Dialysis and sperm count

Male reproductive function is impaired during end-stage renal disease ESRD. Disturbance of the hypothalamic-pituitary-gonadal axis, and therefore the regulation of sex hormones, is one of the major causes. Twenty male patients on hemodialysis, median age 40 26—48 years, were analyzed for follicle-stimulating hormone FSH , luteinizing hormone LH , prolactin, sex hormone-binding globulin SHBG , testosterone, estradiol, AMH and inhibin B levels. We used proven fertile men, median age 32 19—44 years as a control group and analyzed differences using multiple linear regression. Mean value for AMH was lower, Combined with an increase in LH, these findings may indicate a dysfunction of Sertoli cells and an effect on Leydig cells contributing to a potential mechanism of reproductive dysfunction in men with ESRD.

The global disease burden of end stage renal disease ESRD is growing rapidly, and organ transplantation remains the gold standard for improving both the quality and quantity of life particularly in young adults. It is therefore critical to understand the effect of ESRD and renal transplantation on male fertility. Many men in renal failure exhibit subfertility or infertility due to several factors including hypogonadism, erectile dysfunction ED , and direct impairment of spermatogenesis with spermatotoxicity and late stage maturational arrest causing oligospermia or azoospermia. Kidney transplantation has been shown to rescue some—but not all—of these defects, with normalization of reproductive hormonal parameters, improvement in semen parameters sperm count, motility, morphology , and partial restoration of erectile function. This improvement in fertility is sufficient for a subset to father children either naturally or with assisted reproduction. In this review, we summarize the literature regarding fertility in men with chronic kidney disease CKD and on dialysis, and we describe the changes associated with renal transplantation. With the rising prevalence of end stage renal disease ESRD , over , Americans are now currently listed for kidney transplant.

Chronic renal failure has been known to be associated with impotence and loss of libido in men and for many women, infertility and menstrual irregularities. There have been ongoing improvements in survival and quality of life after renal transplantation. These have been accompanied by an improvement in reproductive function and reversal of the relative infertility that occurs despite maintenance hemodialysis. One of the most impressive aspects of successful renal transplantation in the young person is the ability of the male patient to father a child and the female patient to give birth to a healthy baby.

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