Follicle stimulating hormone and anti-mullerian hormone among fertile and infertile women in Ile-Ife, Nigeria: is there a difference?

Background: Reduced ovarian reserve predicts poor ovarian response and poor success rates in infertile women who undergo assisted reproductive technology [ART]. Ovarian reserve also decreases with age but the rate of decline varies from one woman to another. This study aims to detect differences in ovarian reserve as measured by basal serum follicle stimulating hormone [FSH] and anti-Mullerian hormone [AMH] between a matched cohort of fertile and infertile regularly menstruating women, 18-45 years of age

Materials and Methods: This case-control study involved 64 fertile and 64 subfertile women matched by age at recruitment. Peripheral blood samples were taken from the women recruited from the Gynecological and Outpatient Clinics of Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria. Serum FSH and AMH were quantified using ELISA at the Metabolic Research Laboratory of LAUTECH Teaching Hospital, Ogbomoso, Nigeria

Results: A significant difference existed in the mean FSH of fertile [6.97 +/- 3.34] and infertile [13.34 +/- 5.24, P=0.013] women. We observed a significant difference in AMH between fertile [2.71 +/- 1.91] and infertile [1.60 +/- 2.51, P=0.029] women. There was a negative correlation between FSH and AMH in both fertile [r=-0.311, P=0.01] and infertile [r=-0.374, P=0.002] women

Conclusion: The difference in ovarian reserve observed in this study suggests that reduced ovarian reserve in regularly menstruating women may be associated with early ovarian ageing or subfertility

Age as a predictor of embryo quality regardless of the quantitative ovarian response

Background: One determining factor of a successful in vitro fertilization [IVF] cycle is embryo quality. The aim of the present study was to evaluate associations of embryo quality and reserve markers like age, FSH and AMH

Materials and Methods: In this prospective study, 120 infertile women, aged 21-44 years, undergoing routine exploration during an unstimulated cycle preceding assisted reproductive technology [ART] at our center were studied prospectively, from February 2011 to December 2014. Descriptive parameters and patient characteristics were reported as mean [SD] or median [range] depending on the distribution. Student's t test was performed for continuous variables, Wilcoxon and Pearson's Test were used for not distributed variables and Fisher's Test was performed for categorical variables. P<0.05 was considered statistically significant

Results: Overall, at the time of investigation, patients had a mean age of 33.03 +/- 4.15 years old. On cycle day three, serum anti-Mullerian hormone [AMH] level was 3.50 +/- 1.54 ng/mL, serum follicle-stimulating hormone [FSH] level was 6.29 +/- 1.53 mUI/ mL, at baseline, women had 16.57 +/- 7.0 antral follicles. The mean of collected oocytes was 11.80 +/- 5.25, embryo I+II was 2.46 +/- 2.11. A greater number of embryos I+II was observed in young patients. By evaluating 120 patients, a significant relationship was observed between age and FSH [r=0.24, P=0.01], age with AMH [r=-0.22, P=0.02], age with collected oocytes [r=-0.23, P=0.03] and age with embryo I+II [r=-0.22, P=0.03]. A significant relationship was also observed between antral follicle count [AFC] and AMH [r=0.29, P=0.01], AFC and the number of transferred embryo [r=-0.18, P=0.03], AFC and total dose of the drugs [r=-0.23, P=0.03]. Significant relationship of FSH with total dose of drugs [r=0.19, P=0.02] was also observed. In addition, we determined significant relationships between AMH and the number of collected oocytes [r=0.38, P=0.01], AMH and the number of metaphase II oocytes [r= 0.35, P=0.01], AMH and the number of embryo [r=0.19, P=0.04] as well as AMH and total dose of the drugs [r=-0.25, P=0.01]

Conclusion: Commonly used clinical markers of ovarian reserve are reflection of the ovarian reserve, while the outcome measurements of ART and age are the best predictors of embryo quality

Evaluation of central precocious puberty treatment with GnRH analogue at the Triangulo Mineiro Federal University (UFTM)

