FERTILITY IN PARAPLEGIC MALES*: A PRELIMINARY REPORT OF ENDOCRINE STUDIES

Abstract

A study of the fertility of 34 men with spinal cord injuries is presented. Microscopic examination of testicular biopsy specimens revealed pathology in all but 3 cases. The predominant picture was tubular atrophy and no disturbance of Leydig cells. With 2 exceptions, there seemed to be a correlation between the biopsy findings and the level of the spinal cord lesion; a lesser degree of testicular pathology was encountered when the cord lesion was at a level below D-11. Testicular biopsy findings corresponded to the results of sweating tests, with 4 exceptions. The association of lesser testicular pathology with normal sweating and major testicular pathology with impaired sweating, indicates a direct relationship between testicular function and the autonomic nervous system. There was no correlation between biopsy findings and sexual behavior. Urinary 17-ketosteroid levels were at the upper limit of normal or were elevated, in 15 of 33 detns. Urinary estrogen levels were elevated in 30 of the 34 patients. Urinary gonadotropins, detd. in 29 cases, were low in 25 and normal in 4.