Intratesticular Testosterone and Its Precursors among Azoospermic Men: A Pilot Study
Purpose: The study aimed to comprehensively analyze testosterone and precursor concentrations in the testicular interstitial fluid (TIF) of men with azoospermia, exploring their significance in the testicular microenvironment and their correlation with testicular sperm retrieval outcomes. Materia...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Sexual Medicine and Andrology
2025-01-01
|
| Series: | The World Journal of Men's Health |
| Subjects: | |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841561269625159680 |
|---|---|
| author | I-Shen Huang Li-Hua Li Wei-Jen Chen Chi-Chang Juan William J. Huang |
| author_facet | I-Shen Huang Li-Hua Li Wei-Jen Chen Chi-Chang Juan William J. Huang |
| author_sort | I-Shen Huang |
| collection | DOAJ |
| description | Purpose: The study aimed to comprehensively analyze testosterone and precursor concentrations in the testicular interstitial
fluid (TIF) of men with azoospermia, exploring their significance in the testicular microenvironment and their correlation
with testicular sperm retrieval outcomes.
Materials and Methods: We analyzed 37 TIF samples, including 5 from men with obstructive azoospermia (OA) and 32 from
men with non-obstructive azoospermia (NOA). Liquid chromatography with tandem mass spectrometry quantified testosterone
and precursor levels. Comparative assessments of the outcomes of testicular sperm retrieval were performed between the
OA and NOA groups as well as among men with NOA.
Results: Men with NOA who had not undergone hormone treatment exhibited significantly higher intratesticular concentrations
of testosterone (median 1,528.1 vs. 207.5 ng/mL), androstenedione (median 10.6 vs. 1.9 ng/mL), and 17-OH progesterone
(median 13.0 vs. 1.8 ng/mL) than men diagnosed with OA. Notably, in the subgroup of patients with NOA subjected to
medical treatment, men with successful sperm retrieval had significantly reduced levels of androstenedione (median androstenedione
5.7 vs. 18.5 ng/mL, p=0.004). Upon a more detailed analysis of these men who underwent hormone manipulation
treatment, the testosterone/androstenedione ratio (indicative of HSD17B3 enzyme activity) was markedly increased in
men with successful sperm retrieval (median: 365.8 vs. 165.0, p=0.008) compared with individuals with NOA who had unsuccessful
sperm recovery. Furthermore, within the subset of men with NOA who did not undergo medical treatment before
microdissection testicular sperm extraction but achieved successful sperm retrieval, the ratio of 17-OH progesterone/progesterone
(indicative of CYP17A1 activity) was substantially higher.
Conclusions: The study suggests distinct testosterone biosynthesis pathways in men with compromised spermatogenesis and
those with normal spermatogenesis. Among NOA men with successful retrieval after hormone optimization therapy, there
was decreased androstenedione and increased HSD17B3 enzyme activity. These findings have diagnostic and therapeutic
implications for the future. |
| format | Article |
| id | doaj-art-7835a14e4e02446b9f09daba1603474d |
| institution | Kabale University |
| issn | 2287-4208 2287-4690 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Korean Society for Sexual Medicine and Andrology |
| record_format | Article |
| series | The World Journal of Men's Health |