Objective To report our experience of treating central precocious puberty (CPP) with a GnRH analogue with respect to the final heights (FH) attained in patients who completed treatment. Subjects and methods Among 105 records of children diagnosed with precocious puberty, 62 cases (54 girls and 8 boys), who were treated with leuprolide acetate/3.75 mg/monthly, were selected, and divided into 4 groups: group 1 (G1), 25 girls who attained FH; group 2 (G2), 18 girls who completed treatment but did not reach FH; group 3 (G3), 11 girls still under treatment; and group 4 (G4), 8 boys, 5 of which attained FH. Treatment was concluded at a bone age of 12 years, and follow-up continued until FH was achieved. Results In both G1 and G2 groups, height standard deviation score (SDS), weight-SDS and percentile of body mass index (PBMI) did not show intra/intergroup differences at the beginning and at interruption of treatment, but when added, G1+G2, height-SDS and weight-SDS differed significantly (p = 0.002 and 0.0001, respectively). In G1, 19 of 25 cases attained TH, and average height gain was 16.7 cm (7.7- 27.1); there was significant difference between FH and prediction of FH at the start (PFH at start) (p = 0.0001), as well as between PFH at interruption vs TH and vs FH (p = 0.007) with FH higher than TH (p = 0.004). Significant correlation was identified between FH and height gain after treatment. Conclusion As shown by some studies, GnRH analogue treatment was effective in children with CPP reaching FH near the genetic target.

[Effect of sodium azide on sperm parameters and the serum levels of testosterone, LH and FSH in adult male mice]

Sodium azide is a chemical and toxic compound. The aim of this study was to evaluate the effects of sodium azide on the viability of sperms and the serum levels of testosterone, LH and FSH in mature male laboratory small mice. In this experimental study, 50 Balb/C male mice weighing 20-25g were divided into five groups [10 mice in each group]. The animals were prescribed sodium azide for 60 days. Alternatively 5, 10 and 20 milligrams per kilogram of body weight of sodium azide were fed to the animals in the experimental groups 1, 2 and 3. After the completion of treatment, serum values of testosterone, LH and FSH were measured. The viability of sperms was also studied. The number of sperms in three experimental groups showed significant decrease compared to the control and sham groups [p<0.001]. Serum value of testostrone hormone showed dose- dependently significant decrease compared to the control and sham groups. The serum level of FSH in the experimental groups did not show any significant change compared to the control and sham groups. But, the serum level of LH in experimental groups receiving sodium azide 10, 20 mg/kg increased significantly compared to the control and sham groups [p<0.01]. It seems sodium azide reduces serum level of testosterone and the number of sperms under the process of spermatogenesis in the animals

Prevalence of polycystic ovaries among patients with hirsutism and menstrual abnormalities

Polycystic ovaries are considered to be the most frequent cause of hirsutism with its prevalence of 10% of woman of reproductive age group. Polycystic ovarian syndrome [PCOS] reflects multiple potential etiologies and variable clinical presentations. To investigate the prevalence of polycystic ovaries among patients with hirsutism and menstrual abnormalities [oligo- or oligohypomenorrhea] and to correlate presence of hirsutism with BMI, polycystic ovaries, ovarian volume and biochemical markers. All patients who presented with oligo- or oligohypomenorrhea or hirsutism either in outpatient clinic of Obstetrics and Gynecology, Shalamar Hospital or a private laser clinic were enrolled in study. Patients who had hirsutism with normal menstrual cycle were excluded from study. Enrolled patients were categorized into two groups on basis of hirsutism, group 1: oligomenorrhea/oligohypomenorrhea with hirsutism and group 2: oligomenorrhea/oligohypomenorrhea without hirsutism. A detailed clinical history, clinical examination, hormonal profile and abdominopelvic ultrasound were done in all patients. SPSS- version 16 was used for statistical analysis. Out of 90 patients who enrolled in the study, 10 did not report back, so were excluded from study. Out of 80 patients with menstrual problem, 55 [68.7%] had hirsutism [group 1] and 25 [31.3%] had no hirsutism [group 2]. Prevalence of polycystic ovaries was 815% among patients with hirsutism and oligo/oligohypomenorrhea [group 1] as compared to 44% in patients with oligo/oligohypomenorrhea without hirsutism [group 2]. Ovarian volume >10ml and BMI were not statistically significant among both groups. Regarding hormonal profile, serum LH/FSH ratio and testosterone levels were significant among patients with hirsutism as compared to without hirsutism. Prevalence of polycystic ovaries by morphology, FSH/LH ratio and serum testosterone are significantly present among patients with oligo/oligohypomenorrhea and hirsutism as compared to those with oligo/oligohypomennorhea without hirsutism. However Ovarian volume and BMI are not statistically significant among both groups

