Testosterone, Hormone Imbalances, and Male Factor Infertility

Hormone Pathways

Hormone imbalances account for around 10% of all male factor infertility cases, and can manifest themselves in myriad ways, ranging from sexual dysfunction to low sperm concentration. Generally speaking, hormone imbalances are both detectable and correctable.

As we alluded to in the last lesson’s discussion of azoospermia, hormones are regulated in the brain. The hypothalamus detects hormone levels in the body, and messages to the pituitary gland (also in the brain), to begin producing hormones at the necessary levels. The pituitary produces Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH), amongst others.

LH impacts the testes' ability to produce testosterone, which dictates libido and erectile function, while FSH (along with testosterone) regulates sperm production. To complete the loop, the hypothalamus measures the body’s level of these hormones, and determines which signals to send to the pituitary to produce more, or less, of each.

Male Hormonal Pathways

Hormone Detection and Treatment

Typically, a blood draw (done in the morning as levels change during the day) accurately detects hormone levels and this is where the ranges typically fall:

If a hormone imbalance is detected, your urologist should be focused in determining the root cause. For instance, an elevated prolactin level can indicate risk of a pituitary tumor. When there is an FSH or LH deficit, it’s customary to prescribe hormones that mimic the function of naturally-made FSH and LH.

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