Applied Research On Serum Reproductive Hormones In Diagnosis Of Male Infertility

BACKGROUND:The statistical analysis on male reproductive ability taken by World Health Organization (WHO) shows that human fertility is declining. About 10%-15% of couples are infertile; 40%-50% of them are due to male factor. Male infertility has become a serious problem. The latest research shows male reproductive defects are related to a number of factors,such as hormonal changes,immune response, reproductive tract infections,reproductive system abnormalities and material factors. The development of ART has changed the mode of human reproduction. Many infertile couples have their own biological offspring through it,which alleviate the plight of several families.Male reproductive function is mainly affected by regulation and control of the hypothalamus- pituitary- gonadal axis. Reproductive hormones are secreted by the gonads,which are directly involved in regulating human sexual function and reproductive function. And any changes in these functions may lead to male infertility.OBJECTIVES: This paper exerts analysis of reproductive hormones on patients of different types of pathological disorders such as oligospermia,azoospermia, asthenospermia,chromosomal abnormalities,genetic abnormalities etc. And reproductive hormones are important in the diagnostic evaluation of male infertility. Hence, on the basis of change in the reproductive hormone levels, research can be done on different targets which are more sensitive, whose responses are more accurate to the spermatogenic function, and which provide the necessary experimental basis for pathological classification of male infertility. Relationship between Serum Reproductive Hormones and clinical manifestations of male infertility can also provide theoretical foundation for clinical diagnosis and treatment of male infertility.METHODS:infertile patients were classified according to etiological factors and WHO male infertility diagnosis standard. Then,different classification methods were compared;serum hormone and genetic analysis was detected;semen parameters were analyzed. Seminal activity of neutralα-Glucosidase and fructose concentration were measured using spectrophotometry.RESULTS:The Serum PRL,FSH and LH levels of oligospermic groups were significantly higher than those of healthy fertile male groups (P<0.05). The serum T levels of oligospermic groups had no statistical difference in comparison with healthy fertile male groups (P>0.05).The serum FSH and LH in groups of sertoli cell-only syndrome and germinal arrest were significantly higher than those in normal sperm density group (P<0.05),however the serum INHB levels were significantly lower (P<0.05).The serum FSH,LH,INHB and T levels of obstructive azoospermic groups had no statistical difference in comparison with healthy fertile male groups (P>0.05).The Serum T levels of Sertoli cell-only syndrome groups was statistics difference in comparison with healthy fertile male and germinal arrest groups(P<0.05). The serum FSH and LH in Sertoli cell only syndrome groups were significantly higher than those in germinal arrest groups (P<0.05) ,and it was higher more than three times. However the serum INH-B and T levels were significantly lower (P<0.05). Significant positive correlation was found between course of disease and the serum LH and FSH levels (r=-0.77103,P<0.001;r=-0.6389,P<0.001) ,however the serum INH-B levels was negatively correlated with the course of disease (r=0.46655, P<0.001).The serum PRL, FSH and E2 levels of asthenospermic,oligo-asthenospermic groups were significantly higher than those of healthy fertile male groups (P<0.05) ,however T/LH were significantly lower (P<0.05). The serum LH levels of oligospermia and asthenospermia groups were significantly higher than those of healthy fertile male groups (P<0.05) ,which had no statistical difference in comparison with asthenospermia group (P>0.05). The serum T levels of asthenospermia, oligospermia and asthenospermia groups had no statistical difference in comparison with fertile group (P>0.05).The Serum FSH levels of oligospermia and Asthenospermia groups were significantly higher than those of healthy fertile male groups (P<0.05) ,however T/LH were significantly lower (P<0.05).The serum FSH and LH levels ofⅡ°andⅢ°varicocele groups were higher than those of fertile group (P<0.05). The serum FSH and LH levels ofⅠ°varicocele groups had no statistical difference in comparison with fertile group (P>0.05),but there were no