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Endocrine Laboratory Diagnosis

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Andrology

Abstract

The measurements of serum gonadotropins, testosterone, SHBG, and calculated free testosterone have a central role in the endocrine diagnostics of male hypogonadism and infertility. Additional hormone determinations include the newest specific markers of Sertoli (inhibin B, anti-mullerian hormone) and Leydig (insulin-like factor 3) cell function. Dynamic tests (GnRH and hCG stimulation tests) are useful in the assessment of pituitary and testis reserve capacity. In selected cases, molecular biology techniques may be helpful in the endocrine workup.

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References

  • Anand-Ivell R, Wohlgemuth J, Haren MT, Hope PJ, Hatzinikolas G, Wittert G, Ivell R (2006) Peripheral INSL3 concentrations decline with age in a large population of Australian men. Int J Androl 29:618–626

    CAS  PubMed  Google Scholar 

  • Andersen JM, Herning H, Witczak O, Haugen TB (2016) Anti-Müllerian hormone in seminal plasma and serum: association with sperm count and sperm motility. Hum Reprod 31:1662–1667

    CAS  PubMed  Google Scholar 

  • Araujo AB, Esche GR, Kupelian V, O’Donnell AB, Travison TG, Williams RE, Clark RV, McKinlay JB (2007) Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab 92:4241–4247

    CAS  PubMed  Google Scholar 

  • Bae YJ, Zeidler R, Baber R, Vogel M, Wirkner K, Loeffler M, Ceglarek U, Kiess W, Körner A, Thiery J, Kratzsch J (2019) Reference intervals of nine steroid hormones over the life-span analyzed by LC-MS/MS: Effect of age, gender, puberty, and oral contraceptives. J Steroid Biochem Mol Biol 193:105409

    CAS  PubMed  Google Scholar 

  • Bergmann M, Behre HM, Nieschlag E (1994) Serum FSH and testicular morphology in male infertility. Clin Endocrinol 40:133–136

    CAS  Google Scholar 

  • Bertelloni S, Russo G, Baroncelli GI (2018) Human chorionic gonadotropin test: Old uncertainties, new perspectives, and value in 46,XY disorders of sex development. Sex Dev 12:41–49

    CAS  PubMed  Google Scholar 

  • Bhasin S, Pencina M, Jasuja GK, Travison TG, Coviello A, Orwoll E, Wang PY, Nielson C, Wu F, Abdelouahid T, Labrie F, Vesper H, Zhang A, Ulloor J, Singh R, D'Agostino R, Vasan RS (2011) Reference ranges for testosterone in men generated using liquid chromatography tandem mass spectrometry in a community-based sample of healthy nonobese young men in the Framingham Heart Study and applied to three geographically distinct cohorts. J Clin Endocrinol Metab 96:2430–2439

    CAS  PubMed  PubMed Central  Google Scholar 

  • Cangiano B, Swee DS, Quinton R, Bonomi M (2020) Genetics of congenitalhypogonadotropic hypogonadism: peculiarities and phenotypeof an oligogenicdisease. Hum Genet 140(1):77–111

    PubMed  Google Scholar 

  • Caronia LM, Dwyer AA, Hayden D, Amati F, Pitteloud N, Hayes FJ (2013) Abrupt decrease in serum testosterone levels after an oral glucose load in men: implications for screening for hypogonadism. Clin Endocrinol 78:291–296

    CAS  Google Scholar 

  • Casarini L, Santi D, Marino M (2015) Impact of gene polymorphisms of gonadotropins and their receptors on human reproductive success. Reproduction 150:R175–R184

    CAS  PubMed  Google Scholar 

  • Colpi GM, Francavilla S, Haidl G, Link K, Behre HM, Goulis DG, Krausz C, Giwercman A (2018) European Academy of Andrology guideline: Management of oligo- astheno-teratozoospermia. Andrology 6:513–524

    CAS  PubMed  Google Scholar 

  • Diederich S, Feldkamp J, Grussendorf M, Reincke M (2020) Referenz Endokrinologie und Diabetologie. Thieme-Verlag, Stuttgart

    Google Scholar 

  • Diver MJ, Imtiaz KE, Ahmad AM, Vora JP, Fraser WD (2003) Diurnal rhythms of serum total, free and bioavailable testosterone and of SHBG in middle-aged men compared with those in young men. Clin Endocrinol 58:710–717

    CAS  Google Scholar 

  • Fahie-Wilson M, Smith TP (2013) Determination of prolactin: the macroprolactin problem. Best Pract Res Clin Endocrinol Metab 27:725–742

