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Endocrinopathies in Male Infertility

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Male Infertility

Abstract

Endocrine disorders are a potentially reversible cause of some cases of male-factor infertility. Therefore, a meticulous infertility workup must include endocrinologic evaluation and seminal studies. This is especially true where assisted reproductive techniques are becoming more advanced and more widely used. If an endocrine cause is found, reproductive specialists, either urologists or reproductive endocrinologists, should work together to develop the best treatment plan for the couple that addresses any endocrinopathy in the male partner (Sussman et al. 2008).

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References

  • Abramsky L, Chapple J. 47, XXY (Klinefelter syndrome) and 47, XYY: Estimated rates of and indication for postnatal diagnosis with implications for prenatal counseling. Prenat Diagn. 1997;17:363–368.

    Article  PubMed  CAS  Google Scholar 

  • American Association of Clinical Endocrinologists. Medical guidelines for clinical practice for the evaluation and treatment of hypogonadism in adult male patients: 2002 update. Endocr Pract. 2002;8:440–456.

    Google Scholar 

  • Amory JK, Page ST, Bremner WJ. Drug Insight: Recent advances in male hormonal contraception. Nat Clin Pract Endocrinol Metab. 2006;2:32–41.

    Article  PubMed  CAS  Google Scholar 

  • Anawalt BD, Bebb RA, Matsumoto AM, et al. Serum inhibin B levels reflect sertoli cell function in normal men and men with testicular dysfunction. J Clin Endocrinol Metab. 1996; 81:3341–3345.

    Article  PubMed  CAS  Google Scholar 

  • Ascoli P, Cavagnini F. Hypopituitarism. Pituitary. 2006;9:335–342.

    Article  PubMed  CAS  Google Scholar 

  • Bain J, Langevin R, D’Costa M, et al. Serum pituitary and ­steroid hormone levels in the adult male: One value is as good as the mean of three. Fertil Steril. 1988;49:123–126.

    PubMed  CAS  Google Scholar 

  • Bojesen A, Gravholt C. Klinefelter syndrome in clinical practice. Nat Clin Pract Urol. 2007;4:192–204.

    Article  PubMed  Google Scholar 

  • Bojesen A, Juul S, Birkebaek N, et al. Increased Mortality in Klinefelter Syndrome. J Clin Endocrinol Metab. 2004;89:3830–3834.

    Article  PubMed  CAS  Google Scholar 

  • Bojesen A, Juul S, Birkebaek NH, et al. Morbidity in Klinefelter syndrome: A Danish register study based on hospital discharge diagnoses. J Clin Endocrinol Metab. 2006;91:1254–1260.

    Article  PubMed  CAS  Google Scholar 

  • Bruysters M, Christin-Maitre S, Verhoef-Post M, et al. A new LH receptor splice mutation responsible for male hypogonadism with subnormal sperm production in the propositus, and infertility with regular cycles in an affected sister. Hum Reprod. 2008;23:1917–1923.

    Article  PubMed  CAS  Google Scholar 

  • Brydøy M, FossÃ¥ SD, Dahl O, et al. Gonadal dysfunction and fertility problems in cancer survivors. Acta Oncol. 2007;46:480–489.

    Article  PubMed  Google Scholar 

  • Buretic-Tomljanovic A, Vlastelic I, Radojcic Badovinac A, et al. The impact of hemochromatosis mutation and transferrin genotype on gonadotropin serum levels in infertile men. Fertil Steril. 2009;91:1793–1800.

    Article  PubMed  CAS  Google Scholar 

  • Coviello AD, Bremner WJ, Matsumoto AM, et al. Intratesticular testosterone concentrations comparable with serum levels are not sufficient to maintain normal sperm production in men receiving a hormonal contraceptive regimen. J Androl. 2004;25:931–938.

    PubMed  CAS  Google Scholar 

  • Coviello AD, Matsumoto AM, Bremner WJ, et al. Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression. J Clin Endocrinol Metab. 2005;90:2595–2602.

