Serum 17-Hydroxyprogesterone is a Potential Biomarker for Evaluating Intratesticular Testosterone

Lima, Thiago Fernandes Negris; Patel, Premal; Blachman‐Braun, Ruben; Madhusoodanan, Vinayak

doi:10.1097/ju.0000000000001016

Cited by 32 publications

(23 citation statements)

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“…ITT levels were assessed by fine needle aspiration of testicular fluid; serum 17 OHP did not correlate with ITT at baseline, but following hCG treatment, a strong relationship between ITT and 17 OHP was found in men who received 250 or 500 IU hCG [46]. Very recently, Lima et al evaluated the serum 17 OHP levels in 30 men receiving CC and/or hCG, 21 men under exogenous testosterone replacement therapy, and 42 fertile men with normal serum testosterone; despite serum T level was in the normal range in all men, serum 17-OHP was undetectable in men who received exogenous testosterone replacement therapy compared to the other two groups, and increased after CC and hCG treatment [47].…”

Section: Relationship Between Serum Hormones Levels and Sperm Retrievalmentioning

confidence: 99%

Hormonal Treatment of Men with Nonobstructive Azoospermia: What Does the Evidence Suggest?

Caroppo

Colpi²

2021

JCM

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Hormonal stimulation of spermatogenesis prior to surgery has been tested by some authors to maximize the sperm retrieval yield in patients with nonobstructive azoospermia. Although the rationale of such an approach is theoretically sound, studies have provided conflicting results, and there are unmet questions that need to be addressed. In the present narrative review, we reviewed the current knowledge about the hormonal control of spermatogenesis, the relationship between presurgical serum hormones levels and sperm retrieval rates, and the results of studies investigating the effect of hormonal treatments prior to microdissection testicular sperm extraction. We pooled the available data about sperm retrieval rate in patients with low vs. normal testosterone levels, and found that patients with normal testosterone levels had a significantly higher chance of successful sperm retrieval compared to those with subnormal T levels (OR 1.63, 95% CI 1.08–2.45, p = 0.02). These data suggest that hormonal treatment may be justified in patients with hypogonadism; on the other hand, the available evidence is insufficient to recommend hormonal therapy as standard clinical practice to improve the sperm retrieval rate in patients with nonobstructive azoospermia.

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Section: Relationship Between Serum Hormones Levels and Sperm Retrievalmentioning

confidence: 99%

Hormonal Treatment of Men with Nonobstructive Azoospermia: What Does the Evidence Suggest?

Caroppo

Colpi²

2021

JCM

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“…Although the primary outcome was to evaluate changes in intratesticular T and semen parameters after surgery, we did not evaluate effects in pregnancy and live birth rates. Also, we based the correlation of 17-OHP with ITT in Amory et al 12 findings, previously tested by Lima et al, 13 since repeatedly performing testicular aspiration was not feasible.…”

Section: Discussionmentioning

confidence: 99%

“…However, noninvasive assessment of ITT and its use in practice remains poorly described. Serum 17-OHP could be used to titrate medical therapy of men, 13 hypogonadotropic hypogonadism, 22 and men with oligozoospermia 23 and low T. In contrast, baseline 17-OHP could not predict semen analysis improvement after varicocele repair, and its use for this purpose should be investigated in a larger scale for selected patients, such as those with clinical varicocele and baseline low T levels but cannot be used at this time as a biomarker to predict sperm parameter improvement after varicocele repair. Future studies to evaluate biomarkers to predict sperm parameter improvement after varicocele repair should utilize pathways other than androgen synthesis.…”

Section: Discussionmentioning

confidence: 99%

“…We based the correlation of 17-OHP with ITT in Amory et al 12 study, that compared ITT levels through testicular aspiration with serum 17-OHP levels in men previously treated with exogenous T who were distributed in different hCG dosages groups ( r = .78, P < .0001). We published a recent study in J Urol 13 evaluating the positive association between 17-OHP and ITT in a study comparing men receiving exogenous T to men receiving clomiphene citrate or human chorionic gonadotropin, where men receiving exogenous T had undetectable 17-OHP levels in follow-up, while men receiving medications to increase ITT had a significant increase in 17-OHP levels. Since one of the mechanisms by which varicocelectomy improves semen parameters is with improvement in ITT production, we hypothesized that semen analysis parameters improvement after varicocele repair could be associated to augmentation of ITT levels.…”

