Evaluation of a serum 17-hydroxyprogesterone as predictor of semen parameter

Introduction: The goal of medical therapy for infertile men with testosterone deficiency (TD) is to improve intratesticular testosterone (ITT). There is a gap in knowledge to identify those who will respond with semen parameter(s) improvement. We hypothesized that serum 17-hydroxyprogesterone (17-OH...

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Bibliographic Details
Published in:Canadian Urological Association journal 2021-07, Vol.15 (7), p.1
Main Authors: Lima, Thiago Fernandes Negris, Rakitina, Evgeniya, Blachman-Braun, Ruben, Ramasamy, Ranjith
Format: Article
Language:English
Subjects:
Care and treatment
Fertility drugs
Health aspects
Hydroxyprogesterone
Infertility, Male
Measurement
Physiological aspects
Prognosis
Semen
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Summary:Introduction: The goal of medical therapy for infertile men with testosterone deficiency (TD) is to improve intratesticular testosterone (ITT). There is a gap in knowledge to identify those who will respond with semen parameter(s) improvement. We hypothesized that serum 17-hydroxyprogesterone (17-OHP)--a marker of ITT--can be used to predict improvement of semen parameter(s). Methods: Between July 2018 and January 2020, we conducted a prospective study of 31 men with primary infertility, TD, and secondary hypogonadism receiving clomiphene citrate (CC) and/or human chorionic gonadotropin (hCG) for three months. We assessed baseline and followup hormones, including testosterone, 17-OHP, semen parameter(s), and demographics. Semen quality upgrading was based on assisted reproduction eligibility: in-vitro fertilization (9 million). Variables were compared using the Mann-Whitney U or Wilcoxon rank test. Results: Twenty-one men received CC and 10 received CC/hCG. Median followup was 3.7 (3.3-5.1) months. Sixteen men upgraded semen quality. Six of 10 men with baseline total motile sperm count (TMSC) of 0 had motile sperm after treatment, and 11/20 men with TMSC5 range. Low 17-OHP was the only factor that predicted semen quality upgrading. Men with 17-OHP [less than or equal to]55 ng/dL upgraded semen quality and improved hormones, whereas men with 17-OHP >55 ng/dL did not upgrade semen quality. Conclusions: Medical therapy for infertile men with TD resulted in the improvement of sperm concentration, TMSC, testosterone, and 17-OHP. Semen quality upgrading appears to be more significant in patients with low 17-OHP, suggesting that ITT can be used as a biomarker to predict semen parameter(s) improvement.
ISSN:1911-6470
1920-1214
DOI:10.5489/cuaj.6846