Optimal Endocrine Evaluation and Treatment of Male Infertility
This article aims to define the optimal endocrine workup of male factor infertility, including evaluation and treatment of men who have previously been on exogenous testosterone or anabolic steroids. Future directions include the expansion of genetic testing for infertility to include endocrine gene products.
KEY POINTS
· Endocrinopathies that affect male fertility are rare, but important to consider as causes of male factor infertility and should be screened for in the initial history and physical examination.
· Classification of hormonal abnormalities by their effect on the hypothalamic-pituitary-testicular axis and the potential for reversibility guides evaluation and treatment.
· The endpoint for treatment is stimulation of spermatogenesis, usually through hormonal pharmacology to raise the intratesticular concentration of testosterone.
· Precision medicine and genetic testing will likely become standard for infertility evaluation in the future, as more candidate genes for infertility are identified.
McGriff SC, Lo EM, Hotaling JM, Pastuszak AW. Optimal Endocrine Evaluation and Treatment of Male Infertility. The Urologic clinics of North America 2020;47:139-46. https://www.urologic.theclinics.com/article/S0094-0143(19)30109-0/abstract
This article aims to define the optimal endocrine workup of male factor infertility, including evaluation and treatment of men who have previously been on exogenous testosterone or anabolic steroids. Future directions include the expansion of genetic testing for infertility to include endocrine gene products.
KEY POINTS
· Endocrinopathies that affect male fertility are rare, but important to consider as causes of male factor infertility and should be screened for in the initial history and physical examination.
· Classification of hormonal abnormalities by their effect on the hypothalamic-pituitary-testicular axis and the potential for reversibility guides evaluation and treatment.
· The endpoint for treatment is stimulation of spermatogenesis, usually through hormonal pharmacology to raise the intratesticular concentration of testosterone.
· Precision medicine and genetic testing will likely become standard for infertility evaluation in the future, as more candidate genes for infertility are identified.
McGriff SC, Lo EM, Hotaling JM, Pastuszak AW. Optimal Endocrine Evaluation and Treatment of Male Infertility. The Urologic clinics of North America 2020;47:139-46. https://www.urologic.theclinics.com/article/S0094-0143(19)30109-0/abstract
