Serum Testosterone-Estradiol Ratio in Toxoplasma-Seropositive Infertile Men: A Prospective, Single-Center Study

Ragab, Ahmed; Hamdy, Doaa; Ibrahim, Shimaa

doi:10.18502/jri.v25i1.15196

Serum Testosterone-Estradiol Ratio in Toxoplasma-Seropositive Infertile Men: A Prospective, Single-Center Study

Authors

Ahmed Ragab ¹

Doaa Hamdy ²

Shimaa Ibrahim ²

¹ Department of Andrology, Sexology and STIs, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt

² Department of Medical Parasitology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt

10.18502/jri.v25i1.15196

Abstract

Background: The purpose of the current study was to compare the testosterone-estradiol (T:E2) ratio in Toxoplasma gondii (T. gondii) seropositive infertile men with seropositive and seronegative normozoospermic controls. Methods: A total of 200 men with normal virilization, including 100 with idiopathic infertility and 100 normozoospermic men, were included in the study. Participants underwent a comprehensive evaluation including a detailed medical history assessment, physical examination, semen analysis, testing for T. gondii IgM/IgG, and estimation of serum T:E2 ratios. Statistical comparisons between groups were performed using t-test and Chi square (x 2 ) with a significance level set at p<0.05. Results: Infertile cases were diagnosed with oligozoospermia (63%), oligoasthenozoospermia (34%), and oligoasthenoteratozoospermia (3%). Regarding anti-Toxoplasma IgG and IgM antibodies, among infertile men, 34 tested positive for IgG and 8 tested positive for IgM. Among the 34 infertile men who tested positive for IgG antibodies, 13 individuals (38.2%) had disturbed T:E2 ratios. Also, among the 12 IgG-positive controls, 5 individuals (41.7%) had disturbed T:E2 ratios (p=0.834). However, only 2 out of the 83 seronegative controls (2.5%) had disturbed T:E2 ratios, which was statistically significant (p<0.001). Furthermore, 6 out of 8 IgM-positive infertile men had altered T:E2 ratios, compared to 3 out of 5 IgM-positive controls (p=0.568) and 2 out of 83 seronegative controls (p<0.001). The T:E2 ratio was significantly lower (8.68±1.95) among IgM-positive infertile men and higher (13.04±3.78) among IgG-positive infertile men when compared to seronegative controls (10.45±0.54) (p<0.001). There were no significant differences in the testosterone-estradiol (T:E2) ratios between infertile men with positive IgM or IgG serology and the control group with the same serology. Conclusion: A significant proportion of infertile men with toxoplasmosis exhibit altered T:E2 ratios. These findings emphasize the importance of conducting anti-T. gondii-IgG testing in individuals with abnormal T:E2 ratios.

Keywords

Asthenozoospermia

Estradiol

Immunoglobulin G

immunoglobulin M

Male infertility

Oligospermia

testosterone

Toxoplasma

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