title: Abnormality of pituitary gonadal axis among Nigerian males with infertility: study of patterns and possible etiologic interrelationships.
abstract: BACKGROUND
  Hormonal derangements potentially contribute to the diagnosis of infertility in over 60%-70% of couples investigated. Use of hormonal and antihormonal agents has achieved great success in the treatment of male infertility. Our aim was to investigate the prevalence of hormonal abnormalities in males diagnosed with infertility.
  
  
  METHODS
  Males diagnosed clinically with infertility and referred from the gynecologic clinics of the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu State University Teaching Hospital, and some private hospitals in and around Enugu metropolis were recruited for the study. They were grouped according to whether they had primary or secondary infertility on the basis of the World Health Organization definition. Routine fertility test profiles for the subjects were evaluated, and detailed hormonal assays were analyzed.
  
  
  RESULTS
  Of 216 men, 173 (80.1%) were found to have a hormonal imbalance. The mean age was 47.7 ± 3.5 (range 30-55) years for primary infertility and 47.2 ± 6.8 (range 33-61) years for secondary infertility. Patterns of hormonal abnormalities diagnosed amongst the 62 (35.80%) primary infertility subjects included hypergonadotrophic hypogonadism in 39 (62.90%), hypogonadotrophic hypogonadism in 18 (29.03%), and hyperprolactinemia in five (8.07%). Among the 111 (64.2%) cases of secondary infertility, there were 55 (49.55%) cases of hypergonadotrophic hypogonadism, 52 (46.85%) of hypogonadotrophic hypogonadism, and four (3.60%) of hyperprolactinemia. There was no statistically significant difference in the mean values between the two groups (χ(2) < 1.414; P > 0.05) for hormonal indices.
  
  
  CONCLUSIONS
  The hormonal profile should be considered as the gold standard for diagnosis and management of male infertility.
authors.affiliation: Department of Anatomy and Surgery, Ituku/Ozalla, Nigeria.
authors.forename: Ofn
authors.initials: O
authors.lastname: Ozoemena
authors.forename: Jo
authors.initials: J
authors.lastname: Ezugworie
authors.forename: Au
authors.initials: A
authors.lastname: Mbah
authors.forename: Ea
authors.initials: E
authors.lastname: Esom
authors.forename: Bo
authors.initials: B
authors.lastname: Ayogu
authors.forename: Fe
authors.initials: F
authors.lastname: Ejezie
keywords: hormonal indices; infertility; males