Testicular Sertoli cell function in male systemic lupus erythematosus

Rheumatology (Oxford). 2008 Nov;47(11):1692-7. doi: 10.1093/rheumatology/ken338. Epub 2008 Sep 11.


Objective: To assess the testicular Sertoli cell function in male SLE patients.

Methods: Thirty-four consecutive patients were prospectively selected to evaluate serum inhibin B. Clinical features, treatment, semen analysis, urological evaluation, testicular ultrasound, hormones and anti-sperm antibodies were determined.

Results: Patients were subdivided into two groups: low serum inhibin B (Group 1, n = 8) and normal levels (Group 2, n = 26). The median sperm concentration (P = 0.024), total sperm count (P = 0.023) and total motile sperm count (P = 0.025) were lower in Group 1. Inhibin B levels were positively correlated with sperm concentration (r = 0.343), total motile sperm count (r = 0.357), and negatively correlated with follicule-stimulating hormone (FSH) (r = 0.699) and luteinizing hormone (r = 0.397). The median serum inhibin B was lower in SLE patients treated with intravenous cyclophosphamide (IVCYC) compared with those without this therapy (P = 0.031). Further evaluation of the 26 SLE patients with normal inhibin B and FSH levels revealed that medians of inhibin B/FSH ratio were lower in SLE patients with oligozoospermia compared with normozoospermia (P = 0.004). This ratio was also lower in SLE patients treated with IVCYC than those without this therapy (P = 0.04). In contrast, inhibin B serum level alone did not discriminate the later group of patients (P = 0.12).

Conclusions: This is the first study to identify a high frequency of testicular Sertoli cell dysfunction in male SLE associated with semen abnormalities. Further prospective studies are necessary to determine if inhibin levels and inhibin B/FSH ratio will be an earlier and useful marker of IVCYC toxicity in these patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Autoantibodies / blood
  • Chi-Square Distribution
  • Cyclophosphamide / therapeutic use
  • Follicle Stimulating Hormone / blood
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Inhibins / blood
  • Lupus Erythematosus, Systemic / blood
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / pathology*
  • Luteinizing Hormone / blood
  • Male
  • Middle Aged
  • Prospective Studies
  • Sertoli Cells / metabolism
  • Sertoli Cells / pathology
  • Sertoli Cells / physiology*
  • Sperm Count
  • Sperm Motility
  • Spermatozoa / immunology
  • Statistics, Nonparametric
  • Testis / diagnostic imaging
  • Ultrasonography


  • Autoantibodies
  • Immunosuppressive Agents
  • inhibin B
  • Inhibins
  • Cyclophosphamide
  • Luteinizing Hormone
  • Follicle Stimulating Hormone