EFFECTS OF EXOGENOUS ANDROGEN AND GONADOTROPINS ON THE TESTES AND HYPOPHYSIAL FOLLICLE-STIMULATING HORMONE CONTENT OF THE IMMATURE MALE RAT

The influence of pharmaceutical compounds on male fertility

1. Steroid hormones can affect spermatogenesis and thereby fertility directly and/or indirectly. All antigonadotropically active steroids inhibit spermatogenesis via inhibition of gonadotropin secretion, mainly that of H. Androgens and steroids occurring in the biosynthetic chain of testosterone synthesis have a direct promoting effect on spermatogenesis if applied in high doses. It has not been possible as yet to make clinical use of this positive effect since it is obviously not possible to achieve the necessary intratesticular androgen concentrations. 2. As concerns the different androgens and the steroids in the androgen biosynthetic chain, and also all synthetic anabolics, there is no parallelism between the direct spermatogenic activity, the androgenic activity and the antigonadotropic activity. 3. Estrogens and synthetic gestagens do not inhibit spermatogenesis directly at the testicular level. All effects of estrogens can be abolished experimentally by adequate substitution with gonadotropins or androgens, or a combination of androgens and gonadotropins. 4. Only those antiandrogens inhibit spermatogenesis with additional antigonadotropic properties (e.g. cyproterone acetate). Pure antiandrogens, like flutamide or cyproterone, have a slight and transient influence on spermatogenesis at the most. If at all, they merely cause transient subfertility. 5. Beside steroids and several centrally active pharmaceutics (e.g. psychotropic drugs and several antihypertensive compounds), only siloxanes and methallibur seem to affect spermatogenesis via inhibition of gonadotropin secretion. Other antispermatogenic agents act by inhibition of mitosis (Colchicine, alkylating agents) or presumably via damage of the Sertoli cells. 6. Based on present knowledge, contraception in men could be principally managed by administration of a) androgens alone, b) gestagen/androgen combinations, c) estrogen/androgen combinations, d) certain antiandrogens. 7. The difficulties of contraception in men by steroid hormones or steroid hormone combinations have been pointed out. As regards the usefulness of antiandrogens for contraception, no definite conclusions can be drawn at the moment. All non-steroidal inhibitors of spermatogenesis which have been found up to the present are not suitable because of toxic effects.

The influence of testosterone in the brain of the male rat on levels of serotonin (5-HT) and hydroxyindole-acetic acid (5-HIAA)

There were two groups of rats: one was injected with testosterone propionate (10 mg/kg) every 7 days starting from weaning (23 days old); the other group had gonadectomy on the same day. The levels of 5-HT and 5-HIAA were measured by spectrofluorometry. The concentrations of 5-HT in the diencephalon of the testosterone propionate injected rats decreased significantly at 45 days, tending to become reestablished at 60 days; the rest of the brain followed the same pattern, but was less pronounced. The concentrations of 5-HIAA in the diencephalon and the rest of the brain decrease throughout postnatal development, although the differences are not significant. The castrated rats showed a marked increase at 45 days and later decreased at 60 days without recovering their initial values, in both brain areas. 5-HIAA concentrations were similar to those found in the injected animals. These facts can have various interpretations: early modifications in the brain, feed-back regulation mechanisms at the level of the hypothalamus, decrease in the release of the amine or reduction of its catabolism.

Effects of drugs and chemicals on spermatogenesis

Many drugs and chemicals have been found which interfere with the process of spermatogenesis. Among these substances are, for example, sex-hormones (androgens, antiandrogens, estrogens, progestogens, anabolics), chemotherapeutics, antibiotics, antifungal drugs, anticancer drugs, nonsteroidal antiinflammatory drugs, antihypertensives, neuroleptics, dopaminantagonists, indols, tranquilizers, tricyclic antidepressives, heavy metals (Co, Cd), MAO-inhibitors, antimetabolites, barbiturates, immunosuppressives (glucocorticoids), aldosteronantagonists, anticonvulsives, and perhaps alcohol and nicotine. Concerning the mechanism by which spermatogenesis is effected several points of interference have to be considered: inhibition of gonadotrophin secretion, inhibition of enzymes involved in androgen biosynthesis, direct effects on the germinal epithelium or on Sertoli cell function, competitive inhibition of hormone action, damage of the blood-testes barrier and other mechanisms. Some of these mechanisms will be discussed.

Reinitiation of sperm production in gonadotropin-suppressed normal men by administration of follicle-stimulating hormone

The specific roles of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in controlling human spermatogenesis are poorly understood. We studied the effect of an experimentally induced, selective LH deficiency on sperm production in normal men. After a 3-mo control period, five men received 200 mg testosterone enanthate (T) i.m./wk to suppress LH, FSH, and sperm counts. Then, while continuing T at the same dosage, human FSH (hFSH) was administered simultaneously to replace FSH activity, leaving LH activity suppressed. Four men received 100 IU hFSH s.c. daily plus T (high dosage hFSH) for 13-14 wk, while one man received 50 IU hFSH s.c. daily plus T (low dosage hFSH) for 5 mo. The effect on sperm production of the selective LH deficiency produced by hFSH plus T administration was assessed. In the four men who received the high dosage hFSH regimen, sperm counts were markedly suppressed during T administration alone (0.3+/-0.2 million/cm(3), mean+/-SE, compared with 94+/-12 million/cm(3) during the control period). Serum LH bioactivity (determined by in vitro mouse Leydig cell assay) was suppressd (140+/-7 ng/ml compared with 375+/-65 ng/ml during control period) and FSH levels (by radioimmunoassay) were reduced to undetectable levels (<25 ng/ml, compared with 98+/-21 ng/ml during control period) during T alone. With the addition of 100 IU hFSH s.c. daily to T, sperm counts increased significantly in all subjects (33+/-7 million/cm(3), P < 0.02 compared with T alone). However, no subject consistently achieved sperm counts within his control range. Sperm morphology and motility were normal in all four men and in vitro sperm penetration of hamster ova was normal in the two men tested during the hFSH-plus-T period. During high-dosage hFSH administration, serum FSH levels increased to 273+/-44 ng/ml (just above the normal range for FSH, 30-230 ng/ml). Serum LH bioactivity was not significantly changed compared with the T-alone period (147+/-9 ng/ml). After the hFSH-plus-T period, all four men continued to receive T alone after hFSH was stopped. Sperm counts were again severely suppressed (0.2+/-0.1 million/cm(3)), demonstrating the dependence of sperm production on hFSH administration. Serum T and estradiol (E(2)) levels increased two- to threefold during T administration alone compared with the control period. Both T and E(2) levels remained unchanged with the addition of hFSH to T, confirming the lack of significant LH activity in the hFSH preparation. In the one man who received low dosage hFSH treatment, sperm counts were reduced to severely oligospermic levels, serum FSH was suppressed to undetectable levels, and serum LH bioactivity was markedly lowered during the T-alone period. With the addition of 50 IU hFSH s.c. daily to T, sperm counts increased, to a mean of 11+/-3 million/cm(3). During this period, serum FSH levels increased to a mean of 105+/-11 ng/ml (slightly above this man's control range and within the normal adult range), while LH bioactivity remain suppressed. After hFSH was stopped and T alone was continued, sperm counts were again severely reduced to azoospermic levels. We conclude that FSH alone is sufficient to reinitiate sperm production in man during gonadotropin suppression induced by exogenous T administration. FSH may stimulate sperm production in this setting by increasing intratesticular T through androgenbinding protein production or by increasing the sensitivity of the spermatogenic response to the intratesticular T present during exogenous T administration.