Clinical utility of serum 17-hydroxyprogesterone as a marker for medical therapy for male infertility: recommendations based on clinical scenarios.
Journal
International journal of impotence research
ISSN: 1476-5489
Titre abrégé: Int J Impot Res
Pays: England
ID NLM: 9007383
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
received:
18
01
2022
accepted:
03
02
2022
revised:
31
01
2022
medline:
30
3
2023
pubmed:
25
2
2022
entrez:
24
2
2022
Statut:
ppublish
Résumé
Traditional serum hormone testing in the evaluation of male infertility consists of testosterone, follicle-stimulating hormone, luteinizing hormone, and estradiol. Based on these values, medical therapy is often initiated in an attempt to increase intratesticular testosterone levels and, in turn, promote spermatogenesis. While this hormone panel provides serum testosterone levels, it does not evaluate intratesticular testosterone, obviously an important factor that is critical for spermatogenesis. 17-hydroxyprogesterone (17-OHP) is an intermediate in the steroidal pathway of cholesterol to testosterone conversion that has recently demonstrated promise as an accurate serum biomarker for intratesticular testosterone. At present, 17-OHP has not been widely adopted as a clinical tool in the evaluation of male infertility, which likely stems, in part, from a lack of concrete indications for its use. In this review, we present five commonly encountered scenarios of male infertility where the utilization of 17-OHP has aided in the management and provided a more personalized approach to treatment.
Identifiants
pubmed: 35197555
doi: 10.1038/s41443-022-00541-z
pii: 10.1038/s41443-022-00541-z
doi:
Substances chimiques
17-alpha-Hydroxyprogesterone
68-96-2
Testosterone
3XMK78S47O
Luteinizing Hormone
9002-67-9
Follicle Stimulating Hormone
9002-68-0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
79-81Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature Limited.
Références
Jin JM, Yang WX. Molecular regulation of hypothalamus-pituitary-gonads axis in males. Gene. 2014;551:15–25.
doi: 10.1016/j.gene.2014.08.048
pubmed: 25168889
Isidori AM, Giannetta E, Lenzi A. Male hypogonadism. Pituitary. 2008;11:171–80.
doi: 10.1007/s11102-008-0111-9
pubmed: 18404386
Wang RS, Yeh S, Tzeng CR, Chang C. Androgen receptor roles in spermatogenesis and fertility: lessons from testicular cell-specific androgen receptor knockout mice. Endocr Rev. 2009;30:119–32.
doi: 10.1210/er.2008-0025
pubmed: 19176467
pmcid: 2662628
Kumar TR, Wang Y, Lu N, Matzuk MM. Follicle stimulating hormone is required for ovarian follicle maturation but not male fertility. Nat Genet. 1997;15:201–4.
doi: 10.1038/ng0297-201
pubmed: 9020850
Kumar TR. Functional analysis of LHbeta knockout mice. Mol Cell Endocrinol. 2007;269:81–4.
doi: 10.1016/j.mce.2006.10.020
pubmed: 17350160
Schlegel PN, Sigman M, Collura B, De Jonge CJ, Eisenberg ML, Lamb DJ, et al. Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I. Fertil Steril. 2021;115:54–61.
doi: 10.1016/j.fertnstert.2020.11.015
pubmed: 33309062
Walker WH. Testosterone signaling and the regulation of spermatogenesis. Spermatogenesis. 2011;1:116–20.
doi: 10.4161/spmg.1.2.16956
pubmed: 22319659
pmcid: 3271653
Coviello AD, Bremner WJ, Matsumoto AM, Herbst KL, Amory JK, Anawalt BD, et al. Intratesticular testosterone concentrations comparable with serum levels are not sufficient to maintain normal sperm production in men receiving a hormonal contraceptive regimen. J Androl. 2004;25:931–8.
doi: 10.1002/j.1939-4640.2004.tb03164.x
pubmed: 15477366
Hsieh TC, Pastuszak AW, Hwang K, Lipshultz LI. Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. J Urol. 2013;189:647–50.
doi: 10.1016/j.juro.2012.09.043
pubmed: 23260550
White PC. Neonatal screening for congenital adrenal hyperplasia. Nat Rev Endocrinol. 2009;5:490–8.
