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* To whom correspondence should be addressed. E-mail: willem{at}dhooge.org.
Background: Epidemiological studies of sperm quality are hampered by problems such as low participation rates and poor comparability due to methodological differences in semen analysis. More objective sperm quality-related serum markers would facilitate worldwide comparison of male reproductive status. Our objectives were to investigate to what extent a set of hormonal indices of testicular function, previously established in clinical setting, can predict regional variations in seminal parameters in men from the general population. Methods: We recruited 101 men, aged 20-40 years, from two regions in Flanders, and assessed sperm parameters and serum reproductive hormones. Results: In one region compared to the other, participants had a lower sperm concentration (by 34%, p=0.06), total sperm count (by 41%, p=0.02) and sperm morphology (by 32%, p<0.001), which was paralleled by a significantly lower free testosterone (11%, p=0.03), while for total testosterone (T, 10%) and follicle stimulating hormone (FSH, 17%) the differences were non-significant (both p=0.09). There were no differences in inhibin B and the T/luteinizing hormone (LH) ratio, markers of testicular function. Receiver operating characteristic curve analysis demonstrated T/LH, inhibin B, and the inhibin B/FSH ratio to have significant discriminatory power between men with a sperm concentration below or above 13.5x106/mL. Conclusions: Regional variations in semen quality of community-dwelling individuals are not necessarily reflected in altered hormonal indices of testicular function and thus these markers, validated in clinical settings, fail to be substitutes for the traditional semen quality assessment in epidemiological population studies.
Key words: Fertility
Spermatogenesis
Steroidogenesis
FSH
Inhibin B
Spermatogenic arrest
T/LH ratio
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