CONTEXT: The mechanisms by which testicular varicocele affects fertility remain undetermined. Surveying in the literature the correlation of varicocele to seminal parameters as well as sperm characteristics and function, had contradictory results. Male fertility strictly depends on androgens acting through their own receptor. The enzyme 5α-reductase (SRD5A) is involved in the conversion of testosterone to 5α-dihydrotestosterone (DHT), both required for the development and maintenance of male reproductive function. It has been speculated how the importance of androgen in the sperm maturative process goes beyond the length of their life in seminiferous tubules, since ejaculated human spermatozoa possess the AR and its content is reduced in a pathological condition such as varicocele. AIMS AND PATIENTS: To investigate a possible molecular alteration in sperm from testicular varicocele subjects. Samples used in this study were from patients with proved fertility and with diagnosed varicocele of grade III on the left testis. METHODS AND
RESULTS: Herein, we evaluated, by WB analysis, the presence of SRD5A in human spermatozoa evidencing differences in sperm SRD5A content between healthy donors and varicocele-affected patients. In latter patients a reduced DHT production and SRD5A activity were also obtained.
CONCLUSIONS: Our results, strengthening the important role of androgens in male fertility, disclose a new molecular alteration in males suffering from varicocele. Indeed, in our previous studies, we demonstrated in human ejaculated spermatozoa that low DHT concentrations through AR are able to induce a capacitation markers such as cholesterol efflux, according with an increase in protein phosphorylation supporting the concepts that a reduced DHT local production consequent to the decrease in SRD5A expression, could contribute to the reduced fertility in varicocele.
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