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Testosterone-Estradiol Ratio in Evaluation of Infertile Male

Purpose: To evaluate the infertile male using the testosterone to estradiol ratio.

Description

Some infertile males with nonobstructive oligo- or azoo-spermia have an endocrinopathy with the serum testosterone that is below normal or at the low end of normal, while the serum estradiol is elevated or at the high end of normal. The ratio of testosterone-to-estradiol in these patients is decreased. If these patients are treated with the aromatase inhibitor testolactone, then the sperm count may increase enough to allow the patient to be fertile.


 

Specimen collection: Serum was collected in the morning between 08:00 and 10:00.

 

testosterone-to-estradiol ratio =

= (serum testosterone in ng/L) / (serum estradiol in ng/L)

 

where:

• Total testosterone was measured. It might be interesting to see if using free testosterone levels influences the results.

• Serum testosterone is usually reported in ng/dL, so values need to be adjusted to match units.

 

Interpretation:

• Fertile adult males had a ratio of 145 (95% CI 72 to 218).

• Infertile males had a ratio of 69 +/- 6 (63 to 75) prior to treatment, with an increase in the ratio into the normal range with testolactone therapy.

 

NOTE: In the paper the ratio is listed as "x10^(-1)", which causes ratios of 20 to 200 to be displayed as 2 to 20.

 


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Specialty

Objective

ICD-10