Testosterone and male infertility

Abstract

Testosterone is one of the most important hormones of male fertility. Its production is a highly regulated process involving the hypothalamic-pituitarygonadal axis. Hypogonadism can lead to impaired spermatogenesis and is found in up to 30 % of male infertility patients. It can be due to de fi ciencies of gonadotropins and steroidogenic enzymes, congenital abnormalities, chronic illness, history of exogenous testosterone administration, insult, or neoplasm of the brain. Effective treatment of hypogonadism in male infertility involves accurate diagnosis and careful hormone replacement based on our understanding of the hypothalamic-pituitarygonadal physiology. Advancement in genetic research has identi fi ed multiple genetic defects resulting in hypogonadism. Greater understanding of the endocrinologic mechanism of spermatogenesis will further help infertile patients.