Evaluation of the relationship between semen parameters, pregnancy rate of wives of infertile men with varicocele, and gonadotropin-releasing hormone test before and after varicocelectomy.

Abstract

OBJECTIVES:

To determine whether the gonadotropin-releasing hormone (GnRH) test can serve as an indicator for the need and timing of surgery in infertile men with varicocele.

METHODS:

The GnRH test was performed in 121 infertile men with varicocele before surgical correction and 4 to 6, 9 to 12, and 16 to 18 months after. Levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were evaluated immediately before the test and 45 minutes after intravenous injection of 100 jig Relisorm L (a synthetic GnRH analogue). Eighteen fertile men with normal semen parameters served as control patients for defining the preoperative hormone levels. A more than twofold increase in FSH and a more than fivefold increase in LH was considered a positive result. Findings were correlated with semen parameters and rate of pregnancy in the patients' wives at 18 months postoperatively.

RESULTS:

Of the 121 patients, 89 (73.5%) had a positive GnRH test result, and 32 had a negative result. Semen parameters were improved postoperatively in 72 of the GnRH-positive patients (80.9%) and in only 6 of the GnRH-negative patients (1 8.7%). Corresponding pregnancy rates at 18 months in the two subgroups were 60 (67.4%) and 3 (9.3%), respectively.

CONCLUSIONS:

A positive preoperative GnRH test is a good predictor of improvement in semen parameters and pregnancy after varicocele surgery. We suggest that the GnRH test can serve as an additional indicator for varicocelectomy.

• Authors: E Segenreich, S Israilov, J Shmuele, E Niv, J Baniel, P Livne
• Journal: Urology (Urology) Vol. 52 Issue 5 Pg. 853-7 (Nov 1998) ISSN: 0090-4295 [Print] United States
• PMID: 9801113 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Gonadotropin-Releasing Hormone
• Luteinizing Hormone
• Follicle Stimulating Hormone

Topics

• Adult
• Female
• Follicle Stimulating Hormone (blood)
• Gonadotropin-Releasing Hormone (blood)
• Humans
• Infertility, Male (blood, etiology)
• Luteinizing Hormone (blood)
• Male
• Middle Aged
• Postoperative Care
• Pregnancy (statistics & numerical data)
• Preoperative Care
• Sperm Count
• Varicocele (blood, complications, surgery)