The following is a summary of “Assessing the Prevalence of Low Testosterone and Elevated Follicle Stimulating Hormone Among Men Presenting for Fertility Evaluation Without Oligospermia,” published in the OCTOBER 2023 issue of Urology by Greenberg, et al.

For a study, researchers sought to assess the prevalence of abnormal hormone parameters in men with and without oligospermia, aiming to establish the utility of universal hormonal screening during the initial fertility evaluation.

A retrospective analysis was conducted on men who underwent semen analysis and hormonal assessment (morning testosterone [T] and follicle-stimulating hormone [FSH]) between January 2002 and May 2021. Sperm concentration was categorized at 15 million/mL based on World Health Organization (WHO) criteria. Median and interquartile range (IQR) levels of T and FSH were compared using the Kruskal-Wallis test. The prevalence of low testosterone (<300 ng/dL) and abnormal FSH (>7.6 mIU/mL) was compared using the chi-square test.

Out of 1,164 men with morning serum T, no significant difference in median T levels was observed between those with normal and abnormal sperm concentration (316 ng/dL, IQR 250-399 vs. 316 ng/dL, IQR 253-419; P = .52). Among 1,261 men with FSH measurement, those with sperm concentration <15 million/mL exhibited a higher median FSH (6.0 IU/mL, IQR 3.9-10.7 vs. 3.8 IU/mL, IQR 2.7-5.7; P < .001). In men with ≥15 million/mL concentration, 44.1% had low T (P = .874), and 10.8% had FSH ≥7.6 mIU/mL (P < .001). Among those with ≥15 million/mL sperm concentration undergoing T and FSH evaluation, 43.6% manifested at least one hormonal abnormality.

The findings indicated that nearly half of men with normal sperm concentration exhibit low T. Given the potential long-term implications for fertility and overall health, universal testosterone screening should be considered for men seeking fertility evaluation.

Source: goldjournal.net/article/S0090-4295(23)00636-2/fulltext