Serum insulin-like factor 3 is highly correlated with intratesticular testosterone in normal men with acute, experimental gonadotropin deficiency stimulated with low-dose human chorionic gonadotropin: a randomized, controlled trial

• Published in: Fertility and sterility Vol. 99; no. 1; pp. 132 - 139
• Main Authors: Roth, Mara Y., M.D, Lin, Kat, M.D, Bay, Katrine, M.Sc., Ph.D, Amory, John K., M.D., M.P.H, Anawalt, Bradley D., M.D, Matsumoto, Alvin M., M.D, Marck, Brett T., B.S, Bremner, William J., M.D., Ph.D, Page, Stephanie T., M.D., Ph.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2013
• Subjects: 17-alpha-Hydroxyprogesterone - blood; Adolescent; Adult; Androgens; antagonists; Anti-Mullerian Hormone - blood; biomarkers; Biomarkers - blood; blood proteins; blood serum; Chorionic Gonadotropin - pharmacology; clinical trials; Dose-Response Relationship, Drug; gels; gonadotropin-releasing hormone; Gonadotropin-Releasing Hormone - antagonists & inhibitors; gonadotropins; Gonadotropins - deficiency; human chorionic gonadotropin; Humans; inhibin; Inhibins - blood; INSL3; Insulin - blood; Internal Medicine; intratesticular testosterone; Male; male infertility; men; Middle Aged; Obstetrics and Gynecology; Oligopeptides - pharmacology; patients; Proteins; Testis - drug effects; Testis - metabolism; testosterone; Testosterone - metabolism; Young Adult; gonadotropins; Androgens; intratesticular testosterone; INSL3; male infertility
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2012.09.009

Objective To study the potential role for using serum biomarkers, including insulin-like factor 3 (INSL3), 17α-hydroxyprogesterone, antimüllerian hormone, and inhibin B, as correlates of intratesticular T (IT-T) concentrations in men. Design Prospective, randomized, controlled trial. Setting University-based medical center. Patient(s) Thirty-seven healthy men aged 18–50 years. Intervention(s) All men received the GnRH antagonist acyline, plus very low doses of hCG (0 IU, 15 IU, 60 IU, or 125 IU) SC every other day or 7.5 g T gel daily (75 mg delivered). The IT-T concentrations obtained by percutaneous testicular aspiration with simultaneous serum protein and steroid concentrations were measured at baseline and after 10 days of treatment. Main Outcome Measure(s) Intratesticular and serum hormone and gonadotropin concentrations. Result(s) After 10 days of gonadotropin suppression, serum INSL3 decreased by more than 90% and correlated highly with IT-T concentrations. In contrast, serum inhibin B, antimüllerian hormone, and 17α-hydroxyprogesterone did not correlate with IT-T. Serum INSL3 increased with the dose of hCG administered and returned to baseline after treatment. Conclusion(s) Serum INSL3 correlates highly with IT-T and serum T concentrations during acute gonadotropin suppression in men. Human chorionic gonadotropin stimulates dose-dependent increases in INSL3 and IT-T in healthy men and might be a useful biomarker of IT-T concentration in some clinical settings. Clinical Trial Registration Number NCT# 00839319.