A study on the mutual relationship among endocrine glands. I. Thyroid function in male sterility

Abstract

In 105 male patients with sterility recently visiting our Department (81 cases of idiopathic sterility and 24 cases of sterility with complications), thyroid function tests and urinary steroid hormone determinations were carried out, to investigate the relationship of these data with male gonadal function.The following results were obtained. (1) Thyroid 131I uptake was studied in 97 cases, 18 of which (18.6%) gave subnormal values, and 79.4% gave values below the average in healthy subjects. None gave result suggesting hyperfunction. The average of 131I uptake in the whole series was 16.0%, cases of idiopathic sterility giving somewhat lower values than complicated cases. (2) Thyroid weight calculated from scintigram findings showed a tendency similar to that of 131I uptake. (3) Triosorb test was conducted in 93 cases, but failed to give a significant difference from that in healthy subjects. (4) Sperm examination was carried out in 101 cases. Azospermia was found in 38 cases (37.6%). Histological examination of the testes revealed complete absence of spermatogenesis in 21 cases (22.8%), and hypospermatogenesis in 68 cases (73.9%). (5) In 99 cases urinary 17-KS was determined. Subnormal values were obtained in 36 cases (36.4%), although the average of urinary 17-KS in the whole series was within normal range. In 98 cases urinary 17-OHCS was determined. Supernormal values were obtained in 31.6%. Estrogen was frequently high. Average total estrogen in the whole series was above normal, 40.1γ/day. In the estrogen fractions, estriol showed absolute and relative increase along with the increase of total estrogen. Urinary gonadotropin was determined in 21 cases. In 20 cases in which FSH was determined, high values were seen in 9, normal values in 9, and low values in 2. In 18 cases in which LH was determined, 9 gave unmeasurably low values.(6) Thyroid function and spermatogenesisAs the disturbance of spermatogenesis was milder from findings in sperm and histological findings of testes, 131I uptake was lower. Thyroid weight gave similar results. Triosorb tests failed to show an intimate relationship.(7) Thyroid function and urinary steroid hormoneIn cases with low 131I uptake 17-KS tended to give lower values. No particularly intimate relationship was noted between 17-OHCS and 17-KS. In cases with 131I uptake of less than average value in healthy subjects, total estrogen value was above 40γ/day in almost one-half of the cases. No special correlation was noted between Triosorb values and urinary steroid hormone values.(8) Thyroid function and gonadotropinIn cases with idiopathic cases, cases with high FSH values gave low 131I uptake. In LH, on the other hand, the group with normal and high values tended to give lower values of 131I uptake.(9) In summary, 131I uptake was decreased in male sterility and the decrease was especially pronounced in hypospermia than in azospermia and in those in which the spermatogenetic function was rather well maintained in view of the histological findings of the testes. The urinary 17-KS excretion was generally low in these cases, while estrogen was high and gonadotropin was normal or elevated.