    Article  PubMed  CAS  Google Scholar 

  • Cury ML, Fernandes JC, Machado HR, et al. Non-functioning pituitary adenomas: Clinical feature, laboratorial and imaging assessment, therapeutic management and outcome. Arq Bras Endocrinol Metab. 2009;53:31–39.

    Article  Google Scholar 

  • De Rosa M, Zarrilli S, Di Sarno A, et al. Hyperprolactinemia in men. Clinical and biochemical features and response to treatment. Endocrine. 2003;20:75–82.

    Article  PubMed  Google Scholar 

  • Eguchi K, Kawamoto K, Uozumi T, et al. Effect of cabergoline, estrogen-induced rat culture studies a dopamine agonist, on pituitary tumors: In vitro. Endocr J. 1995;42:413–420.

    Article  PubMed  CAS  Google Scholar 

  • Farooqi IS. Genetic and hereditary aspects of childhood obesity. Best Pract Res Clin Endocrinol Metab. 2005;19:359–374.

    Article  PubMed  CAS  Google Scholar 

  • Gillam MP, Molitch ME, Lombardi G, et al. Advances in the treatment of prolactinomas. Endocr Rev. 2006;27:485–534.

    Article  PubMed  CAS  Google Scholar 

  • Hardelin JP, Dode C. The complex genetics of Kallmann syndrome: KAL1, FGFR1, FGF8, PROKR2, PROK2, et al. Sex Dev. 2008;2:181–193.

    Article  PubMed  CAS  Google Scholar 

  • Hayes FJ, DeCruz S, Seminara SB, et al. Differential regulation of gonadotropin secretion by testosterone in the human male: Absence of a negative feedback effect of testosterone on follicle-stimulating hormone secretion. J Clin Endocrinol Metab. 2001;86:53–58.

    Article  PubMed  CAS  Google Scholar 

  • Hill S, Arutchelvam V, Quinton R. Enclomiphene, an estrogen receptor antagonist for the treatment of testosterone deficiency in men. iDrugs. 2009;12:109–119.

    PubMed  CAS  Google Scholar 

  • Hoffman AR, Crowley WF Jr. Induction of puberty in men by long-term administration of low-dose gonadotropin-releasing hormone. N Engl J Med. 1982;307:1237–1241.

    Article  PubMed  CAS  Google Scholar 

  • Howell SJ, Radford JA, Smets EM, et al. Fatigue, sexual function and mood following treatment for haematological malignancy: The impact of mild Leydig cell dysfunction. Br J Cancer. 2000;82:789–793.

    Article  PubMed  CAS  Google Scholar 

  • Huhtaniem I. Mutations of gonadotrophin and gonadotrophin receptor genes: What do they teach us about reproductive physiology? J Reprod Fertil. 2000;119:173–186.

    Article  Google Scholar 

  • Hussein A, Ozgok Y, Ross L, et al. Clomiphene administration for cases of nonobstructive azoospermia: A multicenter study. J Androl. 2005;26:787–791.

    Article  PubMed  CAS  Google Scholar 

  • Jarow JP. Endocrine causes of male infertility. Urol Clin North Am. 2003;30:83–90.

    Article  PubMed  Google Scholar 

  • Jarow JP. Diagnostic approach to the infertile male patient. Endocrinol Metab Clin North Am. 2007;36:297–311.

    Article  PubMed  Google Scholar 

  • Jayasena CN, Dhillo WS, Bloom SR. Kisspeptins and the control of gonadotropin secretion in humans. Peptides. 2009;30:76–82.

    Article  PubMed  CAS  Google Scholar 

  • Kerkhofs S, Denayer S, Haelens A, et al. Androgen receptor knockout and knock-in mouse models. J Mol Endocrinol. 2009;42:11–17.

    Article  PubMed  CAS  Google Scholar 

  • Lan KC, Hseh CY, Lu SY, et al. Expression of androgen receptor co-regulators in the testes of men with azoospermia. Fertil Steril. 2008;89(5 Suppl):1397–1405.

