Diagnostic Importance of HCG in Male Infertility: Clinical Insights

DIAGNOSTIC IMPORTANCE OF HCG IN MALE INFERTILITY BY ORJI CHIBUEZE FAVOUR FEDERAL MEDICAL CENTRE JABI ABUJA

outline Introduction to male infertility Causes of male infertility Introduction to hcg hormone Important of hcg hormone clinical diagnotic importance of hcg hormone Diagnotic procedure Conclusion Recommendation

Introduction to male infertility male infertiltiy is failure to achieve clinical pregnancy after 12 months or more of regular unprotected sexual intercourse (Zegers-Hochschild et al., 2009). WHO estimates 60 80 million couples worldwide currently suffer from infertility (Calverton et al., 2004) It is estimated to affect 8 12% of couples worldwide (Population Council, 2004). 40% of infertility cases are related to men, 40% of women and 20% of both sexes (Sadock, 2003). clinically infertile men shows oligospermia, asthenospermia teratospermia and abnormal hormonal level(Harris et al., 2011).

Causes of male infertility Pre-testicular causes hypogonadotropic hypogonadism, erectile dysfunction, chromosomal (Stephen et al., 2022). Testicular disorders would cover testicular tumors, orchiectomy, primitive cryptorchidism, and atrophic testes (Hikim et al., 2000) abnormalities testicular dysfunction, Post-testicular causes include lesions of the seminal tract, congenital absence of the vas deferens, post- vasectomy, erectile dysfunction, premature ejaculation (Stephen et al., 2022).

Introduction to hcg hormone Human chorionic gonadotropin is a hormone produced by trophoblastic cells of the pla- centa during pregnancy. is a glycoprotein composed of two subunits, the alpha and beta subunits. HCG binds to the same receptor with LH, the LH chorionic gonadotropin receptor (LHCGR) (Ascoliet et al., 2002),

Fuctions of hcg Hormone hCG only promotes progesterone production for 3-4 weeks following pregnancy implantation. hCG/LH receptor gene is expressed by uterine spiral arteries, and hCG acts on them to promote angiogenesis. Pituitary hCG functions in an LH-like manner to promote follicular maturation, ovulation and phases of female menstrual cycle. hCG activates the LH/hCG receptor on Leydig cells and stimulates sex steroid secretion (Bertelloni et al., 2018).

Clinical diagnotic importance of hcg hormone in male infertility. The hCG stimulation test is widely used to assess testicular steroido-genesis. This test evaluates Leydig cell function. Testicular enzyme defects Hypogonadism 46XY sexual development disorders (DSD), micropenis cryptochidism constitutional delay of puberty from anorchia

Therapeutic importance of hcg. hCG also has a stimulatory effect on testicular steroidogenesis and penile growth in patient with micropenis. 50% of children with cryptorchidism responded to HCG therapy and the testes descended from the initial positions to lower levels. Increase in testicular volume in patients with IHH treated with hCG was substantially greater patients treated with testosterone. than that in

CONCLUSION A lot of factors is implicated in male infertility as such as life style, genetic, microbial, xenoiotic and immunological factor. The various factors has a many ways of inducing infertility such as testis destruction, pituitary disorder and others. Hcg stimulation test serve as gold standard in determination of functionality of the leyidg cell of the testis and enzyme deficiency. This gives help to stream line diagnosis into testicular and non testicular causes. Conventional FSH, LH and testosterone level assay cannot give a clue on steriod induced hypogonadism which can cause infertility. Besides its diagnostic importance can serve as a therapeutic agent it can help patient with cryptorchidism and micropenise

RECOMMENATION I recommend that hcg stimulation test shoul be included as one of the parameter in male infertility profile test. I also recommend that awareness increased rate of male infertility should be rised inorder for parents to start early diagnosis in causes of cryptorchidism and micropenis.

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