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     Testicular function is affected in men confronted with all sort of chronic or acute systemic disease, and in the following article we shall speak about some of the most common diseases which can trigger infertility.
     Chronic hepatic diseases are frequently associated with infertility, sexual dysfunctions, and reduced androgyny. Hepatic damages caused by chronic alcoholism leads to testicular damages, to the alteration of the hypothalamus-hypophysis unity, and to increased hepatic globulin sex hormone-binding and adrenal steroid secretions. These effects seem to be triggered by cirrhosis and alcohol toxic effect upon human organism. In hepatic patients, seric FSH and LH levels are usually increased but there can also be exceptions. The opposite affection is haemochromatosis or hemochromatosis, which produces hypogonadotrophic hypogonadism due to the hypothalamic and hypophysis iron deposits, and can also cause cirrhosis, diabetes mellitus and IHD.
     Gonadal dysfunction, frequent in men who suffer from chronic renal insufficiency, decreases libido, causes sexual dysfunctions, muscular mass reduction and also affects androgyny and, all in all contributes to patient’s life quality downfall. Testosterone level is usually low and FSH and LH levels are normal or also decreased, but prolactin level can rise. During dialysis, oligoasthenospermia is very frequent but this is a reversible condition especially after a renal transplant.
     Human immunodeficiency virusHIV, affects male’s reproductive tract. The virus HIV is present in man’s semen, even if the infection is asymptomatic, or if AIDS (acquired immune deficiency syndrome) has already installed; HIV patients have a normal number of sperm in their semen, with normal motility and morphology. Patients with advanced AIDS, however, present pronounced pyospermia, low sperm motility, and an increased number of abnormal sperm.
     AZT- Zidovudine, treatment reduces semen leucocytes concentration and improves their spermatogram. Scientific tests on deceased men, who suffered from AIDS, have shown severe hypo-spermatogenesis, and limfocitar infiltrations.
     Stress and brusque weight loss can trigger testicular dysfunctions. It is well known that female reproductive function can be affected by physical stress, also in men the seric testosterone level decreases after extended physical exercises, and stress, because stress lowers the gonadotropine secretion and decreases libido. Nervous anorexia leads to hypogonadotrophic hypogonadism both in male and female patients.
     Hypogonadotrophic hypogonadism is also suspected in obese male/female patients because it is associated with muscular mass reduction and fat tissue growth. The seric testosterone level in overweight men is usually below the average. The main determinant of testosterone reduced level is the reduced level of sex hormone binding globulin –SHBG.      Estrone seric level can rise due to fat tissue Aromatase increased level, also circulatory estrogen can lead to testosterone lowered secretions due to gonadotropine suppressed secretions. When an obese man loses weight, his Estrone seric level downfalls and testosterone level rises. Moreover there aren’t many scientific data about overweight men’s semen density and motility, but apparently it is not severely affected.
     Thyrotoxicosis patients can have gynecomastia, oligoasthenospermia and suppressed potency and libido. Hyperthyroxinemia stimulates SHBG and increases total seric testosterone level, but free testosterone level is normal. Circulatory estradiol level is increased in men with hyperthyroidism, due to increased peripheral androgens precursors. Also they can have increased LH circulatory levels, Leyding Aromatase level and progesterone secretion. In patients with hyperthyroidism, testicular function can also be affected.
     Old age is clinically associated with the gradual downfall of testicular and sexual performances. The total number of Leyding cells and spermatogenesis decrease. Testosterone average level in a 60-70 years old man equals the minimal level of a young man. LH seric level remains normal probably due to reduced GnRH secretion. The sperm number and quality starts to deteriorate starting with the age of 50.
     Complete androgen insensitivity is an X-linked disease characterized by a feminine phenotype in a man with masculine genotype. Incomplete androgen insensitivity is a limited from of androgenic resistance, which becomes clinically apparent with external genital organs variable ambiguity and affected peripheral androgyny. These abnormal conditions are produced by mutations in the androgen receptor governing sequence of genetic code. These mutations cause a receptor hormone poor binding or the complete lack of active receptor binding to the androgen regulator governing area of the gene. Usually androgenic resistance is associated with infertility but only partially because testicular mioides and Sertoli cells also contain androgen receptors.

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