JLE

Médecine Thérapeutique / médecine de la reproduction

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Evaluation of the testis endocrine function by the young adult Volume 9, issue 5, novembre-décembre 2007

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Author
Service d’Endocrinologie et Maladies Métaboliques, CHU Côte de Nacre, 14033 Caen Cedex

The measurement of morning total testosterone plasma concentration is pivotal for evaluating the endocrine function of the testis. This parameter is generally sufficient for the detection of leydig cell deficiency, but mild lowering of plasma total testosterone may be misleading, particularly in clinical situations that affect SHBG plasma concentration. In such situations, the measurement of free testosterone or bioavailable testosterone levels add subsequent information, and may be performed by direct methods which are highly accurate but performed only in specialized laboratories, or indirect methods based on validated algorithms. Basal plasma gonadotropin measurement by immunometric methods are generally accurate tools for the distinction between primary testicular or secondary hypogonadotrope deficiency. The measurement of plasma inhibin and anti-mullerian hormone are promising tools for the in vivo evaluation of sertoli cell function, and may be used as predictive markers for male infertility. Dynamic testing of the gonadotrope axis has limited value in the clinical investigation of the physiology of the testis.