Avaliação dos níveis basais de FSH em pacientes inférteis com endometriose profunda de ovário tratadas cirurgicamente / Evaluation of basal FSH serum levels in infertile patients with deep ovarian endometriosis who underwent surgery

OBJETIVO: avaliar a reserva ovariana de pacientes inférteis portadoras de endometriose profunda de ovário, submetidas à cirurgia excisional dos endometriomas, atendidas entre os meses de Fevereiro e Novembro de 2008. MÉTODOS: estudo prospectivo que incluiu 30 pacientes portadoras de endometriose graus III e IV com comprometimento profundo de ovário submetidas à cirurgia excisional dos endometriomas e 30 pacientes portadoras de endometriose graus I e II que foram alocadas como Grupo Controle. A reserva ovariana foi avaliada indiretamente a partir do valor do hormônio folículo estimulante (FSH) basal (U/L), entre o terceiro e quinto dias do ciclo, após um período de 12 meses da cirurgia. O índice de massa corpórea (IMC) foi calculado conforme a fórmula de Quetelet [peso (kg)/estatura (cm²)]. Para a comparação das variáveis "idade", "IMC" e "valores de FSH basal" entre os grupos, foi utilizado o teste não paramétrico U de Mann-Whitney. RESULTADOS: não foi encontrada diferença significativa entre os grupos em relação à idade e ao IMC. Em relação ao FSH basal, observou-se que, no grupo das pacientes com endometriose profunda, o valor médio foi de 7,0 U/L, enquanto que, no Grupo Controle, foi de 5,6 U/L (p=0,3), o que demonstra que a diferença no valor médio de FSH encontrado nos dois grupos não foi significativa. CONCLUSÕES: a cirurgia não influenciou de forma deletéria a reserva ovariana das pacientes com endometriose profunda de ovário.

PURPOSE: to evaluate the ovarian reserve of infertile patients with severe ovarian endrometriosis, submitted to excisional surgery of endometriomas and attended from February to November, 2008. METHODS: prospective study, including 30 patients with endometriosis grades III and IV, with severe ovarian impairment, submitted to excisional surgery of the endometriomas, and 30 patients with endometriosis grades I and II, allocated as a Control Group. The ovarian reserve was indirectly assessed, through the basal (U/L) follicle stimulating hormone (FSH), between the third and fifth days of the cycle, 12 months after the surgery. The body mass index (BMI) was calculated according to Quetelet's formula [weight (kg)/height(cm²)]. The Mann-Whitney non-parametric U test was used to compare the variables "age", "BMI" and "basal SFH" between the groups. RESULTS: there was no significant difference between the groups about age and BMI. Concerning basal FSH, in the group of patients with severe endometriosis, the average value was 7.0 U/L, while in the Control Group, it was 5.6 U/L (p=0.3), what demonstrates that the difference between the two groups was not significant. CONCLUSIONS: the surgery did not affect the ovarian reserve of patients with severe ovarian endometriosis.

