Enzyme and hormonal markers in the differential diagnosis of human azoospermia

The serum concentrations of FSH, LH, prolactin, testosterone, and estradiol and the enzymatic activities of hyaluronidase, glucosidases (alpha-glucosidase, beta-glucosidase, alpha-mannosidase, N-acetyl-beta-D-glucosaminidase, beta-glucuronidase, and beta-galactosidase), lactate dehydrogenase and its isoenzymes (LDH1, LDH2, LDH3, LDH-X, LDH4), and total proteins were measured in the semen of 69 subjects (8 normozoospermic controls, 7 secretory, and 54 excretory azoospermic subjects). FSH levels rose with the deterioration in spermatogenesis and served to differentiate the secretory from the excretory azoospermias. The only source of hyaluronidase and LDH-X in the ejaculate is the spermatozoa. alpha-Glucosidase activity essentially originates in the epididymis. The seminal determination of alpha-glucosidase and, to a lesser extent, alpha-mannosidase and N-acetyl-beta-D-glucosaminidase helps rapidly, sensitivity, reliably, and noninvasively to differentiate secretory azoospermias (with higher enzymatic activity) from the excretory type (less enzymatic activity) and may be of use in identifying with a certain degree of reliability the site of obstruction in the male genital tract.

[Sertoli-Leydig-cell ovarian tumor with a retiform pattern and heterologous elements: a rare cause of virilization]

The case is presented of a young female with virilization signs and total circulating testosterone levels above 4 ng/ml, without a concomitant increase in cortisol, 17 OH-progesterone, DHEA-S, or androstenedion levels. On CT scan exam a tumoral mass in the left ovary was observed with polycystic characteristics similar to those observed in ovarian cystadenoma, inspite of the fact that most androgenic ovarian tumors are solid. The pathological study revealed an ovarian Sertoli-Leydig tumor associated to a reticular pattern with heterologous chondroid and mucinoid elements of cystadenoma.

Serum glycosidases in diabetes mellitus in relation to the retinopathy and to the length of the disease

The following glycosidase activities in sera have been studied: alpha-D-mannosidase, beta-D-glucuronidase, N-acetyl-beta-D-galactosaminidase, alpha-D-galactosidase, beta-D-galactosidase, alpha-D-glucosidase, beta-D-glucosidase and beta-D-fucosidase, in diabetic patients in relation to the presence of microangiopathy, evident by retinopathy, and to the length of the disease. A significant increase of all the enzyme activities, except for alpha-D-galactosidase was found. These elevations were independent of the development of retinopathy and the duration of the diabetic process.

Hormone levels in serum and seminal plasma of men with different types of azoospermia

Hormone concentrations in the serum and seminal plasma of 15 normozoospermic, 17 excretory azoospermic and 14 secretory azoospermic men were measured. The results indicate that: (a) serum FSH and LH levels are markedly elevated in secretory azoospermia, as compared with excretory azoospermia and normozoospermia; (b) serum 17 alpha-hydroxyprogesterone levels are somewhat raised in secretory azoospermia as compared with excretory azoospermia and normozoospermia; (c) serum testosterone levels are lower in both types of azoospermia with respect to normozoospermia; (d) in secretory azoospermia the oestradiol serum levels are relatively high and dihydrotestosterone serum levels relatively low, whereas the serum levels of these hormones in excretory azoospermia are similar to those in normozoospermic men; (e) in the seminal plasma of azoospermic patients the levels of prolactin, progesterone, testosterone, dihydrotestosterone and oestradiol were depressed, but only dihydrotestosterone levels could be of value in differentiating types of azoospermia because they are lower in secretory azoospermia. We suggest that the measurement of FSH, LH, 17 alpha-hydroxyprogesterone, dihydrotestosterone and oestradiol in serum and dihydrotestosterone in seminal plasma may be used in the differential diagnosis between secretory and excretory azoospermia when invasive tests are unavailable.

Semen characteristics and serum and seminal plasma hormones in drug-induced hyperprolactinaemia

Semen volume, density, motility, viability, and morphology of spermatozoa, and serum and seminal plasma levels of the hormones FSH, LH, prolactin, progesterone, 17-alpha-hydroxyprogesterone, androstenedione, testosterone, dihidrotestosterone, and estradiol 17-beta have been measured in 22 men subjected to experimental hyperprolactinaemia by the simultaneous administration of the antidopaminergic drugs metoclopramide and sulpiride. Hyperprolactinaemia produces a decrease of semen volume and seminal quality. In hyperprolactinaemia, normozoospermic patients had an increase of serum androstenedione. In both normo- and oligozoospermic groups, a decrease of serum testosterone was observed. Hyperprolactinaemia also causes an inhibition of the secretory activity of the accessory sexual glands of the reproductive tract, as well as either a decrease of 17-ketosteroid reductase or an increase of 17-alpha-hydroxysteroid dehydrogenase (enzymes that participate in the androstenedione-testosterone interconversions). This change appears to be more pronounced in individuals with good seminal quality.

[Idiopathic hemochromatosis: a study of pituitary function in patients and potentially affected relatives (author's transl)]

Anterior pituitary function, particularly the hypothalamus-pituitary gonadal axis, has been investigated in four patients with idiopathic hemochromatosis and in two potentially affected family members (sons) of one patient. All the patients presented a hypogonadotrophic hypogonadism. In one patient there was an associated primary testicular failure. Gonadotropin secretion was intact in the family members. The remaining pituitary functions were usually preserved, except a probable decrease of the glandular reserve of TSH in two patients, and of prolactin in one of them.

[Human semen lactate dehydrogenase isoenzymes in fertility studies (author's transl)]

The lactate dehydrogenase isoenzyme pattern has been obtained in the semen of 87 males undergoing fertility studies. The proportion of LDH-X, the isoenzyme specific to the spermatozoa, is reduced in proportion to the reduction of the sperm density and motility. LDH-X is the most abundant isoenzyme in the semen of normospermic subjects. As to the other isoenzymes, the most abundant ones are the LDH-2 and the LDH-3. The results obtained lead us to conclude that the measurement of the lactate dehydrogenase isoenzymes may be useful in studies of fertility as an indicative parameter of the quality of the semen.