The response of plasma testosterone to varying doses of hCG (0--6000 IU) given as a single im injection has been evaluated in normal men. After an initial rise at 2 h, the levels of testosterone demonstrated a secondary rise, reaching a peak 48 h after the im injection. The magnitude of the response varied directly with the dose of hCG used, and at the highest dose (6000 IU) testosterone levels were still elevated 6 days after administration. Plasma estradiol levels showed a dose-dependent rise, with peak levels being attained 24 h after hCG. The prolonged response of plasma testosterone to a single injection of hCG should prompt a reevaluation of diagnostic and therapeutic regimens using this agent.
We studied the semen quality and plasma testosterone levels (T) in 32 adolescent patients with insulin-dependent diabetes mellitus and in an aged-matched control group. Semen volume, motility and morphology were significantly lower in diabetics whereas seminal fructose and glucose were significantly higher. Even though the sperm count was lower in these adolescent diabetics, the difference was not significant when compared to the control group. No difference was observed in plasma testosterone levels. Patients were divided into two groups according to the presence of retinopathy and neuropathy, and degree of metabolic control. Spermiogram parameters, seminal fructose and glucose were lower in diabetics with neuropathy. No difference was observed in spermiogram parameters between diabetic patients with or without retinopathy, but seminal fructose, and glucose were lower in the former. All spermiogram parameters, as well as seminal fructose were lower in diabetics with poor metabolic control but seminal glucose was higher. No correlation was detected between clinical parameters (age at onset and duration of diabetes mellitus and time since first ejaculation), semen parameters, plasma T, glycemia and glycosuria. In conclusion, a deterioration of the quality of human semen occurs in adolescent diabetic patients. Neuropathy and poor metabolic control seem to be important factors of this deterioration. The presence of retinopathy does not correlate with T and semen quality.
We studied 19 male patients with primary hyperlipoproteinaemia, a control group of 28 healthy men and 44 infertile males before any treatment was undertaken. Spermiogram, seminal biochemical studies, measurements of plasma hormone levels and lipid determinations were carried out. Most hyperlipoproteinaemic patients showed abnormalities in the spermiograms and the mean values were lower than in the controls except for semen volume. Seminal biochemical determinations were normal in the majority and the hormone profile showed some abnormal values, mainly for E2. Lipid abnormalities were more common in azoospermic infertile men and mean lipid levels were higher. Correlation studies suggest that high levels of C and/or Tg are associated with poor semen quality and higher FSH levels. The results of our studies suggest that high lipid levels exert adverse direct effects at the testicular level.
Cushing's syndrome has been demonstrated in four of seven siblings with clinical manifestations appearing around puberty in three of the four siblings. The only other associated findings in these cases were short stature and disturbed carbohydrate metabolism. Adenomatous hyperplasia of the adrenal glands was demonstrated in 3 of the patients, and a virilizing adrenal carcinoma in the fourth sibling. The pathogenesis of the adrenocortical disorders in these siblings is discussed.
The effects of long term administration of the prostaglandin inhibitor, Indomethacin, on semen, in 22 infertile men with severe oligozoospermia and/or asthenozoospermia have been studied. Quantitative assessment of semen in the whole group showed improved sperm motility (P < 0.05), normal morphology (P < 0.05) and concentration (P < 0.002) after treatment. Individual qualitative evaluation of semen parameters showed improvement in sperm count in one third and improved motility and morphology in 18 per cent of the patients. It would seem that Indomethacin has a beneficial effect on semen in some men with idiopathic oligoasthenozoospermia. It remains to be elucidated whether these effects are related to changes in prostaglandin levels.
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