الفهرس 
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Abstract
The present study is conducted to eva1~ ;e the
functional state of thyroid gland, the frequer :y and the
role of thyroid disorders in male sterility tc ;ether with
aasessment of the value of thyroid hormone thJ ’pay in
infertile males. Moreover, evaluation of relie lility at
urinary 17~Oxosteroids (OS) and l7-OXogenic oc ~tloosteroids
(17-0GS) eatimations in male intertilj ;y, and
correlation between the urinary oortiooateroic I and the
different types of semen pictures was tried, ~ Ie effeot
of various types of andr-ogana therapy, was Btl:l1ed.
A series of 106 infertile males and 25 r Irmal fertile
healthyoontrols was investigated. Ninety oase I had idiopathic
infertility and 16 cases had endoord.nop~thiQS which
included J casea of hypothyroidism, one with t J,Yrotonoosis,
two with Addison’s disease, ona with Cu Wing’s
syndrome, one with the AGS, two with Klinefelt or1s syndrome
and 6 oases with eunuohod.ddeci ,
Semen analysis was dona at least twice t ’r every
case before being inoluded in this stUdy and u ,nthly
thereafter until the end of the follow up peri ’d, using
the oriteria of Eliasson (1973).
Testicular biopsy was done in 25 cases ’f azoospermia
and 4 cases of severe oligoasthenospermia. fo: lowing the
method of Amelar (1966).
The thyroid functional state was assess. i clinically,
using the scoring systems of Crooks et a1. (1: 59) and
Wayne (1960). and by determination of serum Pl [ in dupliate
following the method of Foss et al. (1960).
The suprarenal cortical function was stl lied by the
determination of urinary 17-0xosteroids and Ij -Oxogenio
steroids before and after therapy following tr , method of
Norymberski, Stubbs & West (1953).
Therapy was given to 63 patients. Lioth.\;-onf.ne was
administered to 14 patient s with low PBI and a io rhez- 15
oases with normal PBI. Antithyroid therapy wae given to
the oase of thyrotoxicosis and prednisone was ;iven to the
patient having AGS. Androgen therapy was given to 32 cases.
12 patients reoeived small doses of testostero ~, another
12 received high doses of testosterone and 8 p tients
received mesterolone therapy.
The results of this study were analysed nd they
showed the following:
1. Semen analysis revealed oligoasthenosperm a as the
commonest picture (38.8%) in idiopathic s erility,
followed by asthenospermia (25.5%), azoos ermia (20%),
and oligospermia (15.5%). In patients wit endocrinopathies,
the commonest pioture was azoosperm a followed
by asthenospermia.
2. Testicular biopsy in azoospermic patients showed
sloughing and disorganization as the oomm nest picture
(28%), followed by maturation arrest (24%),
Sertoli cell-only syndrome (20%)_ peritub ,lar fibrosis
and tubular hyalinization (20%), an Klinefelter’s
syndrome (4%).
3. Subnormal PBI values were observed in 14. % of the
patients with idiopathic sterility while igher than
normal values were seen in only 2.2%. Ast eno spezml.a
was the most common picture and oligosper ia was the
least in patients with low PBl. Sloughing and disorganization
with variable degrees of mat ration
arrest was the commonest histological pic ure observed
in these patients.
4. A case report of thyrotoxicosis with azoo permia and
spermatogenic maturation arrest was descr bed. It
showed normalization of semen picture aft r medical
control of hyperthyroidism. Explanations rere offered.
5. Liothyronine therapy (20 ug/day) showed a lequate results
only in cases with low PBI especially the Ie having
asthenospermia. Patients with normal PBI .nd received
liothyronine showed either no change or 1 ,came worse.
6. The mean urinary 17-Oxosteroid excretion ras significantly
lower in infertile men compared te the corresponding
value of fertile subjects, demons ;rating the
association between depressed spermatoger ’sis and
lowered androgenicity. Diminution was moe; marked in
the group of asthenospermia.
7. The urinary 17-Oxogenic steroids in infe:r :ile males
showed no variation from the control eubj ,cts.
8. A case of the adult virilizing AGS that w .s diagnosed
during the study by the presence of high :rinary 17-0S,
is described. Semen showed improvement wi h prednisone
therapy.
9. The small dose testosterone method and me rtez-o Lone
therapy showed fairly good results mainly regarding
improvement of sperm motility. Higher dos s of testosterone
showed poor results.