Baker HW. Associations between andrological measures, hormones and semen quality in fertile Australian men: inverse relationship between obesity and sperm output. Hum Reprod 2009;24:1561–8. https://doi.org/10.1093/ humrep/dep075
4. Jensen TK, Andersson AM, Hjollund NH, et al. Inhibin B as a serum marker of spermatogenesis: correlation to differences in sperm concentration and follicle-stimulating hormone levels. A study of 349 Danish men. J Clin Endocrinol Metab 1997;82:4059–63. https://doi.org/10.1210/jc.82. 12.4059
5. Uhler ML, Zinaman MJ, Brown CC, Clegg ED. Relationship between sperm characteristics and hormonal parameters in normal couples. Fertil Steril 2003;79 Suppl 3:1535–42. https://doi.org/10. 1016/S0015-0282(03)00336-4
6. Sina D, Schuhmann R, Abraham R, Taubert HD, Dericks-Tan JS. Increased serum FSH levels correlated with low and high sperm counts in male infertile patients. Andrologia 1975;7:31–7. https:// doi.org/10.1111/j.1439-0272.1975.tb01223.x
7. Keskin MZ, Budak S, Zeyrek T, et al. The relationship between serum hormone levels (follicle-stimulating hormone, luteinizing hormone, total testosterone) and semen parameters. Arch Ital Urol Androl 2015;87:194–7. https://doi.org/ 10.4081/aiua.2015.3.194
8. Andersson AM, Jorgensen N, Frydelund-Larsen L, Rajpert-De Meyts E, Skakkebaek NE. Impaired Leydig cell function in infertile men: a study of 357 idiopathic infertile men and 318 proven fertile controls. J Clin Endocrinol Metab 2004;89:3161–7. https://doi.org/10.1210/jc.2003-031786
9. Dhooge W, van Larebeke N, Comhaire F, Kaufman JM. Regional variations in semen quality of community-dwelling young men from Flanders are not paralleled by hormonal indices of testicular function. J Androl 2007;28:435–43. https://doi.org/10.2164/jandrol.106.001644
10. Wang G, Xu R, Zhang Z, Wang X. [Detection of free testosterone in the serum and semen of idiopathic oligospermia patients and its significance]. Zhonghua Nan Ke Xue 2004;10:684–5.
11. Wang C, Catlin DH, Demers LM, Starcevic B, Swerdloff RS. Measurement of total serum testosterone in adult men: comparison of current laboratory methods versus liquid chromatography-tandem mass spectrometry. J Clin Endocrinol Metab 2004;89:534–43. https://doi.org/10.1210/ jc.2003-031287
12. Vermeulen A, Verdonck L, Kaufman JM. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab 1999;84:3666–72. https://doi. org/10.1210/jcem.84.10.6079
13. Rosner W, Auchus RJ, Azziz R, Sluss PM, Raff H. Utility, limitations, and pitfalls in measuring testosterone: an endocrine society position statement. J Clin Endocrinol Metab 2007;92:405–13. https://doi.org/10.1210/jc. 2006-1864
14. Jorgensen N, Joensen UN, Toppari J, et al. Compensated reduction in Leydig cell function is associated with lower semen quality variables: a study of 8182 European young men. Hum Reprod 2016;31:947–57. https://doi.org/10.1093/humrep/ dew021
15. Jozkow P, Medras M, Lwow F, Zagrodna A, Slowinska-Lisowska M. Associations between physical activity and semen quality in young healthy men. Fertil Steril 2017;107:373–8.e2. https://doi.org/10.1016/j.fertnstert.2016.11.004
16. Lwow F, Medras M, Słowinska-Lisowska M, Józków P, Szmigiero L. The effect of occasional alcohol drinking on semen quality and sperm morphology among young and healthy polish men. J Men's Health 2017;13:e16–24. https://doi. org/10.22374/1875-68126.96.36.199
17. Mędraś M, Lwow F, Jóźków P, Szmigiero L, Zagrodna A, Zagocka E, Słowińska-Lisowska M. The quality of semen among a sample of young, healthy men from Lower Silesia (AndroLS). Endokrynol Pol 2017;68(6):668–675. doi: 10.5603/ EP.a2017.0056. Epub 2017 Oct 12. PubMed PMID: 29022649.
18. World Health Organization. WHO laboratory manual for the examination and processing of human semen. 5th ed. Geneva, Switzerland: World Health Organization; 2010.
19. Kamieniczna M, Fraczek M, Malcher A, et al. Semen quality, hormonal levels, and androgen receptor gene polymorphisms in a population of young male volunteers from two different regions of Poland. Med Sci Monit 2015;21:2494–504. https://doi.org/10.12659/MSM.893628
20. Skakkebaek NE, Rajpert-De Meyts E, Buck Louis GM, et al. Male Reproductive disorders and fertility trends: influences of environment and genetic susceptibility. Physiol Rev 2016;96:55– 97. https://doi.org/10.1152/physrev.00017.2015
21. Conway GS. Clinical manifestations of genetic defects affecting gonadotrophins and their receptors. Clin Endocrinol (Oxf). 1996;45:657–63. https://doi.org/10.1046/j.1365-2265.1996.868 0879.x
22. Subhan F, Tahir F, Ahmad R, Khan ZD. Oligospermia and its relation with hormonal profile. J Pak Med Assoc 1995;45:246–7.
23. Salama N, El-Sawy M. Isolated low follicle-stimulating hormone (FSH) in infertile males – a preliminary report. Arch Ital Urol Androl 2013;85:118–24. https://doi.org/10.4081/aiua.2013.3.118
24. Zheng J, Mao J, Cui M, et al. Novel FSHbeta mutation in a male patient with isolated FSH deficiency and infertility. Eur J Med Genet 2017;60:335–9. https://doi.org/10.1016/j.ejmg.2017.04.004
25. Jensen TK, Andersson AM, Jorgensen N, et al. Body mass index in relation to semen quality and reproductive hormones among 1,558 Danish men. Fertil Steril 2004;82:863–70. https://doi. org/10.1016/j.fertnstert.2004.03.056
26. Valenti D, La Vignera S, Condorelli RA, et al. Follicle-stimulating hormone treatment in normogonadotropic infertile men. Nat Rev Urol 2013;10:55–62. https://doi.org/10.1038/nrurol.2012.234
27. Herati AS, Cengiz C, Lamb DJ. Assays of serum testosterone. Urol Clin North Am 2016;43:177–84. https://doi.org/10.1016/j.ucl.2016.01.003
28. Kumanov P, Nandipati K, Tomova A, Agarwal A. Inhibin B is a better marker of spermatogenesis than other hormones in the evaluation of male factor infertility. Fertil Steril 2006;86:332–8. https://doi.org/10.1016/j.fertnstert.2006.01.022
29. Chiu YH, Edifor R, Rosner BA, et al. What does a single semen sample tell you? Implications for male factor infertility research. Am J Epidemiol 2017;186:918–26. https://doi.org/10.1093/aje/ kwx169
30. Jensen TK, Swan S, Jorgensen N, et al. Alcohol and male reproductive health: a cross-sectional study of 8344 healthy men from Europe and the USA. Hum Reprod 2014;29:1801–9. https://doi. org/10.1093/humrep/deu118
31. Jorgensen N, Andersen AG, Eustache F, et al. Regional differences in semen quality in Europe. Hum Reprod 2001;16:1012–9. https://doi.org/10. 1093/humrep/16.5.1012