doi: 10.1038/nrendo.2009.148
pubmed: 19690561
Lima TFN, Patel P, Blachman-Braun R, Madhusoodanan V, Ramasamy R. Serum 17-hydroxyprogesterone is a potential biomarker for evaluating intratesticular testosterone. J Urol. 2020;204:551–6.
doi: 10.1097/JU.0000000000001016
pubmed: 32167868
Amory JK, Coviello AD, Page ST, Anawalt BD, Matsumoto AM, Bremner WJ. Serum 17-hydroxyprogesterone strongly correlates with intratesticular testosterone in gonadotropin-suppressed normal men receiving various dosages of human chorionic gonadotropin. Fertil Steril. 2008;89:380–6.
doi: 10.1016/j.fertnstert.2007.02.059
pubmed: 17462643
Lee JA, Ramasamy R. Indications for the use of human chorionic gonadotropic hormone for the management of infertility in hypogonadal men. Transl Androl Urol. 2018;7:S348–S52.
doi: 10.21037/tau.2018.04.11
pubmed: 30159241
pmcid: 6087849
Lima TFN, Rakitina E, Blachman-Braun R, Ramasamy R. Evaluation of a serum 17-hydroxyprogesterone as a predictor of semen parameter improvement in men undergoing medical treatment for infertility. Can Urol Assoc J. 2021;15:E340–E5.
pubmed: 33382370
Mulhall JP, Trost LW, Brannigan RE, Kurtz EG, Redmon JB, Chiles KA, et al. Evaluation and management of testosterone deficiency: AUA guideline. J Urol. 2018;200:423–32.
doi: 10.1016/j.juro.2018.03.115
pubmed: 29601923
Ventimiglia E, Ippolito S, Capogrosso P, Pederzoli F, Cazzaniga W, Boeri L, et al. Primary, secondary and compensated hypogonadism: a novel risk stratification for infertile men. Andrology. 2017;5:505–10.
doi: 10.1111/andr.12335
pubmed: 28409903
Shabsigh A, Kang Y, Shabsign R, Gonzalez M, Liberson G, Fisch H, et al. Clomiphene citrate effects on testosterone/estrogen ratio in male hypogonadism. J Sex Med. 2005;2:716–21.
doi: 10.1111/j.1743-6109.2005.00075.x
pubmed: 16422830
Messinis IE, Templeton A. Blockage of the positive feedback effect of oestradiol during prolonged administration of clomiphene citrate to normal women. Clin Endocrinol. 1988;29:509–16.
doi: 10.1111/j.1365-2265.1988.tb03700.x
McBride JA, Carson CC, Coward RM. Diagnosis and management of testosterone deficiency. Asian J Androl. 2015;17:177–86.
doi: 10.4103/1008-682X.143317
pubmed: 25532575
Lazarou S, Reyes-Vallejo L, Morgentaler A. Wide variability in laboratory reference values for serum testosterone. J Sex Med. 2006;3:1085–9.
doi: 10.1111/j.1743-6109.2006.00334.x
pubmed: 17100942
Paduch DA, Brannigan RE, Fuchs EF, Kim ED, Marmar JL, Sandlow JI. The laboratory diagnosis of testosterone deficiency. Urology. 2014;83:980–8.
doi: 10.1016/j.urology.2013.12.024
pubmed: 24548716
Le M, Flores D, May D, Gourley E, Nangia AK. Current practices of measuring and reference range reporting of free and total testosterone in the United States. J Urol. 2016;195:1556–61.
doi: 10.1016/j.juro.2015.12.070
pubmed: 26707506
Pavlovich CP, King P, Goldstein M, Schlegel PN. Evidence of a treatable endocrinopathy in infertile men. J Urol. 2001;165:837–41.
doi: 10.1016/S0022-5347(05)66540-8
pubmed: 11176482
Leavy M, Trottmann M, Liedl B, Reese S, Stief C, Freitag B, et al. Effects of elevated beta-estradiol levels on the functional morphology of the testis - new insights. Sci Rep. 2017;7:39931.
doi: 10.1038/srep39931
pubmed: 28045098
pmcid: 5206739