{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:23:22Z","timestamp":1792182202611,"version":"4.4.0"},"reference-count":31,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T00:00:00Z","timestamp":1606348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Low serum testosterone is found in approximately 15% of subfertile men. Although testosterone is essential in spermatogenesis, it is unclear whether low testosterone levels may have a negative impact on the semen parameters of men belonging to infertile couples with a total sperm count greater than 5 million. Furthermore, it is debatable whether the initial evaluation of the subfertile male should include an endocrine assessment. This was a retrospective, single-center cohort study conducted at a tertiary fertility clinic. Male partners of infertile couples undergoing in vitro fertilization (IVF), with a total sperm count greater than 5 million, were included. All men provided morning blood samples, and none had been on exogenous testosterone or other relevant medications. Low total testosterone (TT) was defined as &lt;264 ng\/dL. Free T was calculated using TT and sex hormone-binding globulin (SHBG) levels (nmol\/L) by a constant albumin concentration of 43 g\/L. In total, 853 patients were included: 116 had low TT (&lt;264 ng\/dL) and 737 had normal TT (\u2265264 ng\/dL). Semen volume, sperm cell count, progressive (A + B) motility and morphology (\u22654% strict Kruger) were lower in the low TT group but not significantly different between low and normal TT groups (3.2 \u00b1 1.79 vs. 3.23 \u00b1 1.64, p = 0.87; 76.82 \u00b1 83.18 vs. 67.55 \u00b1 57.70, p = 0.7; 54.89 \u00b1 19.45 vs. 56.25 \u00b1 19.03, p = 0.6; 5.77 \u00b1 3.23 vs. 6.89 \u00b1 3.94, p = 0.23). The percentage of patients with below-reference sperm volume (&lt;1.5 mL), cell count (&lt;15 \u00d7 106\/mL), motility (A + B) (&lt;32%) and morphology (&lt;4%) was higher in the low TT group but not statistically different compared to the normal TT group. Multivariable regression analysis revealed that low TT and free T levels had no significant effect on the aforementioned semen parameters (coefficient: 3.94, 0.88, 1.37, 0.39; p = 0.53, 0.8, 0.3, 0.2; coefficient: 0.001, 0.06, 0.007, 0.0002; p = 0.73, 0.52, 0.85, 0.98). Despite our robust methodological approach, the presence of biases related to retrospective design cannot be excluded. Our findings highlighted the lack of association between low TT levels and semen parameter alterations in male partners of infertile couples undergoing IVF, with a total sperm count greater than 5 million. However, it is important to emphasize that more patients in the low TT group had subnormal semen parameters, albeit the difference was not statistically significant. Larger, prospective studies are warranted in order to validate these findings, as well as to investigate the existence of a TT threshold below which semen parameters might be negatively affected.<\/jats:p>","DOI":"10.3390\/jcm9123824","type":"journal-article","created":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T22:00:33Z","timestamp":1606428033000},"page":"3824","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Low Testosterone and Semen Parameters in Male Partners of Infertile Couples Undergoing IVF with a Total Sperm Count Greater than 5 Million"],"prefix":"10.3390","volume":"9","author":[{"given":"Federica","family":"Di Guardo","sequence":"first","affiliation":[{"name":"Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan, 101-1090 Brussels, Belgium"},{"name":"Department of General Surgery and Medical Surgical Specialties, Gynecology and Obstetrics Section, University of Catania, Via Santa Sofia 78, 95125 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veerle","family":"Vloeberghs","sequence":"additional","affiliation":[{"name":"Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan, 101-1090 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erlisa","family":"Bardhi","sequence":"additional","affiliation":[{"name":"Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan, 101-1090 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Blockeel","sequence":"additional","affiliation":[{"name":"Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan, 101-1090 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Verheyen","sequence":"additional","affiliation":[{"name":"Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan, 101-1090 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman","family":"Tournaye","sequence":"additional","affiliation":[{"name":"Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan, 101-1090 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9262-785X","authenticated-orcid":false,"given":"Panagiotis","family":"Drakopoulos","sequence":"additional","affiliation":[{"name":"Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan, 101-1090 Brussels, Belgium"},{"name":"Department of Obstetrics and Gynecology, Crete University, 70013 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/S0090-4295(97)00340-3","article-title":"Endocrine Evaluation of Infertile Men","volume":"50","author":"Sigman","year":"1997","journal-title":"Urology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1093\/humupd\/dmx022","article-title":"Temporal Trends in Sperm Count: A Systematic Review and Meta-Regression Analysis","volume":"23","author":"Levine","year":"2017","journal-title":"Hum. 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