Abstract
Male infertility is approaching a concerning prevalence worldwide, and inflicts various impacts on the affected couple. The hormonal assessment is a vital component of male fertility evaluation as endocrine disorders are markedly reversible causatives of male infertility. Precise hormonal regulations are prerequisites to maintain normal male fertility parameters. The core male reproductive event, spermatogenesis, entails adequate testosterone concentration, which is produced via steroidogenesis in the Leydig cells. Physiological levels of both the gonadotropins are needed to achieve normal testicular functions. The hypothalamus-derived gonadotropin-releasing hormone (GnRH) is considered the supreme inducer of the gonadotropins and thereby the subsequent endocrine reproductive events. This hypothalamic–pituitary–gonadal (HPG) axis may be modulated by the thyroidal or adrenal axis and numerous other reproductive and nonreproductive hormones. Disruption of this fine hormonal balance and their crosstalk leads to a spectrum of endocrinopathies, inducing subfertility or infertility in men. This review article will discuss the most essential endocrinopathies associated with male factor infertility to aid precise understanding of the endocrine disruptions-mediated male infertility to encourage further research to reveal the detailed etiology of male infertility and perhaps to develop more customized therapies for endocrinopathy-induced male infertility.
Highlights
Accepted: 16 December 2021Male infertility has stirred global concerns over the trend of its increasing prevalence and ambiguity of its etiopathogenesis [1,2,3,4,5,6]
Four men suffering from hypogonadotropic hypogonadism (HH) were administered with 50 mg clomiphene citrate thrice weekly in a study conducted in the United States, and three of the patients had better testosterone levels and semen parameters
It has been shown that primary hypothyroidism in prepubertal males is associated with histologic abnormalities of the testicular cells, which is consistent with the theory that low luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels in hypothyroid males result in an abnormal number of immature germ cells in the seminiferous tubules [70]
Summary
Male infertility has stirred global concerns over the trend of its increasing prevalence and ambiguity of its etiopathogenesis [1,2,3,4,5,6]. Male reproductive functions are dependent on a complex crosstalk of hormones [10]. The testicular testosterone level must be much greater than that in the serum, to support normal spermatogenesis. This intratesticular testosterone indirectly increases germ cell maturation as a result of its actions on Sertoli cells [11,12]. We elucidate the disorders in which hormone imbalance can have a deleterious impact on male fertility. Increased FSH/LH, normal or ↓testis volume, decreased pubic hair and penis size, infertility [15].
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