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Non-classical 21-hydroxylase deficiency: prevalence in males with unexplained abnormal sperm analysis.
- Source :
-
Fertility and sterility [Fertil Steril] 2010 Apr; Vol. 93 (6), pp. 1887-91. Date of Electronic Publication: 2009 Feb 06. - Publication Year :
- 2010
-
Abstract
- Objective: To evaluate the prevalence of nonclassical 21-hydroxylase deficiency (NC-21OHD) in men with abnormal sperm parameters of unexplained etiology compared with males with normal sperm analysis.<br />Design: Case control study.<br />Setting: Major tertiary medical center.<br />Patient(s): Of 484 healthy men being followed at a fertility clinic, 222 (mean age 33.8 +/- 6.1 [+/-SD] years) presented with abnormal findings on sperm analysis (1999 WHO criteria) of unknown cause and 262 (mean age 34.8 +/- 6.5 [+/-SD] years) with a normal sperm analysis.<br />Intervention(s): Random mid-morning blood sampling to test for 17-hydroxyprogesterone (17-OHP) levels. Subjects with levels of >or= 6 nmol/L underwent a standard adrenocorticotropic hormone (ACTH) stimulation test.<br />Main Outcome Measure(s): NC-21-OHD, defined as a stimulated ACTH level of >or=45 nmol/L.<br />Result(s): A serum 17-OHP level of >or=6 nmol/L was detected in 11 study patients (5.0%) and 14 control subjects (5.3%). Seven study patients and 8 controls subsequently underwent ACTH stimulation test, and none had levels compatible with a diagnosis of NC-21OHD. Mean 17-OHP levels were similar in the two groups (3.3 +/- 1.4 [+/-SD] nmol/L and 3.3 +/- 1.5 [+/-SD] nmol/L, respectively). There was no correlation between sperm parameters and serum 17-OHP levels.<br />Conclusion(s): Until larger studies are performed, the routine measurement of 17-OHP in the evaluation of male infertility is not recommended.<br /> (Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- 17-alpha-Hydroxyprogesterone blood
Adrenal Hyperplasia, Congenital blood
Adrenal Hyperplasia, Congenital complications
Adrenal Hyperplasia, Congenital ethnology
Adrenocorticotropic Hormone blood
Adrenocorticotropic Hormone metabolism
Adult
Case-Control Studies
Humans
Infertility, Male blood
Infertility, Male complications
Infertility, Male ethnology
Male
Prevalence
Semen Analysis
Steroid 21-Hydroxylase genetics
Adrenal Hyperplasia, Congenital epidemiology
Infertility, Male epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1556-5653
- Volume :
- 93
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Fertility and sterility
- Publication Type :
- Academic Journal
- Accession number :
- 19200987
- Full Text :
- https://doi.org/10.1016/j.fertnstert.2008.12.037