ENDOCRINE EVALUATION OF INFERTILE MEN

Objectives. To determine the incidence and type of endocrinologic abno rmalities in men undergoing infertility evaluations and the most appro priate testing to detect them. Methods. A retrospective review of cons ecutive patients attending two infertility centers was performed. Resu lts of endocrine testing were compared to medical history and physical and laboratory findings to determine whether endocrinologic screening could be limited to a specific subpopulation. Results. Only 99 of the 1035 patients (9.6%) had abnormal endocrine studies upon repetitive t esting. The majority of these patients had an isolated elevation of se rum follicle stimulating hormone (FSH) levels. Only 1.7% had a clinica lly significant endocrinopathy that would have had an effect upon dise ase management. Screening with serum testosterone and FSH levels alone was just as effective as a complete hormonal panel of testosterone, F SH, luteinizing hormone, and prolactin for the detection of clinically significant endocrinopathy. Only 1 patient with a clinically signific ant endocrinopathy would not have been identified if hormonal screenin g was limited to only those patients with a sperm density of less than 10 x 10(6)/mL. Conclusions. Endocrinopathies are a rare cause of male infertility. Endocrine screening of men with sperm counts of less tha n 10 million/mL with serum testosterone and FSH levels alone will dete ct the vast majority of clinically significant endocrinopathies. (C) 1 997, Elsevier Science Inc. All rights reserved.