Journal of Andrology
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Published-Ahead-of-Print February 7, 2007, DOI:10.2164/jandrol.106.002097

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Late Hormonal Levels, Semen Parameters and Presence of Antisperm Antibodies in Patients Treated for Testicular Torsion

Marco A. Arap *, Fabio C. Vicentini , Marcello Cocuzza , Jorge Hallak , Kelly Athayde , Antonio M. Lucon , Sami Arap , and Miguel Srougi

* To whom correspondence should be addressed. E-mail: marcoarap{at}usp.br.

In spite of prompt diagnosis and either orchiectomy or preservation of the affected testis, infertility remains a significant sequel of testicular torsion. The objective of this study was to evaluate late endocrine profile, seminal parameters and antisperm antibody levels after testicular torsion. Also, to analyze the impact of orchiectomy or detorsion on the organ fate. Of 24 patients evaluated after testicular torsion 15 were treated with orchiectomy (group 1) and 9 were treated with orchiopexy (group 2). All subjects were assessed by semen analysis, endocrine profile (follicle-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone) and seminal antisperm antibody levels. A group of 20 proven fertile men was used as the control. Median ischemia time in group 1 (48hs) was significantly higher than in group 2 (7hs). Both groups demonstrated a decrease in sperm count and morphology compared with controls. Group 1 showed a significantly higher motility than group 2 (p=0.02). Group 1 also showed a significantly better morphology by WHO and Kruger's criteria than group 2, (p=0.01). All patients presented an endocrine profile within normal ranges and no significant difference in antisperm antibody levels was detected between the groups. However, a trend for higher levels was found in patients treated for testicular torsion, regardless of the fate of the testis. Moreover, no significant correlation was found between antisperm antibody levels and age at torsion, ischemia time, seminal parameters or treatment applied. In conclusion, we found that after torsion, patients maintain late hormonal levels within normal ranges. Testicular fate did not have any correlation with the formation of antisperm antibodies. Although sperm quality is preserved in most of the patients with the exception of sperm morphology, patients treated with orquiectomy presented better motility and morphology compared with the detorsion group. Further studies may clarify whether maintenance of a severely ischemic testicle may impair testicular function.


Key words: Fertility • Hormone • Infertility • Semen Analysis • Testis






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