Gonad evaluation in male systemic lupus erythematosus.
OBJECTIVE
To assess gonad function in male patients with systemic lupus erythematosus (SLE).


METHODS
Thirty-five consecutive male patients with SLE according to the criteria of the American College of Rheumatology were prospectively evaluated for demographic and clinical features as well as previous and current treatment. Patients underwent urologic evaluation and testicular Doppler ultrasound. We obtained a hormone profile and performed a semen analysis including morphology and testing for the presence of antisperm antibodies. Patients were compared with 35 age-matched healthy controls.


RESULTS
Compared with controls, SLE patients had lower median testicular volumes in both testes, a lower median total sperm count, and a lower median total motile sperm count. The mean sperm volume and percentage of normally formed sperm were lower in SLE patients than in controls. Since all SLE patients had semen alterations, they were further subdivided into 2 groups according to the severity of these abnormalities (group 1, with teratozoospermia [n = 18], and group 2, with azoospermia or teratozoospermia in combination with oligozoospermia and/or asthenozoospermia [n = 17]). The frequency of treatment with intravenous cyclophosphamide (IV CYC) after the first ejaculation was higher in group 2 than in group 1. The median testicular volumes measured by ultrasound in both testicles were lower in group 2 than in group 1. Follicle-stimulating hormone levels were higher in group 2 than in group 1. The overall frequency of antisperm antibodies in SLE patients was 40%. The apparent higher frequency of antisperm antibodies in group 1 than in group 2 did not reach significance.


CONCLUSIONS
SLE patients have a high frequency of sperm abnormalities associated with reduced testicular volume. Postpubertal IV CYC treatment was the major factor in potential permanent damage to the testes.
Soares
Pollyana Maria F
PM
University of São Paulo, São Paulo, Brazil.
Borba
Eduardo Ferreira
EF
Bonfa
Eloisa
E
Hallak
Jorge
J
Corrêa
André Luiz
AL
Silva
Clovis Artur A
CA
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000473:pathology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013076:Sperm Count; D013081:Sperm Motility; D013094:Spermatozoa / Q000276:immunology; D013737:Testis / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D014463:Ultrasonography
D001323:Autoantibodies