| spelling | doaj-art-7835a14e4e02446b9f09daba1603474d2025-01-03T03:23:21ZengKorean Society for Sexual Medicine and AndrologyThe World Journal of Men's Health2287-42082287-46902025-01-0143114215310.5534/wjmh.230265Intratesticular Testosterone and Its Precursors among Azoospermic Men: A Pilot StudyI-Shen Huang0https://orcid.org/0000-0003-1669-779XLi-Hua Li1https://orcid.org/0000-0002-2501-0913Wei-Jen Chen2https://orcid.org/0000-0002-0199-7602Chi-Chang Juan3https://orcid.org/0000-0001-5935-6675William J. Huang4https://orcid.org/0000-0002-0113-1307Department of Urology, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Urology, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Physiology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Urology, Taipei Veterans General Hospital, Taipei, TaiwanPurpose: The study aimed to comprehensively analyze testosterone and precursor concentrations in the testicular interstitial fluid (TIF) of men with azoospermia, exploring their significance in the testicular microenvironment and their correlation with testicular sperm retrieval outcomes. Materials and Methods: We analyzed 37 TIF samples, including 5 from men with obstructive azoospermia (OA) and 32 from men with non-obstructive azoospermia (NOA). Liquid chromatography with tandem mass spectrometry quantified testosterone and precursor levels. Comparative assessments of the outcomes of testicular sperm retrieval were performed between the OA and NOA groups as well as among men with NOA. Results: Men with NOA who had not undergone hormone treatment exhibited significantly higher intratesticular concentrations of testosterone (median 1,528.1 vs. 207.5 ng/mL), androstenedione (median 10.6 vs. 1.9 ng/mL), and 17-OH progesterone (median 13.0 vs. 1.8 ng/mL) than men diagnosed with OA. Notably, in the subgroup of patients with NOA subjected to medical treatment, men with successful sperm retrieval had significantly reduced levels of androstenedione (median androstenedione 5.7 vs. 18.5 ng/mL, p=0.004). Upon a more detailed analysis of these men who underwent hormone manipulation treatment, the testosterone/androstenedione ratio (indicative of HSD17B3 enzyme activity) was markedly increased in men with successful sperm retrieval (median: 365.8 vs. 165.0, p=0.008) compared with individuals with NOA who had unsuccessful sperm recovery. Furthermore, within the subset of men with NOA who did not undergo medical treatment before microdissection testicular sperm extraction but achieved successful sperm retrieval, the ratio of 17-OH progesterone/progesterone (indicative of CYP17A1 activity) was substantially higher. Conclusions: The study suggests distinct testosterone biosynthesis pathways in men with compromised spermatogenesis and those with normal spermatogenesis. Among NOA men with successful retrieval after hormone optimization therapy, there was decreased androstenedione and increased HSD17B3 enzyme activity. These findings have diagnostic and therapeutic implications for the future.azoospermiaextracellular fluidinfertility; malesperm retrievaltestistestosterone |
| spellingShingle | I-Shen Huang Li-Hua Li Wei-Jen Chen Chi-Chang Juan William J. Huang Intratesticular Testosterone and Its Precursors among Azoospermic Men: A Pilot Study The World Journal of Men's Health azoospermia extracellular fluid infertility; male sperm retrieval testis testosterone |
| title | Intratesticular Testosterone and Its Precursors among Azoospermic Men: A Pilot Study |
| title_full | Intratesticular Testosterone and Its Precursors among Azoospermic Men: A Pilot Study |
| title_fullStr | Intratesticular Testosterone and Its Precursors among Azoospermic Men: A Pilot Study |
| title_full_unstemmed | Intratesticular Testosterone and Its Precursors among Azoospermic Men: A Pilot Study |
| title_short | Intratesticular Testosterone and Its Precursors among Azoospermic Men: A Pilot Study |
| title_sort | intratesticular testosterone and its precursors among azoospermic men a pilot study |
| topic | azoospermia extracellular fluid infertility; male sperm retrieval testis testosterone |
| work_keys_str_mv | AT ishenhuang intratesticulartestosteroneanditsprecursorsamongazoospermicmenapilotstudy AT lihuali intratesticulartestosteroneanditsprecursorsamongazoospermicmenapilotstudy AT weijenchen intratesticulartestosteroneanditsprecursorsamongazoospermicmenapilotstudy AT chichangjuan intratesticulartestosteroneanditsprecursorsamongazoospermicmenapilotstudy AT williamjhuang intratesticulartestosteroneanditsprecursorsamongazoospermicmenapilotstudy |