Alteration of Sex Hormone and Semen Parameters in Adult Males with Subclinical Hypothyroidism

Aim: To investigate the correlation between subclinical hypothyroidism (SCH) with serum testosterone levels and semen parameters (sperm count, total motility and morphology) in men seeking medical care for sexual dysfunction and infertility.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Endocrinology, Gauhati Medical College and Hospital, Guwahati, India. Study done from November 2015 to December 2016.

Methodology: The patients in study were grouped into two groups: Group I – Men with subclinical hypothyroidism (n=35) and group II – Euthyroid males serving as controls (n=27). The medical history, clinical examination, semen analysis, total thyroxine (T4), total triiodothyronine (T3), thyroid-stimulating hormone (TSH), Luteinizing hormone (LH), Follicular stimulating hormone (FSH), Total testosterone (T) and prolactin (PRL) were obtained. Patients with diabetes mellitus, hypertension, chronic diseases, any testicular or pituitary diseases and prior chemo-radiotherapy were excluded from study.

Results: The age of the patients ranged between 24 and 42 years with mean age 31.57 years. The cases had significantly lower levels of mean serum total testosterone and free T4 and higher serum prolactin levels compared to controls (P< .01). Linear regression analysis showed TSH levels independently associated with low testosterone levels. Also men with subclinical hypothyroidism had lower total sperm motility with preserved sperm count and morphology. Conclusion: We found that SCH is associated with reduction in testosterone levels and total sperm motility. Our study data conclude that SCH may be a contributing factor for hypoandrogenemia and sexual dysfunction in men.