Endocrine disorders in patients with sickle cell anemia

Red blood cell transfusions are a therapeutic mainstay in Sickle Cell Disease [SCD] and repeated transfusions can result in iron overload. Endocrine dysfunction is the most common and earliest organ toxicity seen in subjects with chronic iron-induced cellular oxidative damage. The aim of the present work is to investigate some of the endocrine functional disorders in patients with SCD. The present study consisted of 30 patients with SCD [proved by hemoglobin electrophoresis from the start of the condition] recruited from the Medical Department of King Fahd Hospital-Hofuf, Eastern Province-Saudi Arabia. Most of the patients had a history of repeated blood transfusions [5 times/year]. Patients were classified into two groups. Group 1 [15 males] and Group 2 [15 females] with mean age for both sex [28.6 +/- 5.4 years]. Thirty age and sex matched normal subjects were, also, included in the study as a control group. Plasma level of testosterone for group 1 and male control group, FSH and LH for group 2 and female control group. Complete blood count, biochemistry, iron profile, as well as thyroid function tests were assessed for both group 1 and 2 and control group. A total of 30 patients with SCD were recruited in the study [15 males and 15 females] with mean age 28.6 +/- 5.4 years. They were compared to a control group of 30 healthy subjects and showed no significant difference between group 1 and the control group regarding the level of testosterone [5.03 +/- 3.37 Vs 6.95 +/- 1.69; respectively, p0.0S]. Also the plasma level of testosterone showed insignificant correlation with the serum iron level among groupi [r=-O.18.p=0.5]. A significant lower level in T4 was detected in group 1 compared to the control group [5.17 +/- 3.41 Vs. 11.01 +/- 1.44; respectively, p=0.001]. There was insignificant correlation between testosterone level in group 1 and the T4 level in the same group [r=-0.Ol, p=0.89]. On the other hand, no significant correlation was detected between group 1 and control group as regard TSH level [p=0.3]. Female patients with SCD [group 2] have a significant lower level of LH than the control group [72 +/- 5.44 Vs. 16.2 +/- 2.74; respectively, p=0.001]. The present study revealed that there was no significant difference between the level of FSH among group 2 and the control group [6.19 +/- 3, 60 Vs. 6.4 +/- 1.3; respectively, p=0.05], as regard the correlation between the LH level and the serum iron among group 2, there was no significant correlation [r=-0.35, p=0.18]. Also group 2 showed significant lower level of the T4 than the control group [6.5 8 +/- 6.3 Vs 11.64 +/- 1.05; respectively, p=0.001]. On the other hand no significant correlation was found between patients in group 2 and control group as regard TSH level p=0.3]. There was no significant correlation between the level of T4 and the serum iron level in both group 1 and group 2 [p=0.5]. The present study had demonstrated that SCD had a depressant effect on the hormone LH in female patients with SCD, and T4 in both males anti females with SCD irrespective of the serum iron level

relation between the duration of inhalation abuse of a volatile substance and its effect on the testis. a histological and biochemical study in adult male albino rats

