Effects of thyroid hormones and sex hormones on male fertility

doi:10.11958/20221648

Abstract

Abstract:

Objective To explore effects of thyroxine and sex hormone on male fertility. Methods A total of 481 male infertile patients were included in this study. Semen routine analysis and fertility index calculation were performed in each group. Sperm DNA fragmentation rate was detected. Chemiluminescence method was used to detect hyroid hormones [free triiodothy ronine (FT3), free tetraiodothyronine (FT4), thyrotropin (TSH)] and sex hormones [luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (T), prolactin (PRL) andestradiol (E2)]. According to thyroxine levels,patients were divided into the low hormone level group (61 cases), the normal hormone level group (376 cases) and the high hormone level group (44 cases). The correlation between thyroid hormone and sex hormone and the correlation between T/E2, T/FSH, T/LH, T/PRL, semen parameters and fertility index were analyzed. Results Compared with the normal hormone group, the forward motion rate was decreased in the low hormone group, the forward motion rate and fertility index were decreased in the high hormone group, and the malformation rate was increased (P<0.05). FT3 was negatively correlated with PRL level, FT4 was negatively correlated with FSH and E2 level, and TSH was positively correlated with PRL level (P<0.05). T/E2 was negatively correlated with the malformation rate, T/FSH was positively correlated with total sperm count, sperm concentration, forward motility rate and fertility index, but negatively correlated with the malformation rate (P<0.05). T/LH was positively correlated with total sperm count and sperm concentration (P<0.01). T/PRL was negatively correlated with the deformity rate. Conclusion Abnormal thyroid hormone levels can affect male fertility, and the effect is more pronounced at higher levels.

Key words: thyroid hormones, semen analysis, DNA fragmentation, sex hormones, fertility

CLC Number:

