madman
Super Moderator
Abstract
INTRODUCTION AND OBJECTIVES:
Early studies evaluating the role of 17-hydroxyprogesterone (17-OHP) in male reproduction were primarily conducted in fertile men receiving exogenous testosterone with varying doses of human chorionic gonadotropin (hCG). However, few studies have investigated 17-OHP within the context of true male infertility. Although higher 17-OHP levels might intuitively be expected to reflect greater steroidogenic activity, the only prior study in infertile men paradoxically found that elevated 17-OHP was associated with more severe infertility. In this study, we obtained comprehensive steroidogenesis profiles in men presenting for infertility evaluation to assess the relationship between steroidogenesis component and infertility.METHODS:
Men presenting to an academic andrology clinic for infertility evaluation were retrospectively reviewed. Subjects were stratified by the ratio of 17-hydroxypregnenolone to 17-hydroxyprogesterone (17OHPreg:17OHP) and divided into tertiles. Comparisons were made between men in the lowest and highest tertiles. All laboratory samples were obtained before 1:00 PM to minimize diurnal variation. Laboratory parameters were compared using the Mann–Whitney U test.RESULTS:
Forty-nine men completed steroidogenesis evaluation. The median 17OHPreg:17OHP ratio for the cohort was 1.88 (1.04–2.55). Men in the highest tertile demonstrated a median ratio of 2.50 (1.99–2.58), compared to 1.02 (0.75–1.23) in the lowest tertile. While men in the lowest tertile exhibited higher absolute 17-OHP levels, no other hormonal parameters differed significantly between groups. Importantly, men with a lower 17OHPreg:17OHP ratio had significantly lower total motile sperm counts, suggesting a negative association between elevated 17-OHP and spermatogenic output.CONCLUSIONS:
Among men presenting with infertility, higher 17-OHP levels were inversely associated with total motile sperm count. These findings indicate that elevated 17-OHP may reflect impaired steroidogenic efficiency or dysregulation within the 17-hydroxylase pathway. Further investigation is warranted to clarify the mechanistic and diagnostic role of 17-OHP in the evaluation of male infertility.
