Endocrine Genetic Defects

Nearly 15% of all couples will struggle with infertility. The role of the clinician is to not only evaluate and treat potentially correctable etiologies of infertility but also to discover and educate the couple on any potential genetic factors at play. After completion of the human genome sequencing (International Human Genome Sequencing Consortium, 2001), the genetic basis of human reproduction began to take shape. The process of spermatogenesis relies on a complex hormonal interplay between the hypothalamus, pituitary, and testis to influence testicular function. Due to these complex interactions, there can be numerous problems in the hormonal support of male fertility due to genetic defects. These defects may lead to alterations in the hormonal milieu necessary for successful spermatogenesis by disrupting upstream signaling hormones such as gonadotropin releasing hormone (GNRH), luteinizing hormone (LH), and/or follicle-stimulating hormone (FSH). Alternatively, chromosomal defects may affect the testicular microenvironment, thereby impeding testicular function.