head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2023, vol. 29, issue2
Subject Area: Medicine
DOI: 10.5272/jimab.2023292.5009
Published online: 27 June 2023

Original article
J of IMAB. 2023 Apr-Jun;29(2):5009-5013
Georgi Lazarov1, 2ORCID logoCorresponding Autoremail, Vladislav Mladenov3ORCID logo,
1)Department Molecular Immunology, Institute of Biology and Immunology of Reproduction, Bulgarian Academy of Sciences, Sofia, Bulgaria.
2 ) Hospital in Obstetrics and Gynecology "St. Sofia ", Andrological office, Sofia, Bulgaria.
3) Department of Urology, UMBAL Alexandrovska, Medical University - Sofia, Bulgaria.

In our practice, we are increasingly seeing men aged from 37 to 45 years' old who have permanent low normal testosterone levels.
Aim: We set out to investigate whether there is an association between permanent low normal testosterone levels and negative change in seminal fluid parameters in young men.
Patients and Methods: For the period from January 2013 to December 2015 at the Andrology office at Hospital "St. Sofia" we examined 73 men aged 37 to 45 years with normal or elevated body mass index, permanent low normal testosterone level, and negative change in seminal fluid parameters. In order to compare the results we obtained, at the very beginning of the study we selected a control group of 20 healthy men of the same age.
Results: We obtained, although within reference ranges, significantly lower values for total testosterone in the 73 men with negative change in seminal fluid parameters, compared with those in the control group without seminal damages (p<0.001) We found a high correlation relationship between the level of testosterone and the results of the first (r = 0.614, p<0.001) and second spermograms (r = 0.662, p<0.001).
1. Our study shows that in a number of men at a young age, some decrease in normal testosteronе secretion occurs, with a concomitant negative change in seminal fluid parameters, which is remarkably different from the same parameters in their peers with a high normal testosterone level.
2. We identify permanent low normal testosterone, overweight and obesity as predictors, signaling a possible negative change in seminal fluid parameters.
3. We can say that if obesity plays some role in seminal damages, the mechanism in most cases is most likely related to the sustained permanent low normal testosterone level, as a result of increased adipose tissue.

Keywords: low normal testosterone, BMI, seminal damages,

pdf - Download FULL TEXT /PDF 616 KB/
Please cite this article as: Lazarov G, Mladenov V. Permanent low normal testosterone levels and seminological damages in men from 37 to 45 years old. J of IMAB. 2023 Apr-Jun;29(2):5009-5013. [Crossref - 10.5272/jimab.2023292.5009]

Corresponding AutorCorrespondence to: Georgi Lazarov, MD, Department of Molecular Immunology, Institute of Biology and Immunology of Reproduction, Bulgarian Academy of Sciences, Sofia; 73, Tzarigradsko shose Blvd., Sofia; Hospital in Obstetrics and Gynecology "St. Sofia ", Аndrological office; 2, Mihalaky Tashev Srt., Sofia, Bulgaria; E-mail: doctorlazarov30@gmail.com