statistics difference amongⅡ°andⅢ°varicocele groups(P>0.05). The serum T, PRL and E2 levels ofⅠ°,Ⅱ°andⅢ°varicocele groups had no statistical difference in comparison with fertile group (P>0.05).Through the analysis of abnormal reproductive hormone level in normal chromosome karyotype, it was found that FSH, LH and T levels in 3 cases of (inv)patients were lower than normal level,while FSH, LH and T levels showed different results in 9 cases of(t)patients. Among them 3 cases had less than those of healthy fertile male,other 6 cases had higher than those of healthy fertile male. Of 57 cases with sex chromosome abnormality,54 cases belonged to sex chromosome numerical abnormality,3 cases belonged to sex chromosome structural abnormality. In Both cases, the serum FSH and LH levels were found two times higher than normal value. The serum FSH and LH levels of sex chromosome numerical abnormality (such as Klinefelter syndrome) groups were significantly higher more than two times than those of healthy fertile male groups,however T levels were significantly lower.There were 45 cases of AZF microdeletion in male infertility,including one case of AZFa (2.2%) whose phenotype was azoospermia, and two cases of AZFb(4.4%),whose phenotype were severe oligospermia and azoospermia. Among 36 cases of AZFc/DAZ (80%) ,27.8% of patients showed severe oligospermia, and 72.2% of patients showed azoospermia. There were 6 cases of AZFb+c(13%),whose phenotype was azoospermia. The serum FSH,LH and T levels of AZFb+c microdeletion groups were significantly higher than those of healthy fertile male groups. The serum FSH and LH levels of AZFc/DAZ microdeletion groups were significantly higher than those of healthy fertile male groups,however the serum T levels had no statistical difference in comparison with fertile group.CONCLUSIONS :1. Oligospermic patients should be examined on the serum reproductive hormone levels. In general, the serum FSH and LH levels are significantly increased. Therefore, we should take prostrate gland and seminal vesicle function into accounts when the serum FSH and LH levels are significantly increased.2. Significant positive correlation is found between course of disease and the serum LH and FSH,however the serum INH-B level is negatively correlated with the course of disease. The serum inhibin B can reveal the testicular spermatogenic function directly,so it can be the more effective marker for evaluating the testicular spermatogenic function. Combination of FSH and LH can be better used for the classification and diagnostic analysis of azoospermia.3. Measurement of serum reproductive hormone has a clinical significance on diagnosis and treatment of asthenospermia, oligo-asthenospermia. While the testicular function is impaired, changes in the serum FSH and LH levels become obvious. The changes of serum LH levels are less obvious than that of the serum FSH levels. The T/LH can reveal the condition of testicular cells of Leydig more accurately. The serum PRL and E2 levels can indicate the motility of sperm. Hence, we should focus on them.4. The serum FSH and LH levels ofⅡ°andⅢ°varicocele groups are higher than those of fertile group. The serum FSH and LH levels ofⅠ°varicocele groups had no statistical difference in comparison with fertile group. Moreover, the serum T,PRL and E2 levels ofⅠ°,Ⅱ°andⅢ°varicocele groups had no statistical difference in comparison with fertile group. The results indicate that the serum reproductive hormones FSH,LH may be influenced by varicocele, however varicocele clinical grading on serum reproductive hormone levels is not found to be directly related.5. Chromosome abnormality,especially sex chromosome abnormality can lead to azoospermia, which results in secretion abnormality of reproductive hormones. Changes of reproductive hormones FSH,LH,T and PRL levels can reveal the lesion sites and levels of injury of the patients who suffer azoospermia. The causes of azoospermia can be revealed from the analysis of chromosome karyotype and the levels of reproductive hormones. Therefore, it can be used as a marker for diagnosis and treatment.6. In Y chromosome deletion,the main parts are AZFb+c deletion and AZFc/DAZ deletion. The clinical manifestations are severe oligospermia and azoospermia. The levels of serum FSH and LH are significantly increased. It suggests that Y chromosome microdeletions can be detected if the human assisted reproductive technology is implemented. At the same time,reproductive hormones also need to be analyzed as assistant diagnosis.