Evaluation of Reproductive Parameters in Men with Solitary Testis
Purpose: To evaluate reproductive parameters of men with solitary testis compared to men with bilateral testes.
Materials and methods: We conducted a cross-sectional case control study comparing infertility evaluation parameters in men with solitary testis to men with two testes. Men presenting for fertility consultation with semen analysis data collected within 90 days of clinical and hormonal assessment were included. Differences in semen and hormonal levels were characterized using descriptive statistics, multivariate analysis on matched semen parameters and evaluation of hypogonadism subtypes.
Results: A total of 837 men were identified. After applying exclusion criteria, we analyzed 29/39 (74%) men with solitary testis and compared them to 656/798 (82%) men with two testes.
A 1:1 match on sperm concentration and motility showed FSH in men with solitary testis (13.9 [5.8-24.2] mIU/ml) was more elevated than FSH in men with bilateral testes (5.0 [3.4-9.8] mIU/ml), p=0.009.
Men with bilateral testes were uniformly azoospermic after an FSH of 25.0 mIU/ml, whereas men with solitary testis had some sperm in the ejaculate at FSH levels as high as 54.6 mIU/ml.
Testosterone levels were similar between men with solitary (381 [248-500] ng/dL) and two testes (387 [296-507] ng/dL). The prevalence of compensated hypogonadism (high LH and normal testosterone) was higher in men with solitary testis than in men with bilateral testes, 8/29 (28%) and 54/656 (8.2%) respectively, p=0.002.
Conclusions: Men with solitary testis have compensated pituitary strain as indicated by higher serum FSH and LH levels for the same testosterone and semen parameters as compared to men with bilateral testes. Follow up is needed to evaluate any detrimental consequences of this compensated state that may lead to pituitary burnout and decreased testicular function.
Tradewell MB, Ory J, Nassau DE, Rezk AH, Ibrahim E, Ramasamy R. Evaluation of Reproductive Parameters in Men with Solitary Testis. J Urol. 2020 Nov 18:101097JU0000000000001477. doi: 10.1097/JU.0000000000001477. Epub ahead of print. PMID: 33207135. American Urological Association
Purpose: To evaluate reproductive parameters of men with solitary testis compared to men with bilateral testes.
Materials and methods: We conducted a cross-sectional case control study comparing infertility evaluation parameters in men with solitary testis to men with two testes. Men presenting for fertility consultation with semen analysis data collected within 90 days of clinical and hormonal assessment were included. Differences in semen and hormonal levels were characterized using descriptive statistics, multivariate analysis on matched semen parameters and evaluation of hypogonadism subtypes.
Results: A total of 837 men were identified. After applying exclusion criteria, we analyzed 29/39 (74%) men with solitary testis and compared them to 656/798 (82%) men with two testes.
A 1:1 match on sperm concentration and motility showed FSH in men with solitary testis (13.9 [5.8-24.2] mIU/ml) was more elevated than FSH in men with bilateral testes (5.0 [3.4-9.8] mIU/ml), p=0.009.
Men with bilateral testes were uniformly azoospermic after an FSH of 25.0 mIU/ml, whereas men with solitary testis had some sperm in the ejaculate at FSH levels as high as 54.6 mIU/ml.
Testosterone levels were similar between men with solitary (381 [248-500] ng/dL) and two testes (387 [296-507] ng/dL). The prevalence of compensated hypogonadism (high LH and normal testosterone) was higher in men with solitary testis than in men with bilateral testes, 8/29 (28%) and 54/656 (8.2%) respectively, p=0.002.
Conclusions: Men with solitary testis have compensated pituitary strain as indicated by higher serum FSH and LH levels for the same testosterone and semen parameters as compared to men with bilateral testes. Follow up is needed to evaluate any detrimental consequences of this compensated state that may lead to pituitary burnout and decreased testicular function.
Tradewell MB, Ory J, Nassau DE, Rezk AH, Ibrahim E, Ramasamy R. Evaluation of Reproductive Parameters in Men with Solitary Testis. J Urol. 2020 Nov 18:101097JU0000000000001477. doi: 10.1097/JU.0000000000001477. Epub ahead of print. PMID: 33207135. American Urological Association