Volatile substance abuse in general, and toluene inhalation in particular, for their neuropsychological effects, represents a significant problem in many developed and developing countries. The present work was designed to investigate the histopathological changes in the testis of adult male albino rats, induced by toluene vapour inhalation over different periods. The present study was carried out on forty adult male albino rats with body weights ranging from 60-100g. The animals were categorized into two groups: Group I: [Control Group] included ten rats received no treatment, Group II: [Toluene inhalants] included thirty adult rats exposed to toluene vapour inhalation. A clean dry piece of cotton was soaked with toluene liquid and placed in the covered cages three times daily, each for about thirty minutes for six days per week. These animals were subdivided into three equal subgroups according to the exposure period; Subgroup [A]: ten rats exposed to toluene vapour for two weeks, Subgroup [B]: ten rats exposed to toluene vapour for eight weeks, Subgroup [C]: ten rats exposed to toluene vapour for twelve weeks. At the end of each duration of the experiment, animals were scarificed by decapitation using light ether anesthesia after taking blood samples. I- Histological examination: Specimens were taken from the testis of all rats and processed for examination by light microscope using haematoxylin and eosin stain and ultrastructural study using the transmission electron microscope. II. Hormonal assay: The concentration of testosterone level, luteinizing hormone [LH] and follicle - stimulating hormone [FSH] were estimated by radio immunoassay. III. GAS chromatography: Concentration of toluene vapour in the blood was measured by High performance liquid chromatography. IV. Statistical analysis: The one way ANOVA test was applied to estimate the significant values of the hormonal assay for serum testosterone, LH and FSH and the 5% level of significance was chosen. The histopathological changes observed in the testis of rats exposed to toluene inhalation demonstrated its potentials to induce cytotoxic effects on the spermatogenic cells, Sertoli cells and the interstitial cells of Leydig. The severity of the toluene damaging potentials appeared to be dependent on and directly proportionate to the duration of toluene inhalation. So, the histological changes were mild and scattered in the testis specimens of group A [2 weeks inhalation] and was more severe in both eight and twelve weeks groups. The correlation between high performance liquid chromatography for toluene gas in blood, the biochemical gonadal and gonadotrophin hormonal assay and the histological assessment, explored the various mechanisms that were incorporated in the establishment of the toluene induced testicular injury. The present study proved the undoubting evidences for the damage potentials of toluene on the testis as the major reproductive organ in the male. Furthermore, the study showed the direct proportionality between the toxic effects of toluene vapor and the length of the exposure duration. Yet, the observed histological alterations were highly suggestive for a probable impaired reproduction in experimental animals which needs further study

Metformin improves insulin sensitivity and hyperandrogenemia in Egyptian hirsute patients with polycystic ovary syndrome

PCOS is a heterogeneous clinical syndrome characterized by a spectrum of symptomatology, pathology and laboratory findings. It is now accepted that polycystic ovary syndrome has important long-term health implications, including metabolic disorders and increased risk factors for cardiovascular disease like insulin resistance, abdominal obesity, dyslipidemia, hypertension and markers of abnormal vascular function. The aim of this work was to study the effect of metformin on the clinical, metabolic and endocrine parameters in hirsute women secondary to polycystic ovary syndrome. The study was conducted on 30 Egyptian hirsute patients suffering from polycystic ovary syndrome. Clinical examination included anthropometric measurements [BMI and WHR] and Ferriman and Gallwey scoring for hirsutism. Fasting serum insulin and fasting blood glucose were measured from which insulin resistance [IR] was assessed by HOMA. The glucose to insulin ratio [GIR] was calculated. Lipid profile was estimated. Serum luteinizing hormone [LH] and follicle stimulating hormone [FSH] were estimated in the early follicular phase. Total serum testosterone and sex hormone-binding globulin [SHBG] were measured. Ultrasonographgy was done on the pelvis for examination of the ovaries. The patients were instructed to do diet and physical exercise. They received metformin 1500 mg/day for 6 successive months. Clinical, metabolic and endocrine parameters were reevaluated after the medication. A significant 31% improvement in the frequency of the menstrual cycle was observed. Hirsutism improved by 19%. BMI was reduced by 8%. WHR decreased by 2.3%. Insulin resistance decreased by 54%. Total serum cholesterol, LDL-cholesterol, serum triglyceride and total cholesterol/H DL-cholesterol ratio showed slight decrease [3%, 6%, 9% and 9%, respectively], while HDL-cholesterol showed a slight increase by 7%. Total serum testosterone decreased by 32% and LH/FSH ratio improved by 28%. SHBG levels increased by 9%. There was a positive correlation between BMI and HOMA-IR, serum cholesterol and serum TG. There was a highly significant positive correlation between BMI and FBG as well as fasting serum insulin and HOMA-IR. On the other hand, there was a significant negative correlation between BMI and GIR. A highly significant positive correlation was found between BMI and total cholesterol and TG. Also, there was a significant positive correlation between BMI and total cholesterol/HDL-cholesterol ratio. Again, BMI showed a highly significant positive correlation with LH/FSH ratio. There was a highly significant positive correlation between WHR and the frequency of the menstrual cycle and fasting serum insulin. There was a significant positive correlation between WHR and HOMA-IR, serum total cholesterol and TG. There was a significant negative correlation between WHR and SHBG. HOMA-IR showed a significant positive correlation with GIR. Metformin improves insulin sensitivity and hyperandrogenemia in Egyptian hirsute women with polycystic ovary syndrome. This is associated with improvement in menstrual abnormalities. Metformin has additional benefit in reducing hair growth in Egyptian hirsute young women with polycystic ovary syndrome

