Sperm Count and Hypogonadism as Markers of General Male Health

Ferlin, Alberto; Garolla, Andrea; Ghezzi, Michele; Selice, Riccardo; Palego, Pierfrancesco; Caretta, Nicola; Mambro, Antonella Di; Valente, Umberto; Ponce, Maurizio De Rocco; Dipresa, Savina; Sartori, Leonardo; Plebani, Mario; Foresta, Carlo

doi:10.1016/j.euf.2019.08.001

Cited by 76 publications

(58 citation statements)

References 28 publications

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“…5 Large previous studies performed on infertile men reported that, according to the World Health Organization (WHO), 7 oligozoospermia was detected in 10% 8 to 30% [9][10][11] of cases, asthenozoospermia in 30%, 9,11 teratozoospermia in 21% 8 to 49%, 9 and low semen volume in 11% 11 to 15%. 8,10 Severe male factor infertility has been reported in 20.4% of infertile men, 2 azoospermia in ~ 5% 2,9 to 11%, 12 and T deficiency in 10.1 12 to 25.6% 13 of cases. On the other hand, large previous studies performed on fertile men reported lower rates of semen abnormalities compared with those of infertile men, showing oligozoospermia in ~ 3% 14,15 to 6% 16,17 of cases, asthenozoospermia in 10.4% 14 to 17%, 16 teratozoospermia in 2.5% 14 to ~ 10%, 15,16 and low semen volume in 4% 16 to 5.8%.…”

Section: Introductionmentioning

confidence: 99%

The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: clinical, seminal and biochemical characteristics

et al. 2020

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Background Infertility affects 7%‐12% of men, and its etiology is unknown in half of cases. To fill this gap, use of the male genital tract color‐Doppler ultrasound (MGT‐CDUS) has progressively expanded. However, MGT‐CDUS still suffers from lack of standardization. Hence, the European Academy of Andrology (EAA) has promoted a multicenter study (“EAA ultrasound study”) to assess MGT‐CDUS characteristics of healthy, fertile men to obtain normative parameters. Objectives To report (a) the development and methodology of the “EAA ultrasound study,” (b) the clinical characteristics of the cohort of healthy, fertile men, and (c) the correlations of both fertility history and seminal features with clinical parameters. Methods A cohort of 248 healthy, fertile men (35.3 ± 5.9 years) was studied. All subjects were asked to undergo, within the same day, clinical, biochemical, and seminal evaluation and MGT‐CDUS before and after ejaculation. Results The clinical, seminal, and biochemical characteristics of the cohort have been reported here. The seminal characteristics were consistent with those reported by the WHO (2010) for the 50th and 5th centiles for fertile men. Normozoospermia was observed in 79.6% of men, while normal sperm vitality was present in almost the entire sample. Time to pregnancy (TTP) was 3.0[1.0‐6.0] months. TTP was negatively correlated with sperm vitality (Adj.r =−.310, P = .011), but not with other seminal, clinical, or biochemical parameters. Sperm vitality and normal morphology were positively associated with fT3 and fT4 levels, respectively (Adj.r = .244, P < .05 and Adj.r = .232, P = .002). Sperm concentration and total count were negatively associated with FSH levels and positively, along with progressive motility, with mean testis volume (TV). Mean TV was 20.4 ± 4.0 mL, and the lower reference values for right and left testes were 15.0 and 14.0 mL. Mean TV was negatively associated with gonadotropin levels and pulse pressure. Varicocoele was found in 33% of men. Conclusions The cohort studied confirms the WHO data for all semen parameters and represents a reference with which to assess MGT‐CDUS normative parameters.

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Section: Introductionmentioning

confidence: 99%

The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: clinical, seminal and biochemical characteristics

et al. 2020

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“…Importantly, semen analysis gives information on the status of the entire seminal tract; therefore, it gives indications for further analyses other than fertility assessment. Importantly, semen analysis is not the final factor in a diagnosis of male factor infertility [12,13], and many aetiologies and different pathophysiological mechanisms might result in the same semen alteration. Semen analysis merely indicates the fertility potential and health status of the testes and seminal tract.…”

Section: Semen Analysis: the Mainstream For Further Decision-making Imentioning

confidence: 99%

“…To this regard, a practical aspect is to consider total sperm count per ejaculate, rather than sperm concentration per milliliter, because it better reflects testicular and seminal tract function [16]. Furthermore, total sperm count has been recently demonstrated to reflect the general health of a man [12].…”

Section: Semen Analysis: the Mainstream For Further Decision-making Imentioning

confidence: 99%

“…Information on the hypothalamic-pituitary-testicular (HPT) axis is easily performed, as initial step, by follicle stimulating hormone (FSH), luteinizing hormone (LH), and total testosterone morning serum concentrations [1][2][3][4][5][6][7][8][9][10], which reflect the two inter-related functions of the testis: spermatogenesis and androgen production. The HPT axis could be affected at different levels by different causes, mainly at the hypothalamic-pituitary level (secondary hypogonadism) or at the testicular levels (primary hypogonadism and subclinical hypogonadism) [12]. Furthermore, combined analysis of both testicular axes (FSH: Sertoli cell, LH: Leydig cells) in association with total sperm count give a better indication of the male general health [12].…”

Section: When and Why Second-line Investigation Is Indicated: The Rolmentioning

confidence: 99%

“…The HPT axis could be affected at different levels by different causes, mainly at the hypothalamic-pituitary level (secondary hypogonadism) or at the testicular levels (primary hypogonadism and subclinical hypogonadism) [12]. Furthermore, combined analysis of both testicular axes (FSH: Sertoli cell, LH: Leydig cells) in association with total sperm count give a better indication of the male general health [12]. In cases of primary testiculopathy, no other endocrine assessment is generally required, whereas in cases of central, secondary hypogonadism, other pituitary hormones and endocrine axis should be investigated (e.g., prolactin, Thyroid Stimulating Hormone (TSH), and thyroid hormones, growth hormone), as well as pituitary MRI should be hypothesized depending on clinical data and aetiology.…”

Section: When and Why Second-line Investigation Is Indicated: The Rolmentioning

confidence: 99%

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Infertility: Practical Clinical Issues for Routine Investigation of the Male Partner

Ferlin

2020

JCM

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About one-fifth of couples has fertility problems in Western countries. Male factors are present in about half of them, either alone or in combination with female causes. Therefore, both partners should be evaluated simultaneously. The fertility status and/or specific conditions of each partner influence the clinical and treatment approach. This article summarizes in a practical way when, how, and why the male partner of an infertile couple should be investigated. The available evidence and international guidelines were used, interpreting, discussing, and expanding them from personal decades-long experience in this field. The aim is to delineate the most appropriate clinical approach for the male partner of infertile couples, considering traditional and emerging technologies and laboratory analyses in the context of their clinical significance. Components of the initial evaluation in men without known risk factors for infertility should include at minimum medical history, physical examination, and semen analysis. Semen microbiological examination, endocrine assessment, scrotal ultrasound, and transrectal ultrasound are suggested in most men and are mandatory when specific risk factors for male infertility are known to be present or when the initial screening demonstrated abnormalities. Full examination, including genetic tests, testicular histology, or additional tests on sperm, is clinically oriented and/or suggested after the results of initial investigations.

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