Some Interrelationships Between Plasma Levels of LH, FSH, Oestradiol 17β, Androgens and Semen Analysis Data in Male Infertility Patients

Summary Serum LH, FSH and immunoreactive testosterone-like substances (TLS) have been measured by radioimmunoassay in 130 male infertility patients and oestradiol 17β in 26 cases. A weak but significant negative correlation was found between FSH and sperm count (rs = –0.19, p <0.05) but not LH and sperm count. However, LH and FSH were strongly correlated in the azoospermic (rs = 0.71, p <0.01) and oligozoospermic (rs = 0.53, p <0.01) groups and levels of both gonadotrophins were significantly elevated in the azoospermic and oligozoospermic as compared to the normozoospermic group. The elevated LH levels in the oligozoo- and azoospermic groups could not be explained by reduced negative feedback of testosterone or oestradiol 17β since firstly, TLS and oestradiol 17β levels were similar in all three groups and, secondly, within-group correlations between LH and TLS were either non-significant or positive (azoospermic group r = 0.37, p = 0.06). It is suggested that spermatogenesis-related feedback factor(s) may inhibit LH as well as FSH secretion. No role for oestradiol 17β as a selective inhibitor of FSH secretion seemed likely as oestradiol 17β levels were similar in the three groups and were correlated (r = 0.51, p < 0.01) to TLS levels i.e. to leydig cell rather than spermatogenic function. Seminal fructose was negatively correlated (r = –0.26, p <0.01) with sperm count but not significantly with plasma TLS. It would thus seem unlikely that the tendency for seminal fructose levels to increase as sperm count decreases is due to increased androgen production or that seminal fructose can be used as an index of a patient's androgenic status. Patients with varicoceles had hormone levels similar to other patients of similar sperm count. Both sperm morphology and motility were strongly correlated to log sperm count (r = 0.84 and 0.55 respectively) and semen volume was significantly greater in oligozoospermic than normozoospermic patients (p <0.01). Zusammenfassung Bei 130 infertilen Patienten wurden LH, FSH und “testosterone like substances” (TLS) und in 26 Fällen 17β-Östradiol radioimmunologisch in Blutplasma bestimmt. Eine schwache, aber signifikante, negative Korrelation zwischen Spermatozenzahl und FSH konnte nachgewiesen werden. Bei Oligozoo- und Azoospermie waren LH und FSH signifikant erhöht. Weil es nicht möglich war, die erhöhten LH-Spiegel bei Oligozoo- und Azoospermie mit erniedrigtem TLS oder 17β-Östradiol zu erklären, kann angenommen werden, daß “Inhibin” nicht nur FSH, sondern auch LH hemmt. Die Plasma-Hormonwerte bei Patienten mit Varicocele und bei Patienten mit entsprechenden Spermatozoenzahlen waren ähnlich. Es zeigte sich keine Korrelation zwischen Fruktosegehalt im Seminalplasma und TLS, deswegen empfehlen die Autoren nicht die Benutzung des Fruktosewertes statt androgener Werte. Eine starke Korrelation zwischen log. Spermatozoenzahl und Morphologie und log. Spermatozoenzahl und Motilität wurde nachgewiesen. Das Samenvolumen bei Oligozoospermie war im Vergleich zur Normozoospermie signifikant erhöht.