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Hormone Balance and Cancer Risk in Men with Severe Infertility

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Testis Molecular Pathways in CAIS Unveil TestosteroneEstradiol on Germ Cell Tumor Risk in Non-Obstructive Azoospermia.DOI 10.1210clinemdgaf404

Some men are born unable to make sperm. This condition is called non-obstructive azoospermia. It affects about one in every hundred men. These men often have smaller testicles, low testosterone levels, and health problems that appear earlier in life. Doctors have also noticed a higher risk of testicular cancer in some of these men.

Researchers wanted to understand why this risk is higher. They studied how cells inside the testis behave at a very detailed level. The focus was on men with non-genetic infertility and men with rare genetic conditions that also affect hormone response. One of these conditions is complete androgen insensitivity syndrome. In this condition, the body cannot respond properly to male hormones.

The study looked closely at Leydig cells. These cells make testosterone. Across many conditions, these cells looked older and less active than normal. In men with non-genetic infertility, the Leydig cells showed changes linked to testicular cancer. Many of these changes were linked to estrogen activity rather than testosterone.

The researchers also studied blood hormone levels in large groups of men. They found an important pattern. Men with lower testosterone compared to estrogen had a higher risk of developing testicular germ cell cancer. This hormone imbalance was a strong warning sign, especially in men with non-genetic infertility.

This finding matters for patients. Hormone balance may help doctors identify men at higher cancer risk earlier. Blood tests that look at testosterone and estrogen together could become part of future care. The study also suggests that some men may benefit from medicines that reduce estrogen levels. These drugs are already used in other hormone-related conditions.

This research helps explain why cancer risk is higher in some infertile men. It also opens the door to better screening and more personal care. Understanding hormones at the cellular level may help protect long-term health.

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dr swati shah - uro & gynec cancer surgeon
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