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Abstract The present study is conducted to eva1~ ;e the functional state of thyroid gland, the frequer :y and the role of thyroid disorders in male sterility tc ;ether with aasessment of the value of thyroid hormone thJ ’pay in infertile males. Moreover, evaluation of relie lility at urinary 17~Oxosteroids (OS) and l7-OXogenic oc ~tloosteroids (17-0GS) eatimations in male intertilj ;y, and correlation between the urinary oortiooateroic I and the different types of semen pictures was tried, ~ Ie effeot of various types of andr-ogana therapy, was Btl:l1ed. A series of 106 infertile males and 25 r Irmal fertile healthyoontrols was investigated. Ninety oase I had idiopathic infertility and 16 cases had endoord.nop~thiQS which included J casea of hypothyroidism, one with t J,Yrotonoosis, two with Addison’s disease, ona with Cu Wing’s syndrome, one with the AGS, two with Klinefelt or1s syndrome and 6 oases with eunuohod.ddeci , Semen analysis was dona at least twice t ’r every case before being inoluded in this stUdy and u ,nthly thereafter until the end of the follow up peri ’d, using the oriteria of Eliasson (1973). Testicular biopsy was done in 25 cases ’f azoospermia and 4 cases of severe oligoasthenospermia. fo: lowing the method of Amelar (1966). The thyroid functional state was assess. i clinically, using the scoring systems of Crooks et a1. (1: 59) and Wayne (1960). and by determination of serum Pl [ in dupliate following the method of Foss et al. (1960). The suprarenal cortical function was stl lied by the determination of urinary 17-0xosteroids and Ij -Oxogenio steroids before and after therapy following tr , method of Norymberski, Stubbs & West (1953). Therapy was given to 63 patients. Lioth.\;-onf.ne was administered to 14 patient s with low PBI and a io rhez- 15 oases with normal PBI. Antithyroid therapy wae given to the oase of thyrotoxicosis and prednisone was ;iven to the patient having AGS. Androgen therapy was given to 32 cases. 12 patients reoeived small doses of testostero ~, another 12 received high doses of testosterone and 8 p tients received mesterolone therapy. The results of this study were analysed nd they showed the following: 1. Semen analysis revealed oligoasthenosperm a as the commonest picture (38.8%) in idiopathic s erility, followed by asthenospermia (25.5%), azoos ermia (20%), and oligospermia (15.5%). In patients wit endocrinopathies, the commonest pioture was azoosperm a followed by asthenospermia. 2. Testicular biopsy in azoospermic patients showed sloughing and disorganization as the oomm nest picture (28%), followed by maturation arrest (24%), Sertoli cell-only syndrome (20%)_ peritub ,lar fibrosis and tubular hyalinization (20%), an Klinefelter’s syndrome (4%). 3. Subnormal PBI values were observed in 14. % of the patients with idiopathic sterility while igher than normal values were seen in only 2.2%. Ast eno spezml.a was the most common picture and oligosper ia was the least in patients with low PBl. Sloughing and disorganization with variable degrees of mat ration arrest was the commonest histological pic ure observed in these patients. 4. A case report of thyrotoxicosis with azoo permia and spermatogenic maturation arrest was descr bed. It showed normalization of semen picture aft r medical control of hyperthyroidism. Explanations rere offered. 5. Liothyronine therapy (20 ug/day) showed a lequate results only in cases with low PBI especially the Ie having asthenospermia. Patients with normal PBI .nd received liothyronine showed either no change or 1 ,came worse. 6. The mean urinary 17-Oxosteroid excretion ras significantly lower in infertile men compared te the corresponding value of fertile subjects, demons ;rating the association between depressed spermatoger ’sis and lowered androgenicity. Diminution was moe; marked in the group of asthenospermia. 7. The urinary 17-Oxogenic steroids in infe:r :ile males showed no variation from the control eubj ,cts. 8. A case of the adult virilizing AGS that w .s diagnosed during the study by the presence of high :rinary 17-0S, is described. Semen showed improvement wi h prednisone therapy. 9. The small dose testosterone method and me rtez-o Lone therapy showed fairly good results mainly regarding improvement of sperm motility. Higher dos s of testosterone showed poor results. |