Non-classical 21-hydroxylase deficiency: prevalence in males with unexplained abnormal sperm analysis.
OBJECTIVE
To evaluate the prevalence of nonclassical 21-hydroxylase deficiency (NC-21OHD) in men with abnormal sperm parameters of unexplained etiology compared with males with normal sperm analysis.


METHODS
Case control study.


METHODS
Major tertiary medical center.


METHODS
Of 484 healthy men being followed at a fertility clinic, 222 (mean age 33.8 +/- 6.1 [+/-SD] years) presented with abnormal findings on sperm analysis (1999 WHO criteria) of unknown cause and 262 (mean age 34.8 +/- 6.5 [+/-SD] years) with a normal sperm analysis.


METHODS
Random mid-morning blood sampling to test for 17-hydroxyprogesterone (17-OHP) levels. Subjects with levels of >or= 6 nmol/L underwent a standard adrenocorticotropic hormone (ACTH) stimulation test.


METHODS
NC-21-OHD, defined as a stimulated ACTH level of >or=45 nmol/L.


RESULTS
A serum 17-OHP level of >or=6 nmol/L was detected in 11 study patients (5.0%) and 14 control subjects (5.3%). Seven study patients and 8 controls subsequently underwent ACTH stimulation test, and none had levels compatible with a diagnosis of NC-21OHD. Mean 17-OHP levels were similar in the two groups (3.3 +/- 1.4 [+/-SD] nmol/L and 3.3 +/- 1.5 [+/-SD] nmol/L, respectively). There was no correlation between sperm parameters and serum 17-OHP levels.


CONCLUSIONS
Until larger studies are performed, the routine measurement of 17-OHP in the evaluation of male infertility is not recommended.
Pinkas
Haim
H
Infertility and IVF Unit, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, Israel.
Fuchs
Sonia
S
Klipper-Aurbach
Yaffa
Y
Zvulunov
Alex
A
Raanani
Hila
H
Mimouni
Galit
G
Fisch
Benjamin
B
Weintrob
Naomi
N
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000312:Adrenal Hyperplasia, Congenital / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000378:metabolism; D000328:Adult; D016022:Case-Control Studies; D006801:Humans; D007248:Infertility, Male / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D008297:Male; D015995:Prevalence; D055101:Semen Analysis; D013255:Steroid 21-Hydroxylase / Q000235:genetics
D019326:17-alpha-Hydroxyprogesterone; D000324:Adrenocorticotropic Hormone; D013255:Steroid 21-Hydroxylase