Dynamic Alteration Of Sex Hormones In Adult Males And Effects On Reproductive Function

Object: The aim of this study was to investigate dynamic changes of serum reproductive hormones with aging in healthy Chinese male and to explore its influencing factors and effects on late-onset hypogonadism and male fertility.Methods: 1093 adult men were selected to detect the serum testosterone,luteinizing hormone,sex hormone binding globulin,free testosterone index and testosterone secreting index.We analyzed the trends with age and influencing factors.608 men over 45 years old were enrolled in the AMS and ADAM questionnaire survey and sex hormones measurement to explore the prevalence and diagnostic criteria of LOH.636 couples with infertility who received assisted reproductive technology were selected to analyze the relationship between age,sex hormones,semen quality and outcome of assisted reproductive technology(ART).Data were analyzed by SPSS21.0 program.Results: 1093 adult men ranged in age from 20 to 87,with an average serum testosterone of 15.36±4.86 nmol/L,LH of 4.76±2.76 IU/L,SHBG of 32.61±17.24nmol/L.The level of T decreased from 20 to 34 years old,kept steady in 35-50 years old and rose after the age of 50.Serum LH and SHBG increased gradually with age and were positively correlated with age.Testosterone was negatively correlated with BMI(r =-0.585,p < 0.001).The positive rate was 87% in the ADAM questionnaire and 69.9% in the AMS questionnaire according to the survey of middle-aged and elderly men.Total testosterone was not associated with age,but calculated free testosterone(cFT)was negatively correlated with age.There was significant difference in cFT between the AMS positive group and the negative group.The average age of the 636 men who received ART treatment was 33.56 ± 5.72 years old.After statistical analysis,it was found that FSH was negatively correlated with total sperm count and sperm motility,LH was negatively correlated with sperm count,andT was not correlated with sperm count and motility.We found that only sperm concentration and female age had an effect on clinical pregnancy after Logistic regression analysis and multiple factor correction.Conclusion: Serum total testosterone fluctuated with aging in adult men,and cFT decreased gradually with aging.While age was not significantly correlated with T level,BMI was significantly and negatively correlated with T level.The calculated free testosterone was more suitable for the diagnosis of LOH than the total testosterone.With the increase of age,the number of sperm did not change significantly,but sperm motility decreased.FSH was negatively correlated with sperm count and motility.The most important factors affecting the clinical pregnancy of ART were sperm concentration and female age.