    CAS  PubMed  Google Scholar 

  • Frost M, Wraae K, Nielsen TL, Hougaard DM, Brixen K, Hagen C, Andersen M (2013) Similar reference intervals for total testosterone in healthy young and elderly men: results from the Odense Androgen Study. Clin Endocrinol 78:743–751

    CAS  Google Scholar 

  • Hackney AC (2020) Hypogonadism in exercising males: Dysfunction or adaptive-regulatory adjustment? Front Endocrinol (Lausanne) 11:11

    PubMed  Google Scholar 

  • Hayes LD, Sculthorpe N, Herbert P, Baker JS, Hullin DA, Kilduff LP, Reed D, Spagna R, Grace FM (2015) Salivary testosterone measurement does not identify biochemical hypogonadism in aging men: a ROC analysis. Endocrine 50:256–259

    CAS  PubMed  Google Scholar 

  • Huhtaniemi I, Alevizaki M (2006) Gonadotropin resistance. Best Pract Res Clin Endocrinol Metab 20:561–576

    CAS  PubMed  Google Scholar 

  • Josso N, Rey RA, Picard JY (2013) Anti-müllerian hormone: a valuable addition to the toolbox of the pediatric endocrinologist. Int J Endocrinol 2013:674105. https://doi.org/10.1155/2013/674105

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kelleher S, Conway AJ, Handelsman DJ (2004) Blood testosterone threshold for androgen deficiency symptoms. J Clin Endocrinol Metab 89:3813–3817

    CAS  PubMed  Google Scholar 

  • Lehtihet M, Arver S, Bartuseviciene I, Pousette A (2012) S-testosterone decrease after a mixed meal in healthy men independent of SHBG and gonadotrophin levels. Andrologia 44:405–410

    CAS  PubMed  Google Scholar 

  • Lood Y, Aardal-Eriksson E, Webe C, Ahlner J, Ekman B, Wahlberg J (2018) Relationship between testosterone in serum, saliva and urine during treatment with intramuscular testosterone undecanoate in gender dysphoria and male hypogonadism. Andrology 6:86–93

    CAS  PubMed  Google Scholar 

  • Ly LP, Sartorius G, Hull L, Leung A, Swerdloff RS, Wang C, Handelsman DJ (2010) Accuracy of calculated free testosterone formulae in men. Clin Endocrinol 73:382–388

    CAS  Google Scholar 

  • Meachem SJ, Nieschlag E, Simoni M (2001) Inhibin B in male reproduction: pathophysiology and clinical relevance. Eur J Endocrinol 145:561–571

    CAS  PubMed  Google Scholar 

  • Nieschlag E (2019) Late-onset hypogonadism: a concept comes of age. Andrology. https://doi.org/10.1111/andr.12719. [published online ahead of print, 2019 Oct 22]

  • Nieschlag E, Behre HM, Bouchard P, Corrales JJ, Jones TH, Stalla GK, Webb SM, Wu FC (2004) Testosterone replacement therapy: current trends and future directions. Hum Reprod Update 10:409–419

    CAS  PubMed  Google Scholar 

  • O'Connor AE, De Kretser DM (2004) Inhibins in normal male physiology. Semin Reprod Med 22:177–185

    CAS  PubMed  Google Scholar 

  • Rey RA (2020) Biomarkers of male hypogonadism in childhood and adolescence. Adv Lab Med 2020:20200024. https://doi.org/10.1515/almed-2020-0024

    Article  Google Scholar 

  • Sansone A, Kliesch S, Isidori AM, Schlatt S (2019) AMH and INSL3 in testicular and extragonadal pathophysiology: what do we know? Andrology 7:131–138

    CAS  PubMed  Google Scholar 

  • Schänzer W, Thevis M (2012) Detection of illegal use of androgens and selective androgen receptor modulators, chapt. 24. In: Nieschlag E, Behre HM, Nieschlag S (eds) Testosterone: action, deficiency, substitution, 4th edn. Cambridge University Press, Cambridge, pp 517–534

    Google Scholar 

  • Schürmeyer T, Jung K, Nieschlag E (1984) The effect of an 1100 km run on testicular, adrenal and thyroid hormones. Int J Androl 7:276–282

    PubMed  Google Scholar 

  • Sequera AM, Fideleff HL, Boquete HR, Pujol AB, Suárez MG, Ruibal GF (2002) Basal ultrasensitive LH assay: a useful tool in the early diagnosis of male pubertal delay? J Pediatr Endocrinol Metab 15:589–596

