Testicular Steroids in Spermatic and Peripheral Veins After Single Injection of Hcg in Patients With Varicocele

Abstract

To determine the function of Leydig cells in patients with varicocele, hCG-stimulated levels of progesterone (Prog), 17α-Hydroxy-4-pregnene-3,20-dione (17OHP), 4-Androstene-3,17-dione (A-dione), testosterone (T), and estradiol-17β (E₂) in both spermatic and peripheral veins were measured. Seventy-two patients with idiopathic varicocele were divided into four groups: patients in group 1 were untreated, whereas patients in groups 2, 3, and 4 were given a single i.m. injection of 10,000 IU hCG 24 h, 96 h, and 168 h before surgery, respectively. In the spermatic and peripheral veins, levels of Prog, 17OHP, and E₂ showed peaks at 24 h, whereas levels of A-dione and T showed peaks at 96 h. Significant increases in the ratios of spermatic veins 17OHP to A-dione and 17OHP to T, and a significant decrease in the ratio of T to E₂, was found 24 h following hCG treatment. These results demonstrate that, following hCG injection, there is a transient inhibition of testicular C_17–20-lyase activity, probably mediated by E₂, even in subfertile males with varicocele.

Key Words:

• Varicocele
• Spermatic vein
• Leydig cell
• hCG test.