Reproductive Medicine and Biology

, Volume 11, Issue 4, pp 207–211

Severe oligozoospermia in a patient with myxedema coma

  • Akira Komiya
  • Akihiko Watanabe
  • Yoko Kawauchi
  • Atsuko Takano
  • Hideki Fuse
Case Report

Abstract

A case of severe oligozoospermia with myxedema coma is herein presented. The patient was referred to a male infertility clinic with a 5-year history of primary infertility. Decreased serum testosterone and elevated serum prolactin without abnormal MRI findings in the hypothalamus, and decreased semen volume and sperm motility were noted. A GnRH test revealed a decreased luteinizing hormone response, whereas the HCG test showed a normal testosterone increase. Because a urinalysis after ejaculation indicated retrograde ejaculation, imipramine administration was started. However, the semen quality deteriorated, so the patient was referred to an ART clinic. Twenty-one months from the initial visit, the patient developed a loss of consciousness and edema due to myxedema coma, a life-threatening state of hypothyroidism. The patient recovered after 1 month of thyroid hormone replacement therapy (HRT) with corticosteroids. Three months after the myxedema coma, a semen analysis showed a decreased semen volume (0.2 mL) and severe oligozoospermia (two spermatozoa/ejaculate). Elevated prolactin and decreased testosterone levels were still present. These parameters gradually improved after restoration of euthyroidism by HRT. In conclusion, physicians should confirm the thyroid function in the management of male infertility, especially in patients with elevated prolactin levels.

Keywords

Hyperprolactinemia, hypothyroidism Male infertility Myxedema coma Oligozoospermia 

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Copyright information

© Japan Society for Reproductive Medicine 2012

Authors and Affiliations

  • Akira Komiya
    • 1
  • Akihiko Watanabe
    • 1
  • Yoko Kawauchi
    • 1
  • Atsuko Takano
    • 2
  • Hideki Fuse
    • 1
  1. 1.Department of UrologyGraduate School of Medicine and Pharmaceutical Sciences for Research, University of ToyamaToyamaJapan
  2. 2.Department of Internal MedicineSaiseikai Takaoka HospitalTakaokaJapan

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