Adrenal Androgens and their Effect on Human Semen Quality

The purpose of this study was to elucidate the relationship between the sperm quality (concentration, motility, vitality and morphology) and elevated 17‐ketosteroids (17KS) and their metabolites; Androsterone (A). Etiocholanolone (E), Dehydroepiandrosterone (D) and Pregnanediol (P₂). 162 men with normally fractionated urinary 17KS but with different degrees of sperm quality were evaluated. Statistical analysis did not reveal any correlation between sperm quality and levels of the metabolites. The same evaluation was performed on 36 men with elevated abnormal fractionated urinary 17KS metabolites. Here too, no correlation could be indicated. Eight men with pathological fractionated metabolites underwent adrenal gland stimulation by the ACTH test and suppression by dexamethasone concomitant with stimulation by hCG. All the 8 men responded normally. 4 men with abnormal urinary metabolites were treated with dexamethasone (0.5 mg/day) for 3 months. Sperm quality and urinary metabolites were checked during every month of treatment. No improvement in sperm quality was observed, although adrenal function was suppressed. However, 2 wives of the treated men conceived during treatment. No correlation could be established between the metabolites of androgens in the urine, sperm quality and male fertility.