Significance of Testicular Size and Plasma Hormone Levels in Infertile Males

Lee, Sung Won; Lee, Hee Yong

Abstract

For the evaluation and management of male infertility, measurements of testicular size (volume) and plasma hormones (FSH, LH and testosterone) have been considered as very important procedures besides the routine examinations of history, physical examination, laboratory works including semen analyses and testicular biopsy and special studies. A total of 99 infertile males with small testes which were less than 1Oml in volume was subjected to the assessment of plasma FSH, LH and testosterone levels. They were divided into 6 study groups; such as Group I. Control: 28 men with normal semen parameters and plasma hormone values. Group II. Oligospermia: 12 patients with sperm density of less than 20 X 10 6/ml. Group III. Testicular azoospermia: 22 patients with testicular biopsy of better than germ cell arrest. Group IV Sertoli cell only syndrome: 25 patients proved by testicular histology. Group V. Klinefelter`s syndrome: 30 patients proved by karyotype studies. Group VI. Eunuchoidism: 10 patients proved by laboratory and physical examinations. The results obtained in this clinical study were as follows (Table 1): Testicular sizes were decreased in Groups IV. Sertoli cell only syndrome, V. klinefelter`s syndrome, and VI. Eunuchoidism. Plasma LH levels were increased in Groups IV. Sertoli cell only syndrome, and V Klinefelter`s syndrome. Plasma FHS levels were increased in Groups IV. Sertoli cell only syndrome, and V. Klinefelter`s syndrome. The long-term hormonal therapy with high doses of human chorionic gonadotropin and human menopausal gonadotropin combined with testosterone was applied to a total of 216 infertile patients with small tests (less than 10ml in volume) for 12 months (range: 3-24 months). Semen parameters were improved in 10 patients who were severe oligozoospermia before the treatment and spermatogenesis was induced in 14 patients who were azoospermic before the treatment following the hormonal therapy. In conclusion, an infertile male with small testis (less than 10ml, should be adequately evaluated before declaration of final diagnosis of sterility.