    Article  PubMed  CAS  Google Scholar 

  • Levron J, Aviram-Goldring A, Madgar I, et al. Sperm chromosome analysis and outcome of IVF in patients with non-mosaic Klinefelter’s syndrome. Fertil Steril. 2000;74:925–929.

    Article  PubMed  CAS  Google Scholar 

  • Lofrano-Porto A, Barcelos Barra G, Giacomini LA, et al. Luteinizing hormone beta mutation and hypogonadism in men and women. N Engl J Med. 2007;357:897–904.

    Article  PubMed  CAS  Google Scholar 

  • Luciano AA. Clinical presentation of hyperprolactinemia. J Reprod Med. 1999;44:1085–1090.

    PubMed  CAS  Google Scholar 

  • Mancini T, Casanueva FF, Giustina A. Hyperprolactinemia and prolactinomas. Endocrinol Metab Clin North Am. 2008;31:67–99.

    Article  Google Scholar 

  • McLachlan RI. The endocrine control of spermatogenesis. Baillieres Best Pract Res Clin Endocrinol Metab. 2000;14:345–362.

    Article  PubMed  CAS  Google Scholar 

  • McLachlan RI, de Krester DM. Hypogonadotropism with elevated serum testosterone: Reversible causes of secondary infertility. Nat Clin Pract Urol. 2006;3:560–565.

    Article  PubMed  Google Scholar 

  • Paduch DA, Bolyakov A, Cohen P, et al. Reproduction in men with Klinefelter syndrome: The past, the present and the future. Semin Reprod Med. 2009;27:137–148.

    Article  PubMed  Google Scholar 

  • Patwardhan AJ, Eliez S, Bender B, et al. Brain morphology in Klinefelter syndrome: Extra X chromosome and testosterone supplementation. Neurology. 2000;54:2218–2223.

    Article  PubMed  CAS  Google Scholar 

  • Pavlovich CP, King P, Goldstein M, et al. Evidence of a treatable endocrinopathy in infertile men. J Urol. 2001;165:837–841.

    Article  PubMed  CAS  Google Scholar 

  • Raivio T, Falardeau J, Dwyer A, et al. Reversal of idiopathic hypogonadotropic hypogonadism. N Engl J Med. 2007;357: 863–873.

    Article  PubMed  CAS  Google Scholar 

  • Raman JD, Schlegel PN. Aromatase inhibitors for male infertility. J Urol. 2002;167:624–629.

    Article  PubMed  CAS  Google Scholar 

  • Ramasamy R, Ricci JA, Palermo GD, et al. Successful fertility treatment for Klinefelter’s syndrome. J Urol 2009;182:1108–1113.

    Article  PubMed  CAS  Google Scholar 

  • Roa J, Aguilar E, Dieguez C, et al. New frontiers in kisspeptin/GPR54 physiology as fundamental gatekeepers of reproductive function. Front Neuroendocrinol. 2008;29:48–69.

    Article  PubMed  CAS  Google Scholar 

  • Saare M, Belousova A, Punab M, et al. Androgen receptor gene haplotype is associated with male infertility. Int J Androl. 2008;31:395–402.

    Article  PubMed  CAS  Google Scholar 

  • Salameh W, Choucair M, Guo TB, et al. Leydig cell hypoplasia due to inactivation of luteinizing hormone receptor by a novel homozygous nonsense truncation mutation in the ­seventh transmembrane domain. Mol Cell Endocrinol. 2005; 229:57–64.

    Article  PubMed  CAS  Google Scholar 

  • Schiff JD, Palermo GD, Veeck LL, et al. Success of testicular sperm injection and intracytoplasmic sperm injection in men with Klinefelter Syndrome. J Clin Endocrinol Metab. 2005;90:6263–6267.

