Neuroendocrinological studies in males with aspermia.

Data on 9 patients aged 19-49 who suffer from aspermia and infertility due to various neuroendocrine disorders are presented. Neurological examination revealed the presence of a pituitary tumor with extension into the hypothalamus in 4 cases and olfacto-genital syndrome in 2 cases. Hormonal substitution for adrenal and thyroid insufficiency was required in all tumor cases. 3 tumor cases had pahtological circadi an cortisol rhythm and metyrapone tests and the vasopressin test was pathological in 2 of these patients. Follicle stimulating hormone and interstitial cell stimulating hormone levels were normal in all cases of fertile eunuch syndrome but plasma levels of testosterone were very low. All of these patients responded to treatment with human chorionic gonadotropin but not to clomiphene. 3 tumor cases and 2 olfacto-genital syndrome cases did not respond to infusion of 100 mcg of luteinizing hromone-releasing hormone. The individual cases are discussed.