1. De Kretser D. Endocrinology of male infertility. Br Med Bull. 1979 May;35(2):187-92. [PubMed]
2. Pierrepoint CG, Jenkins BM, Wilson DW, Gow JG. An examination of blood steroid and gonadotropin concentrations in relation to fertility status and testicular function in men. Fertil Steril. 1982 Oct;38(4):465-70. [PubMed]
3. Di Guardo F, Vloeberghs V, Bardhi E, Blockeel C, Verheyen G, Tournaye H, et al. Low Testosterone and Semen Parameters in Male Partners of Infertile Couples Undergoing IVF with a Total Sperm Count Greater than 5 Million. J Clin Med. 2020 Nov 26; 9(12):3824. [PubMed ]
4. Meeker JD, Godfrey-Bailey L, Hauser R. Relationship between serum hormone levels and semen quality among men from an infertility clinic. J Androl. 2007 May-Jun;28(3):397-406. [PubMed]
5. Jorgensen N, Joensen U, Toppari J, Punab M, Erenpreiss J, Zilaitiene B, et al. Compensated reduction in Leydig cell function is associated with lower semen quality variables: A study of 8182 European young men. Hum Reprod. 2016 May;31(5):947-57. [PubMed]
6 Olesen IA, Joensen UN, Petersen JH, Almstrup K, Rajpert-De Meyts E, Carlsen E, et al. Decrease in semen quality and Leydig cell function in infertile men: a longitudinal study. Hum Reprod. 2018 Nov 1; 33(11): 1963-1974. [PubMed]
7. Wu FC, Tajar A, Beynon JM, Pye SR, Silman AJ, Finn JD, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med. 2010 Jul 8;363(2):123-35. [PubMed]
8. MacDonald AA, Herbison GP, Shovell M, Farquhar CM. The impact of body mass index on semen parameters and reproductive hormones in human males: a systemic review with meta-analysis. Hum Reprod. 2010 May-Jun; 16(3): 293-311. [PubMed]
9. MacDonald AA, Stewart AW, Farquhar C. Body mass index in relation to semen quality and reproductive hormones in New Zealand men: a cross sectional study in fertility clinics. Hum Reprod. 2013 Dec; 28(12): 3178-87.
10. Salas-Huetos A, Maghsoumi-Norouzabad L, James ER, Carrell DT, Aston KI, Jenkins TG, et al. Male adiposity, sperm parameters and reproductive hormones: An updated systematic review and collaborative meta-analysis. Obes Rev. 2021 Jan; 22(1):e13082. [PubMed]
11. Sermondade N, Faure C, Fezeu L, Shayeb AG, Bonde JP, Jensen TK et al. BMI in relation to sperm count: an updated systematic review and collaborative meta-analysis. Hum Reprod Update. 2013 May; 19(3):221-231. [PubMed]
12. Zhong O, Ji L, Wang J, Lei X, Huang H. Association of diabetes and obesity with sperm parameters and testosterone levels: a meta-analysis. Diabetol Metab Syndr. 2021 Oct 16; 13(1): 109. [PubMed]
13. Ma JX, Wang B, Li HS, Jiang XJ, Yu J, Ding CF, et al. Association between obesity-associated markers and semen quality parameters and serum reproductive hormones in Chinese infertile men. Reprod Biol Endocrinol. 2020 Sep 29; 18(1): 95. [PubMed]
14. Bhasin S, Cunningham G, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, et al. Testosterone therapy in adult men with androgen deficiency syndromes: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2006 Jun;91(6):1995-2010. [PubMed]
15. Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab. 2001 Feb; 86(2):724-31. [PubMed]
16. Wang C, Swerdloff RS, Iranmanesh A, Dobs A, Snyder PJ, Cunningham G, et al. Transdermal testosterone gel improves sexual function, mood, muscle strength and body composition parameters in hypogonadal men. Testosterone Gel Study Group. J Clin Endocrinol Metab. 2000 Aug; 85(8):2839-53. [PubMed]
17. Kirilov G. [Problematics in the study of testosterone as the main test for assessing androgen deficiency in men. In: Male Reproductive Endocrinology.] [in Bulgarian] Academic Publishing House "Marin Drinov", Sofia.  2013, 159-181.
18. Weir CB, Jan A. BMI Classification Percentile And Cut Off Points. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2022 Jun 27. [PubMed]
19. WHO laboratory manual for the examination and processing of human semen. Sixth Edition. World Health Organization. Jul 27 2021. [Internet]
20. Minhas S, Bettocchi C, Boeri L, Capogrosso P, Carvalho J, Cilesiz NC, et al. European Association of Urology Guidelines on Male Sexual and Reproductive Health: 2021 Update on Male Infertility. Eur Urol. 2021 Nov; 80(5):603-620. [PubMed ].

Received: 24 February 2023
Published online: 27 June 2023

back to Online Journal