    Article  PubMed  CAS  Google Scholar 

  • Schiff JD, Ramirez ML, Bar-Chama N. Medical and surgical management: Male infertility. Endocrinol Metab Clin N Am. 2007;36:313–331.

    Article  Google Scholar 

  • Seftel A. Male hypogonadism. Part I: Epidemiology of hypogonadism. Int J Imp Res. 2006a;18:115–120.

    Article  CAS  Google Scholar 

  • Seftel A. Male hypogonadism. Part II: Etiology, pathophysiology, and diagnosis. Int J Imp Res. 2006b;18:223–228.

    Article  CAS  Google Scholar 

  • Shiraishi K, Naito K. Fertile eunuch syndrome with the mutations (Trp8Arg and Ile15Thr) in the B subunit of luteinizing hormone. Endocr J. 2003;50:733–737.

    Article  PubMed  CAS  Google Scholar 

  • Sigman M, Jarow JP. Endocrine evaluation of infertile men. Urology. 1997;50:659–664.

    Article  PubMed  CAS  Google Scholar 

  • Simoni M. Mutations of the G protein-coupled receptors of the hypothalamo–pituitary–gonadal axis. Where do we stand? Eur J Endocrinol. 1998;139:145–147.

    Article  PubMed  CAS  Google Scholar 

  • Sokol RZ. Endocrinology of male infertility: Evaluation and treatment. Semin Reprod Med. 2009;27:149–158.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  • Swerdlow AJ, Higgins CD, Schoemaker MJ, et al. Mortality in patients with Klinefelter syndrome in Britain: A cohort study. J Clin Endocrinol Metab. 2005;90:6516–6522.

    Article  PubMed  CAS  Google Scholar 

  • Themmen APN, Huhtaniemi IT. Mutations of gonadotropins and gonadotropin receptors: Elucidating the physiology and pathophysiology of pituitary-gonadal function. Endocr Rev. 2000;21:551–583.

    Article  PubMed  CAS  Google Scholar 

  • 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;84:3666–3672.

    Article  PubMed  CAS  Google Scholar 

  • Vien L, Leo L, Billy C. Gonadotropin-releasing hormone: Regulation of the GnRH gene. FEBS J. 2008;275:5458–5478.

    Article  Google Scholar 

  • Weedin JW, Rumohr JA, Bennett RC, et al. Leydig cell failure frequently associated with spermatogenic failure. J Urol. 2009;181:788–789.

    Article  Google Scholar 

  • Weiss J, Axelrod L, Whitcomb RW, et al. Hypogonadism caused by a single amino acid substitution in the B subunit of luteinizing hormone. N Engl J Med. 1992;326:179–183.

    Article  PubMed  CAS  Google Scholar 

  • Whitten SJ, Nangia AK, Kolettis PN. Select patients with hypogonadotropic hypogonadism may respond to treatment with clomiphene citrate. Fertil Steril. 2006;86: 1664–1668.

    Article  PubMed  CAS  Google Scholar 

  • Wikstrom AM, Dunkel L. Testicular function in Klinefelter Syndrome. Horm Res. 2008;69:317–326.

    Article  PubMed  CAS  Google Scholar 

  • Wikström AM, Dunkel L, Wickman S, et al. Are adolescent boys with Klinefelter syndrome androgen deficient? A longitudinal study of Finnish 47, XXY Boys. Pediatr Res. 2006;59: 854–859.

    Article  PubMed  Google Scholar 

  • Wu FC, Tajar A, Pye SR, et al. 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. 2008;93:2737–2745.

    Article  PubMed  CAS  Google Scholar 

  • Yong E, Loy C, Sim K. Androgen receptor gene and male infertility. Hum Reprod Update. 2003;9:1–7.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Craig S. Niederberger .

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Harris, S.E., Kandil, H.M.S., Niederberger, C.S. (2011). Endocrinopathies in Male Infertility. In: Sabanegh, E. (eds) Male Infertility. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-193-6_6

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  • DOI: https://doi.org/10.1007/978-1-60761-193-6_6

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