Testicular function in postpubertal patients with growth hormone deficiency: A prospective controlled study.

BACKGROUND

We have previously shown that treatment with recombinant human growth hormone (GH) influences testicular growth in children with GH deficiency (GHD) and have suggested that GH plays a role in testicular growth in childhood. Little evidence is available on testicular function in post-pubertal GHD patients.

OBJECTIVE

This prospective controlled study was undertaken to evaluate testicular function in patients with GHD.

PATIENTS AND METHODS

Post-pubertal patients with non-syndromic GHD over the age of 16 years were enrolled. Each patient underwent to the assessment of serum levels of gonadotropins and total testosterone (TT), conventional sperm parameters, and testicular volume (TV) measured by ultrasound examination. Age-matched healthy subjects served as controls. Patients with disorders capable of interfering with testicular function were excluded.

RESULTS

26 patients with GHD and 25 age-matched post-pubertal controls were enrolled. They did not differ in serum luteinizing hormone, follicle-stimulating hormone, and TT levels. However, GHD patients had lower semen volume, total sperm count, progressive motility, and total motility values, and a higher prevalence of oligozoospermia compared to controls. No difference was found in sperm concentration and normal morphology. Importantly, GHD patients had lower TV, and a higher prevalence of testicular hypotrophy.

CONCLUSION

This is the first evidence of mildly impaired sperm parameters and TV in GHD patients compared to healthy controls. The integrity of the GH-IGF1 axis in prepuberty is important for achieving normal testicular function in adulthood. Evaluating testicular growth over time in GHD children and measuring TV and sperm parameters in postpubertal GHD boys is advisable.