R691.5

Figures/Tables 3

References 24

[1]	CÉSAIRE MOMO TETSATSI A, ALUMETI MUNYALI D, ROMEO BONSOU FOZIN G, et al. Semen quality among men attending urology services in the Dschang Health District,west Cameroon:A retrospective study on 379 cases[J]. Int J Reprod Biomed, 2020, 18(2):121-128. doi:10.18502/ijrm.v18i2.6419.
[2]	欧阳斌, 赵玉, 耿强. 《欧洲泌尿外科学会男性不育症诊疗指南(2013年版)》解读[J]. 生殖与避孕, 2015, 35(1):9-14.
	OUYANG B, ZHAO Y, GEN Q. Introduction to European Association of Urology (EAU) Male Infertility Guidelines(2013)[J]. Reproduction and Contraception, 2015, 35(1):9-14. doi:10.7669/j.issn.0253-357X.2015.01.0009.
[3]	HERNANDEZ A. Thyroid hormone deiodination and action in the gonads[J]. Curr Opin Endocr Metab Res, 2018, 2:18-23. doi:10.1016/j.coemr.2018.01.010.
[4]	NELSON ER, ALLAN ER, PANG FY, et al. Auto-regulation of thyroid hormone receptors in the goldfish ovary and testis[J]. Gen Comp Endocrinol, 2011, 172(1):50-55. doi:10.1016/j.ygcen.2010.12.017.
[5]	KRASSAS G E, MARKOU K B. The impact of thyroid diseases starting from birth on reproductive function[J]. Hormones(Athens), 2019, 18(4):365-381. doi:10.1007/s42000-019-00156-y.
[6]	NOLI L, KHORSANDI S E, PYLE A, et al. Effects of thyroid hormone on mitochondria and metabolism of human preimplantation embryos[J]. Stem Cells, 2020, 38(3):369-381. doi:10.1002/stem.3129.
[7]	马婉璐, 王曦, 茅江峰, 等. 青中年男性甲状腺功能亢进症患者治疗前后性激素和性激素结合球蛋白的变化[J]. 中华医学杂志, 2019, 99(24):1875-1880.
	MA W L, WANG X, MAO J F, et al. Changes of sex hormones and sex hormone-binding globulin levels in male adults with hyperthyroidism before and after antithyroid drug treatment[J]. Natl Med J China, 2019, 99(24):1875-1880. doi:10.3760/cma.j.issn.0376-2491.2019.24.008.
[8]	世界卫生组织. 世界卫生组织人类精液检查与处理实验室手册[M]. 谷翊群,陈振文,卢文红,等译. 5版. 北京: 人民卫生出版社, 2011:11-86.
	World Health Organization. WHO laboratory manual for the examination and processing of human semen[M. Translated by GU Y Q,CHEN Z W,LU W H,et al. 5th ed. Beijing: People's Medical Publishing House, 2011:11-86.
[9]	HERNANDEZ A. Thyroid hormone role and economy in the developing testis[J]. Vitam Horm, 2018, 106:473-500. doi:10.1016/bs.vh.2017.06.005.
[10]	张以林. 男性甲亢患者12例的精液参数改变的临床分析及文献复习[D]. 南宁: 广西医科大学, 2020.
	ZHANG Y L. Clinical analysis and literature review of the semen parameters changes in 12 male hyperthyroidism patients[D]. Nanning: Guangxi Medical University, 2020.
[11]	刘翠明, 马学芹, 唐正和. 男性亚临床甲状腺功能减退症患者治疗前后性激素水平及性功能的变化[J]. 临床内科杂志, 2018, 35(7):455-456.
	LIU C M, MA X Q, TANG Z H. Changes in sex hormone levels and sexual function before and after treatment in male patients with subclinical hypothyroidism[J]. Journal of Clinical Internal Medicine, 2018, 35(7):455-456. doi:10.3969/j.issn.1001-9057.2018.07.007.
[12]	LA VIGNERA S, VITA R. Thyroid dysfunction and semen quality[J]. Int J Immunopathol Pharmacol, 2018, 32:2058738418775241. doi:10.1177/2058738418775241.
[13]	ROMANO R M, GOMES S N, CARDOSO N C, et al. New insights for male infertility revealed by alterations in spermatic function and differential testicular expression of thyroid-related genes[J]. Endocrine, 2017, 55(2):607-617. doi:10.1007/s12020-016-0952-3.
[14]	吴朝霞, 方寅飞, 邵丽佳. 甲状腺激素影响精子线粒体功能和精子DNA完整性分析[J]. 中国卫生检验杂志, 2020, 30(18):2204-2207.
	WU C X, FANG Y F, SHAO L J. Analysis of thyroid hormones affecting sperm mitochondrial function and sperm DNAintegrity[J]. Chin J Health Lab Tec, 2020, 30(18):2204-2207.
[15]	ROTGERS E, JØRGENSEN A, YAO H H. At the Crossroads of fate-somatic cell lineage specification in the fetal gonad[J]. Endocr Rev, 2018, 39(5):739-759. doi:10.1210/er.2018-00010.
[16]	FRANÇA L R, HESS R A, DUFOUR J M, et al. The Sertoli cell:one hundred fifty years of beauty and plasticity[J]. Andrology, 2016, 4(2):189-212. doi:10.1111/andr.12165.
[17]	MALOLINA E A, KULIBIN AY. Rete testis and the adjacent seminiferous tubules during postembryonic development in mice[J]. Russian Journal of Developmental Biology, 2017, 48(6):385-392. doi:10.1134/S1062360417060029.
[18]	FIGUEIREDO A, WNUK N T, TAVARES A O, et al. Prepubertal PTU treatment in rat increases Sertoli cell number and sperm production[J]. Reproduction, 2019, 158(2):199-209. doi:10.1530/REP-19-0127.
[19]	王淑婵, 冯书锐. 男性甲状腺功能亢进及低下患者血清性激素测定分析[J]. 国际检验医学杂志, 2014, 35(5):547-548,551.
	WANG S C, FENG S R. Analysis of hormone serum level in male patients with hyperthyroidism and hypothyroidism[J]. Int J Lab Med, 2014, 35(5):547-548,551. doi:10.3969/j.issn.1673-4130.2014.05.017.
[20]	王金波, 李海英, 白咪红, 等. 男性甲功异常者甲状腺激素与血清性激素相关性分析及临床意义[J]. 标记免疫分析与临床, 2016, 23(5):529-532.
	WANG J B, LI H Y, BAI M H, et al. Correlation analysis and clinical significance of thyroid hormone and serum sex hormone levels in male patients with thyroid dysfunction[J]. Labeled Immunoassays＆Clin Med, 2016, 23(5):529-532. doi:10.11748/bjmy.issn.1006-1703.2016.05.016.
[21]	江立玉. 性激素、促性腺激素及其比值对精液质量、受精能力及生育力的影响研究[D]. 杭州: 杭州师范大学, 2020.
	JANG L Y. Effect of sex hormones,gonadotropin and their ratio on semen quality,fertilization ability and fertility[D]. Hangzhou: Hangzhou Normal University, 2020.
[22]	WEI T C, HUANG W J, LIN A T, et al. The role of hormones on semen parameters in patients with idiopathic or varicocele-related oligoasthenoteratozoospermia(OAT)syndrome[J]. J Chin Med Assoc, 2013, 76(11):624-628. doi:10.1016/j.jcma.2013.07.005.
[23]	徐惠明, 丁悦虹, 张军荣, 等. 血清睾酮雌二醇比值变化对精子缺陷及生育的影响[J]. 中华泌尿外科杂志, 2011, 32(3):164-168.
	XU H M, DING Y H, ZHANG J R, et al. Effect of the serum testosterone/estradiol ratio alteration on sperm defect and fertility[J]. Chin J Urol, 2011, 32(3):164-168. doi:10.3760/cma.j.issn.1000-6702.2011.03.006.
[24]	GREGORIOU O, BAKAS P, GRIGORIADIS C, et al. Changes in hormonal profile and seminal parameters with use of aromatase inhibitors in management of infertile men with low testosterone to estradiol ratios[J]. Fertil Steril, 2012, 98(1):48-51. doi:10.1016/j.fertnstert.2012.04.005.