Section: Introductionmentioning

confidence: 99%

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Effect of microsurgical varicocelectomy on semen parameters, serum, and intratesticular testosterone levels

et al. 2020

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Objective The goal of this work was to evaluate if men who underwent microsurgical varicocelectomy would have improvement in serum testosterone (T) as well as serum 17-hydroxyprogesterone (17-OHP—An intratesticular T biomarker) in addition to semen parameters after operation. Materials and Methods We conducted a prospective analysis of 30 men who underwent microsurgical varicocelectomy from December 2018 to September 2019. We assessed varicocele grade and laterality, serum T, serum 17-OHP, serum follicle- stimulating hormone (FSH), serum LH, and semen parameters in baseline and follow-up. According to the data distribution, we reported the median and interquartile ranges and utilized the Mann-Whitney U, Student’s t test and Wilcoxon rank test. Correlation analysis was performed with the Spearman test. Results In the baseline, 9 (30%) men had 17-OHP < 55 ng/dL and 21 (70%) men presented with 17-OHP > 55 ng/dL. Also, 19 men had TMSC < 9 million, including 6 men with azoospermia, 1 man with cryptozoospermia, and 11 men with TMSC > 9 million. We found an improvement in most SA parameters of most men, which include concentration (63.3%, 19/30), motility (46.6%, 14/30), and TMSC (60%, 18/30). About seven (36.8%) men had TMSC upgraded to > 9. There was a significant change in volume (2.1 [1.5–2.8] to 2.4 [1.7–3.6] cc, P = .018), concentration (6.8 [0.8–22.5] to 12.5 [1–31] million/cc, P = .047) and TMSC (4.4 [0.3–15.1] to 10.5 [0–41.8] million, P = .012) after surgery. We neither found a change in serum T nor a change in intratesticular T (serum 17-OHP) after varicocelectomy ( P > .05). FSH, LH and T were similar both before and after varicocelectomy ( P > .05). Conclusion Despite improvement in semen parameters following varicocelectomy, we did not see changes in either serum or intratesticular T. This suggests that improvement of semen parameters following varicocele repair could be from factors other than changes in androgen levels within the testis.

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“…Due to the inherent risks of performing testicular aspiration to obtain a direct assessment of ITT level, a measurement of the circulating levels of 17-hydroxyprogesterone (17OHP) has been proposed as an indirect biomarker of ITT levels, since 17 OHP is likely to be of testicular and not adrenal origin in men. Indeed, serum 17 OHP levels were found to be undetectable in men receiving exogenous testosterone replacement therapy, and to increase after CC and hCG treatment [ 46 ]. Studies evaluating the predictive ability of serum 17 OHP on the probability of SSR in patients with NOA are needed to provide evidence in support or against such a hypothesis.…”

Section: Hormonal Parametersmentioning

confidence: 99%

Prediction Models for Successful Sperm Retrieval in Patients with Non-Obstructive Azoospermia Undergoing Microdissection Testicular Sperm Extraction: Is There Any Room for Further Studies?

Caroppo

Colpi²

2021

JCM

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Several prediction models for successful sperm retrieval (SSR) in patients with azoospermia due to spermatogenic dysfunction (also termed non-obstructive azoospermia—NOA) have been developed and published in the past years, however their resulting prediction accuracy has never been strong enough to translate their results in the clinical practice. This notwithstanding, the number of prediction models being proposed in this field is growing. We have reviewed the available evidence and found that, although patients with complete AZFc deletion or a history of cryptorchidism may have better probability of SSR compared to those with idiopathic NOA, no clinical or laboratory marker is able to determine whether a patient with NOA should or should not undergo microdissection testicular sperm extraction (mTESE) to have his testicular sperm retrieved. Further research is warranted to confirm the utility of evaluating the expression of noncoding RNAs in the seminal plasma, to individuate patients with NOA with higher probability of SSR.

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Serum 17-Hydroxyprogesterone is a Potential Biomarker for Evaluating Intratesticular Testosterone

Cited by 32 publications

References 0 publications

Hormonal Treatment of Men with Nonobstructive Azoospermia: What Does the Evidence Suggest?

Hormonal Treatment of Men with Nonobstructive Azoospermia: What Does the Evidence Suggest?

Effect of microsurgical varicocelectomy on semen parameters, serum, and intratesticular testosterone levels

Prediction Models for Successful Sperm Retrieval in Patients with Non-Obstructive Azoospermia Undergoing Microdissection Testicular Sperm Extraction: Is There Any Room for Further Studies?

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