Suppression of spermatogenesis in ipsilateral and contralateral testiculartissues in patients with seminoma by human chorionic gonadotropin beta subunit

Objectives. The pathologic complexity of the testicular tumor makes it diff icult to demonstrate exactly the relationship between the impaired spermato genesis in patients with a testicular tumor and the serum level of the huma n chorionic gonadotropin beta subunit (beta-hCG). Therefore, we performed q uantitative evaluation of spermatogenesis in ipsilateral and contralateral testicular tissues of seminoma to simplify the relation pathologically and endocrinological ly and to demonstrate the exact correlation between sperma togenesis and serum beta-hCG levels. Methods. Fifty-three biopsy specimens from ipsilateral and contralateral te sticular tissues of seminoma were analyzed histologically. The quantitative evaluation of spermatogenesis was performed by the mean Johnsen's score co unt (MJSC). Beta-hCG expression in seminoma was examined immunohistochemica lly. Serum beta-hCG, testosterone, estradiol, luteinizing hormone, and foll icle-stimulating hormone levels were analyzed before orchiectomy. Results. A significant linear relationship (r = -0.82; P <0.005) was found between the serum level of beta-hCG and the MJSC in contralateral testicula r tissues but not in ipsilateral ones, although the suppression of spermato genesis was observed in both sides without suppression of luteinizing hormo ne and/or follicle-stimulating hormone production. Conclusions. A clearcut fall in the MJSC with an associated rise in the ser um level of beta-hCG was demonstrated in the contralateral testicular tissu es but not in the ipsilateral ones of seminoma. It seems most likely that s erum beta-hCG suppresses spermatogenesis in both ipsilateral and contralate ral testicular tissues without the suppression occurring through the hypoth alamus-pituitary-gonadal system, and also that some less well recognized fa ctors affect spermatogenesis, making the relation between serum beta-hCG an d MJSC obscure in ipsilateral testicular tissues. UROLOGY 58: 251-257, 2001 . (C) 2001, Elsevier Science Inc.