Sperm concentration is poorly associated with hypoandrogenism in infertile men.
OBJECTIVE
To evaluate the utility of routine hormone evaluation in all men presenting for infertility by understanding the relationship between sperm concentration and hypoandrogenism.


METHODS
We performed a retrospective cross-sectional study between September 2013 and May 2014 at a tertiary referral center in Utah. Ninety-four men presenting for infertility consecutively between the ages of 18 and 55 years were identified. Our primary outcome was rate of hypoandrogenism among infertile men defined as the baseline total serum testosterone levels <300 ng/dL or bioavailable testosterone (BAT) levels <155 ng/dL. Secondary outcomes included association of normospermia, oligozoospermia, or azoospermia with biochemical or clinical hypoandrogenism.


RESULTS
Thirty-nine men (41%) had a total serum testosterone level of <300 ng/dL, and 41 men (43%) had a BAT level <155 ng/dL. Biochemical and symptomatic hypoandrogenism was common; 17 men (18%) had a total testosterone level <300 ng/dL and ≥ 3 positive Androgen Deficiency in Aging Male (ADAM) responses, and 18 men (19%) had a BAT level of <155 ng/dL and ≥ 3 positive ADAM responses. Sperm concentration (normospermia, oligozoospermia, and azoospermia) was not associated with biochemical hypoandrogenism (total testosterone level <300 ng/dL or BAT level <155 ng/dL), symptomatic hypoandrogenism (≥ 3 positive ADAM responses), or sexual dysfunction (Sexual Health Inventory for Men score <21).


CONCLUSIONS
Hypoandrogenism is common among infertile men, and routine hormonal evaluation may identify hypoandrogenism in many infertile men with otherwise normal semen analysis. Sperm concentration (normospermia, oligozoospermia, and azoospermia) is not well associated with hypoandrogenism in infertile men.
The Center for Reconstructive Urology and Men's Health, Division of Urology, University of Utah, Salt Lake City, UT; Division of Urology, University of Utah, Salt Lake City, UT. Electronic address: Darshan.Patel@utah.edu.
Darshan P
DP
Patel
The Center for Reconstructive Urology and Men's Health, Division of Urology, University of Utah, Salt Lake City, UT; Division of Urology, University of Utah, Salt Lake City, UT.
William O
WO
Brant
The Center for Reconstructive Urology and Men's Health, Division of Urology, University of Utah, Salt Lake City, UT; Division of Urology, University of Utah, Salt Lake City, UT.
Jeremy B
JB
Myers
Division of Epidemiology, University of Utah, Salt Lake City, UT.
Chong
C
Zhang
Division of Epidemiology, University of Utah, Salt Lake City, UT.
Angela P
AP
Presson
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT.
Erica B
EB
Johnstone
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT.
Jessie A
JA
Dorais
The Center for Reconstructive Urology and Men's Health, Division of Urology, University of Utah, Salt Lake City, UT; Division of Urology, University of Utah, Salt Lake City, UT; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT; Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, UT.
Kenneth I
KI
Aston
The Center for Reconstructive Urology and Men's Health, Division of Urology, University of Utah, Salt Lake City, UT; Division of Urology, University of Utah, Salt Lake City, UT; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT; Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, UT.
Douglas T
DT
Carrell
The Center for Reconstructive Urology and Men's Health, Division of Urology, University of Utah, Salt Lake City, UT; Division of Urology, University of Utah, Salt Lake City, UT.
James M
JM
Hotaling
D000328:Adult; D053713:Azoospermia / Q000097:blood*; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D009845:Oligospermia / Q000097:blood*; D012189:Retrospective Studies; D013076:Sperm Count; D013739:Testosterone / Q000097:blood* / Q000172:deficiency*
D013739:Testosterone