Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Andrology, Sexology

Aim of work: Growth hormone has an important role in the function of the male reproductive system. We investigated GH status in infertile men and compared them with normal fertile men. Materials and Methods: Growth hormone status was studied in 50 fertile men, 62 infertile men with azoospermia due to spermatogenetic maturation arrest and 50 men with oligozoospermia in whom sperm count was less than 5 million/ml. Following basal assessment of GH level, clonidine and insulin stimulation tests were used as provocative factors. Serum growth hormone concentrations were measured at 0, 30, 60, 90 and 120 minutes. Serum follicle-stimulating hormone, luteinizing hormone, prolactin, and testosterone were also measured before the test. Results: Serum follicle-stimulating hormone concentrations were significantly increased in the azoospermic group and basal levels of growth hormone were similar to those in the control group. Serum growth hormone concentrations measured after stimulation and the levels of growth hormone peaked after 60 minutes in both groups.. Men with azoospermia due to spermatogenetic maturation arrest and oligozoospermic men had lower response to the growth hormone stimulation than fertile group. We found that, the basal GH at a cut off level (1.4 ng/ml) could truly predict successful sperm extraction in 75.0% of men with positive TESE and truly predicts no sperm retrieval in 60% of TESE negative cases. The cut off level provided overall true prediction in 38 out of 62 cases (61.3%). Conclusions: Relative growth hormone insufficiency is strongly related to decreased fertility potential and spermatogenic dysfunction

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