    CAS  PubMed  Google Scholar 

  • Simoni M, Fanelli F, Roli L, Pagotto U (2012) Methodology for measuring testosterone, dihydrotestosterone and sex hormone-binding globulin in a clinical setting, chapt. 4. In: Nieschlag E, Behre HM, Nieschlag S (eds) Testosterone: action, deficiency, substitution, 4th edn. Cambridge University Press, Cambridge, pp 60–86

    Google Scholar 

  • Simoni M, Brigante G, Rochira V, Santi D, Casarini L (2020) Prospects for FSH treatment of male infertility. J Clin Endocrinol Metab 105:dgaa243. https://doi.org/10.1210/clinem/dgaa243

    Article  PubMed  Google Scholar 

  • Sinisi AA, Esposito D, Maione L, Quinto MC, Visconti D, De Bellis A, Bellastella A, Conzo G, Bellastella G (2008) Seminal anti-mullerian hormone level is a marker of spermatogenic response during long-term gonadotropin therapy in male hypogonadotropic hypogonadism. Hum Reprod 23:1029–1034

    CAS  PubMed  Google Scholar 

  • Sussman EM, Chudnovsky A, Niederberger CS (2008) Hormonal evaluation of the infertile male: has it evolved? Urol Clin North Am 35:147–155

    PubMed  Google Scholar 

  • Toulis KA, Iliadou PK, Venetis CA, Tsametis C, Tarlatzis BC, Papadimas I, Goulis DG (2010) Inhibin B and anti-Mullerian hormone as markers of persistent spermatogenesis in men with non-obstructive azoospermia: a meta-analysis of diagnostic accuracy studies. Hum Reprod Update 16:713–724

    CAS  PubMed  Google Scholar 

  • Trevisan CM, Montagna E, de Oliveira R, Christofolini DM, Barbosa CP, Crandall KA, Bianco B (2018) Kisspeptin/GPR54 System: What do we know about its role in Human Reproduction? Cell Physiol Biochem 49:1259–1276

    CAS  PubMed  Google Scholar 

  • Vermeulen A, Verdonck L, Kaufman JM (1999) A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab 84:3666–3672

    CAS  PubMed  Google Scholar 

  • von Eckardstein S, Simoni M, Bergmann M, Weinbauer GF, Gassner P, Schepers AG, Nieschlag E (1999) Serum inhibin B in combination with serum follicle-stimulating hormone (FSH) is a more sensitive marker than serum FSH alone for impaired spermatogenesis in men, but cannot predict the presence of sperm in testicular tissue samples. J Clin Endocrinol Metab 84:2496–2501

    Google Scholar 

  • Wu FC, Tajar A, Pye SR, Silman AJ, Finn JD, O’Neill TW, Bartfai G, Casanueva F, Forti G, Giwercman A, Huhtaniemi IT, Kula K, Punab M, Boonen S, Vanderschueren D, European Male Aging Study Group (2008) Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study. J Clin Endocrinol Metab 93:2737–2745

    CAS  PubMed  Google Scholar 

  • Zitzmann M, Nieschlag E (2001) Testosterone levels in healthy men and the relation to behavioural and physical characteristics: facts and constructs. Eur J Endocrinol 144:183–197

    CAS  PubMed  Google Scholar 

  • Zitzmann M, Nieschlag E (2003) Hypogonadism in the elderly men. Reliable diagnosis and therapy. Internist 44:1313–1321

    CAS  PubMed  Google Scholar 

  • Zitzmann M, Faber S, Nieschlag E (2006a) Association of specific symptoms and metabolic risks with serum testosterone in older men. J Clin Endocrinol Metab 91:4335–4343

    CAS  PubMed  Google Scholar 

  • Zitzmann M, Nordhoff V, von Schönfeldt V, Nordsiek-Mengede A, Kliesch S, Schüring AN, Luetjens CM, Kamischke A, Cooper T, Simoni M, Nieschlag E (2006b) Elevated follicle-stimulating hormone levels and the chances for azoospermic men to become fathers after retrieval of elongated spermatids from cryopreserved testicular tissue. Fertil Steril 86:339–347

    CAS  PubMed  Google Scholar 

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Correspondence to Manuela Simoni .

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Simoni, M., Nieschlag, E. (2023). Endocrine Laboratory Diagnosis. In: Nieschlag, E., Behre, H.M., Kliesch, S., Nieschlag, S. (eds) Andrology. Springer, Cham. https://doi.org/10.1007/978-3-031-31574-9_7

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  • DOI: https://doi.org/10.1007/978-3-031-31574-9_7

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