组别	n	年龄（岁）	精子总数（×10⁶/一次射精）	精子浓度（×10⁶/mL）	前向运动率（%）	畸形率（%）	DNA碎片率（%）	生育力指数
正常水平激素组	376	34.24±5.66	129.50（72.25，225.75）	62.00（33.85，101.70）	43.54±19.52	92.12±2.96	14.02±7.93	1.780（0.795，4.757）
低水平激素组	61	34.36±4.90	142.00（65.50，289.00）	62.60（22.50，108.00）	35.15±19.93^a	92.75±2.20	14.62±8.28	1.350（0.220，4.585）
高水平激素组	44	34.91±5.61	109.00（42.75，217.75）	44.20（18.57，79.35）	30.38±19.31^a	93.34±3.39^a	15.52±9.48	0.660（0.167，2.355）^a
F或χ²		0.282	2.880	1.554	12.357^＊＊	4.247^＊	0.753	12.631^＊＊

组别	n	年龄（岁）	精子总数（×10⁶/一次射精）	精子浓度（×10⁶/mL）	前向运动率（%）	畸形率（%）	DNA碎片率（%）	生育力指数
正常水平激素组	376	34.24±5.66	129.50（72.25，225.75）	62.00（33.85，101.70）	43.54±19.52	92.12±2.96	14.02±7.93	1.780（0.795，4.757）
低水平激素组	61	34.36±4.90	142.00（65.50，289.00）	62.60（22.50，108.00）	35.15±19.93^a	92.75±2.20	14.62±8.28	1.350（0.220，4.585）
高水平激素组	44	34.91±5.61	109.00（42.75，217.75）	44.20（18.57，79.35）	30.38±19.31^a	93.34±3.39^a	15.52±9.48	0.660（0.167，2.355）^a
F或χ²		0.282	2.880	1.554	12.357^＊＊	4.247^＊	0.753	12.631^＊＊

性激素	FT3		FT4		TSH
性激素	r_s	P	r_s	P	r_s	P
T	-0.014	0.753	0.029	0.529	-0.037	0.108
LH	-0.007	0.886	-0.026	0.564	0.004	0.931
FSH	-0.032	0.488	-0.093	0.042	-0.039	0.393
PRL	-0.091	0.046	-0.005	0.917	0.128	0.005
E2	-0.068	0.134	-0.114	0.012	0.035	0.446

性激素	FT3		FT4		TSH
性激素	r_s	P	r_s	P	r_s	P
T	-0.014	0.753	0.029	0.529	-0.037	0.108
LH	-0.007	0.886	-0.026	0.564	0.004	0.931
FSH	-0.032	0.488	-0.093	0.042	-0.039	0.393
PRL	-0.091	0.046	-0.005	0.917	0.128	0.005
E2	-0.068	0.134	-0.114	0.012	0.035	0.446

指标	精子总数	精子浓度	前向运动率	畸形率	DNA 碎片率	生育力指数
T/E2	-0.017	-0.018	-0.007	-0.119^＊＊	0.022	0.013
T/FSH	0.180^＊＊	0.181^＊＊	0.148^＊＊	-0.159^＊＊	0.032	0.142^＊＊
T/LH	0.194^＊＊	0.196^＊＊	0.056	-0.065	-0.025	0.053
T/PRL	0.067	-0.028	-0.020	-0.092^＊	-0.011	-0.048