Short-term suppression of GH and IGF-I levels improves gonadal function and sperm parameters in men with acromegaly.
Experimental data support a role for GH and IGF-I in the reproductive process in humans, but the effect of chronic GH excess on gonadal and reproductive function in men has been never investigated. To understand the effects of short-term GH and IGF-I suppression on the gonadal axis and seminal fluid characteristics in men with acromegaly, we evaluated 35 patients (age 27-59 yr) with active disease and 35 age-matched healthy controls. Gonadal hormones and seminal fluid analysis were evaluated before and 6 months after surgery or lanreotide (LAN) (60 mg/month). At study entry, FSH, testosterone (T), and dihydrotestosterone (DHT) (P < 0.0001) levels, seminal volume, sperm count, total motility and forward progression, normal morphology, and vitality were significantly lower in patients with acromegaly than in controls. After 6 months, 22 patients achieved disease control after surgery (n = 11) or LAN (n = 11), whereas 13 had uncontrolled disease. Serum T and DHT levels and sperm number significantly increased in all groups. FSH and LH levels and total motility increased only in patients achieving disease control. Posttreatment IGF-I levels significantly correlated with total motility (r = -0.45; P = 0.006). In conclusion, short-term GH and IGF-I suppression after surgery or LAN significantly increased T and DHT levels and improved sperm number and motility in acromegalic men.
Colao
A
A
Department of Molecular, Federico II University of Naples, 80131 Naples, Italy. colao@unina.it
De Rosa
M
M
Pivonello
R
R
Balestrieri
A
A
Cappabianca
P
P
Di Sarno
A
A
Rochira
V
V
Carani
C
C
Lombardi
G
G
D000172:Acromegaly / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D000236:Adenoma / Q000150:complications; D000328:Adult; D000726:Androgen Antagonists / Q000627:therapeutic use*; D013196:Dihydrotestosterone / Q000097:blood; D018450:Disease Progression; D004958:Estradiol / Q000097:blood; D005640:Follicle Stimulating Hormone / Q000097:blood; D019382:Human Growth Hormone / Q000037:antagonists & inhibitors* / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000037:antagonists & inhibitors* / Q000378:metabolism; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D010911:Pituitary Neoplasms / Q000150:complications; D012044:Regression Analysis; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use*; D013076:Sperm Count; D013081:Sperm Motility / Q000187:drug effects; D013739:Testosterone / Q000097:blood
D000726:Androgen Antagonists; D010456:Peptides, Cyclic; D013196:Dihydrotestosterone; C060347:lanreotide; D019382:Human Growth Hormone; D013739:Testosterone; D004958:Estradiol; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone