TY - JOUR

T1 - Clinical, genetic, biochemical, and testicular biopsy findings among 1,213 men evaluated for infertility

AU - Olesen, Inge Ahlmann

AU - Andersson, Anna-Maria

AU - Aksglaede, Lise

AU - Skakkebaek, Niels Erik

AU - Rajpert-De Meyts, Ewa

AU - Jørgensen, Niels

AU - Juul, Anders

N1 - Copyright © 2016. Published by Elsevier Inc.

PY - 2017/1

Y1 - 2017/1

N2 - OBJECTIVE: To study the pathologic findings among men evaluated for infertility.DESIGN: A retrospective, single-center, cross-sectional study.SETTING: University hospital-based research center.PARTICIPANT(S): We included data from 1,213 medical records from infertile men referred for diagnostic work-up from 2005 to 2009.INTERVENTIONS(S): None.MAIN OUTCOME MEASURE(S): Health history, clinical findings, chromosome/genetic aberrations, semen quality, reproductive hormones.RESULT(S): In total, 64.4% of the infertile men had one or more reproductive disorders or factors influencing fertility, leaving 35.6% diagnosed as idiopathic infertile. In 244 patients (20%), including seven cases of testicular cancer and/or germ cell neoplasia in situ, a pathologic finding was first detected during diagnostic work-up. Two hundred four patients (16.8%) had a history of cryptorchidism and 154 (12.7%) of varicocele (grade 2 and 3). Thirty-three patients had chromosomal abnormalities, including 16 with sex chromosome abnormalities (11 with 47,XXY). Y-chromosome microdeletions were detected in 65 patients (5.4%). One hundred thirty-three had azoospermia, of which 58 had testicular biopsy findings (Sertoli cell-only syndrome: n = 23; spermatogenic arrest: n = 7; impaired spermatogenesis and atrophy: n = 28). Additionally, in idiopathic infertile men and infertile men with additional symptoms of testicular dysgenesis syndrome, 22.5% presented with a degree of Leydig cell insufficiency, with the highest frequency (33.1%) among patients with sperm concentration <5 million/mL.CONCLUSION(S): We report pathologic findings that could explain the male-factor infertility in two-thirds of infertile men referred to our center. Thus, male infertility may be a sign of an underlying disease that warrants attention.

AB - OBJECTIVE: To study the pathologic findings among men evaluated for infertility.DESIGN: A retrospective, single-center, cross-sectional study.SETTING: University hospital-based research center.PARTICIPANT(S): We included data from 1,213 medical records from infertile men referred for diagnostic work-up from 2005 to 2009.INTERVENTIONS(S): None.MAIN OUTCOME MEASURE(S): Health history, clinical findings, chromosome/genetic aberrations, semen quality, reproductive hormones.RESULT(S): In total, 64.4% of the infertile men had one or more reproductive disorders or factors influencing fertility, leaving 35.6% diagnosed as idiopathic infertile. In 244 patients (20%), including seven cases of testicular cancer and/or germ cell neoplasia in situ, a pathologic finding was first detected during diagnostic work-up. Two hundred four patients (16.8%) had a history of cryptorchidism and 154 (12.7%) of varicocele (grade 2 and 3). Thirty-three patients had chromosomal abnormalities, including 16 with sex chromosome abnormalities (11 with 47,XXY). Y-chromosome microdeletions were detected in 65 patients (5.4%). One hundred thirty-three had azoospermia, of which 58 had testicular biopsy findings (Sertoli cell-only syndrome: n = 23; spermatogenic arrest: n = 7; impaired spermatogenesis and atrophy: n = 28). Additionally, in idiopathic infertile men and infertile men with additional symptoms of testicular dysgenesis syndrome, 22.5% presented with a degree of Leydig cell insufficiency, with the highest frequency (33.1%) among patients with sperm concentration <5 million/mL.CONCLUSION(S): We report pathologic findings that could explain the male-factor infertility in two-thirds of infertile men referred to our center. Thus, male infertility may be a sign of an underlying disease that warrants attention.

KW - Journal Article

U2 - 10.1016/j.fertnstert.2016.09.015

DO - 10.1016/j.fertnstert.2016.09.015

M3 - Journal article

C2 - 27793385

VL - 107

SP - 74-82.e7

JO - Sexuality, Reproduction and Menopause

JF - Sexuality, Reproduction and Menopause

SN - 1546-2501

IS - 1

ER -