Serum Testosterone-Estradiol Ratio in Toxoplasma-Seropositive Infertile Men: A Prospective, Single-Center Study

Abstract

Background: The purpose of the current study was to compare the testosterone-estradiol (T:E2) ratio in Toxoplasma gondii seropositive infertile men with seropositive and seronegative normozoospermic controls.
 Methods: Totally, 200 men with normal virilization, 100 with idiopathic infertility and 100 normozoospermic men, were included. Participants underwent medical history assessment, physical examination, semen analysis, testing for T. gondii IgM/ IgG, and estimation of serum T:E2 ratios. Statistical comparisons were done using t-test and Chi-square with p<0.05 significance level.
 Results: Infertile cases were diagnosed with oligozoospermia (63%), oligoastheno-zoospermia (34%), and oligoasthenoteratozoospermia (3%). Regarding anti-Toxo-plasma IgG and IgM antibodies, among infertile men, 34 tested positive for IgG and 8 tested positive for IgM. Among cases tested positive for IgG antibodies, 13 (38.2%) had disturbed T:E2 ratios. Also, among the 12 IgG-positive controls, 5 (41.7%) had disturbed T:E2 ratios (p=0.834). However, only 2 out of the 83 seronegative controls (2.5%) had disturbed T:E2 ratios (p<0.001). Furthermore, 6 out of 8 IgM-positive cases had altered T:E2 ratios, compared to 3 out of 5 IgM-positive controls (p=0.568) and 2 out of 83 seronegative controls (p<0.001). The T:E2 ratio was significantly lower (8.68±1.95) among IgM-positive and higher (13.04±3.78) among IgG-positive cases when compared to seronegative controls (10.45±0.54) (p<0.001). There were no significant differences in T:E2 ratios between infertile men with positive IgM or IgG serology and the control group with the same serology.
 Conclusion: A substantial number of infertile men with toxoplasmosis showed disrupted T:E2 ratios, highlighting the significance of anti-T. gondii-IgG testing in individuals with abnormal ratios.