HIGH-DOSE TESTOSTERONE THERAPY FOR REDUCTION OF FINAL HEIGHT IN CONSTITUTIONALLY TALL BOYS - DOES IT INFLUENCE TESTICULAR FUNCTION IN ADULTHOOD

OBJECTIVE We have studied the effect of treatment with high doses of a ndrogens during puberty on testicular function in adult men with const itutionally tall stature, taking into account confounding factors inte rfering with sperm quality, since existing published data do not inclu de whether testicular function is impaired by such treatment. DESIGN H istorical cohort study. PATIENTS Forty-three previously androgen treat ed tall men (cases) and 30 non-treated tall men (controls). MEASUREMEN TS Physical examination, semen analysis and plasma levels of LH, FSH, testosterone (T), sex hormone binding globulin (SHBG) and inhibin. RES ULTS Sperm quality and testis volume were comparable between cases and controls. Mean sperm concentration was 66.4 x 10(6)/ml in cases and 6 6.2 x 10(6)/ml in controls. A left-sided varicocele was found in 45% o f the cases and 37% of the controls. In cases we observed a significan t effect of the age at start of androgen therapy on sperm motility (re gr. coeff. (SE): 4.92 (2.41)%, P = 0.048). In addition, testicular siz e at start of therapy had a significant effect on sperm concentration (regr. coeff. (SE): 5 57 (1.54)x10(6)/ml, P=0.0012) and on total sperm count (regr. coeff. (SE): 43.1 (7.73)x10(6), P=0.0001). Plasma levels of T, SHBG and inhibin were not statistically different between the g roups. Cases had significantly higher FSH levels (mean (SD) 3.3 (2.2) vs 2.1 (0.8)IU/l, P = 0.004) and significantly lower LH levels (mean ( SD) 2.3 (0.9) vs 3.1 (1.4) lull, P = 0.019). We found a significant ef fect of age at start of therapy on plasma FSH level in the treated men (regr. coeff. (SE): -0.73 (0.18) IU/l, P = 0.0003). CONCLUSIONS Treat ment with high doses of androgens for reduction of final height in con stitutionally tall stature has no long-term side-effect on sperm quali ty, testicular volume or plasma testosterone levels. However, treated men had significantly higher plasma levels of FSH compared with contro ls. The meaning of this difference remains to be established. Varicoce le was present in 42% of the adult tall men.