The effect of chronic treatment with GH on gonadal function in men with isolated GH deficiency

Abstract

Eleven adult males, previously submitted to neurosurgery because of a pituitary lesion (three with craniopharyngioma, three with clinically non-functioning adenoma and five with macroprolactinoma) were treated with recombinant GH for 12 months after the diagnosis of GH deficiency was made. Circulating FSH, LH, prolactin, testosterone, 17b-estradiol (E 2 ), dehyroepiandrosterone (DHEA-S), androstenedione, 17-OH-progesterone (17OHP), IGF-I, and steroid hormone-binding protein (SHBG) levels were assayed before and after CG test at study entry and 6 and 12 months after GH treatment.A significant increase in plasma IGF-I levels was obtained after 6 and 12 months of GH treatment. In addition, CG-stimulated, but not baseline, testosterone levels showed a significant increase after 6 and 12 months of GH treatment when compared with study entry (9.6Ϯ0.5 and 9.9Ϯ0.5 vs 7.9Ϯ0.5 ng/ ml; P<0.05). Baseline, but not CG-stimulated, serum 17OHP levels were significantly increased only after 12 months of GH treatment (1.7Ϯ0.1 vs 1.4Ϯ0.1 ng/ml; P<0.05). No significant difference was found as far as both basal and CG-stimulated E 2 , androstenedione, DHEA-S and SHBG were concerned. With regards to the semen analysis, only seminal plasma volume was significantly increased after 12 months of GH treatment (2.9Ϯ0.3 vs 1.7Ϯ0.3 ml; P<0.05). No significant change in sperm count, motility and abnormal forms was observed.These data show that GH treatment displays a clear-cut effect upon Leydig cell function and increases the production of seminal plasma volume in fertile adult males with isolated GH deficiency.

Association between GH receptor polymorphism (exon 3 deletion), serum IGF1, semen quality, and reproductive hormone levels in 838 healthy young men

“…In accordance with the results obtained by GHR genotyping, one clinical study found reduced semen volume in patients with untreated isolated GHD (4), whereas another study reported increased semen volume during GH replacement therapy (2). As concerns the Table 2 Associations between serum IGF1 and IGFBP3 vs semen quality.…”

“…Reduced total sperm numbers have been reported in a group of patients with isolated GHD (4), whereas two other studies did not report any influence on spermatogenesis during GH replacement therapy (2,26). Experimental GH therapy has also been applied to infertile men without pituitary disease (27,28) or as adjuvant therapy during gonadotropin therapy of hypogonadotropic hypogonadism (29).…”

“…One clinical study of patients with isolated GHD showed an improved Leydig cell function in response to GH treatment, supporting a causal role for GH/IGF1 action on Leydig cell steroidogenesis (2). In analogy, patients with Laron dwarfism have delayed and prolonged puberty, and in some cases IGF1 treatment has led to a marked increase in levels of androgens (3).…”

“…The influence of GH/IGF1 activity seems to involve reproductive hormone levels (2, 3), semen characteristics (2,4) and phenotype (e.g. penile size and risk of cryptorchidism) (3,5,6,7,8).…”

Drug therapy options for oligoasthenoteratozoospermia syndrome

“…In einer aktuellen Studie konnte durch Gabe für die proteinogene α-Aminosäure L-Arginin eine gesteigerte Motilität nachgewiesen werden [89]. Positive Effekte zeigten die Gabe von rekombinantem Wachstumshormon (GH) bei isoliertem Hormonmangel [90] und im Tierversuch Lisinopril, einem Angiotensin-Converting-Enzyme-(ACE-)Hemmer [91]. Der Versuch, mittels einmaliger i. v.-Gabe von Oxytocin eine schwere Oligozoospermie zu verbessern, war erfolglos [92].…”