Prediction of successful sperm retrieval in patients with nonobstructive azoospermia

Our aim was to evaluate the predictive values of factors that indicate successful sperm retrieval in men with nonobstructive azoospermia. We evaluated 85 infertile men with nonobstructive azoospermia who underwent multiple bilateral testicular biopsies. Factors including age, infertility period, surgical history, testicular volume, testicular consistency, serum follicle-stimulating hormone [FSH], serum inhibin B, serum luteinizing hormone, and serum total testosterone were assessed in relation to sperm retrieval results. Spermatozoa were retrieved in 18 biopsies [21.2%]. Follicle-stimulating hormone, serum inhibin B, and testicular volume were associated with the results of sperm retrieval. Men with a higher testicular volume, a higher serum inhibin B, and a lower FSH had successful sperm retrieval. The cutoff points were determined as 9.5 mL for testicular volume, 9.9 IU/L for serum FSH, and 39.8 pg/mL for serum inhibin B. These 3 factors had strong correlations with each other. The sensitivities and specificities were 88.9% and 94% for testicular volume, 97% and 83.3% for FSH, and 72.2% and 95.5% for serum inhibin B, respectively. The positive predictive value for a combination of serum FSH and inhibin B was 100%. Serum FSH and serum inhibin B are useful markers for evaluation of the presence of sperm in patients with nonobstructive azoospermia. Inhibin B has a high specificity when combined with serum FSH and their measurements can be helpful in all patients with nonobstructive azoospermia before decision making for sperm retrieval

relation between third day FSH level and incidence of poor response in patients undergoing ART cycles

The number and the quality of oocyte are very important in ART cycles. The level of FSH on third day of menstrual cycle plays an important role in success ART cycles. To study the relation between third day FSH level and ovarian response in patients undergoing control ovarian hyperstimulation for IVF cycles. This was an analytical study in which 2200 files form patients referred to Royan institute between 1991 and 1999 were examined. The study group included 212patients whose serum FSH was measured for a maximum of six months before ovation stimulation with long protocol GnRHa. Exclusion criteria included endometriosis and pervious treatment with ART. The patients were divided into two groups on the basis of third day serum FSH levels. Group I included 36 patients with FSH >/= 151IU/L and group II included 176 patients with FSH<151IU/l. The data [age, number of mature follicles, infertility duration, infertility type, and the levels of FSH, LH and progesterone] were analyzed X[2], t-test and Fisher's exact test. Finding: There statistically significant differences between two groups in the number of mature follicles [3.3 +/- 3.3 vs. 5.2 +/- 2.9, respectively], number of oocytes [4.5 +/- 7.75 vs. 7.0 +/- 5.5]], number of transferred embryos [1.4 +/- 1.5 vs. 2.2 +/- 1.7], number of cancelled cycles [30.5% vs. 2.8%] and the level of serum LH [23.5 +/- 20.5 vs. 9 +/- 8.5]. The third day level of serum FSH can be relatively used as a predictor of ovarian reserve and success of ART cycles

Gonadal hormones and gonadotrophins in healthy males beyond forty years

To determine and compare the sex hormones, gonadotrophins and sex hormone binding globulin [SHBG] in healthy males of different age groups. One hundred eighty five consecutive healthy nonobese males of age 40-90 years were studied. Serum samples were assayed for total testosterone, estradiol, LH, FSH and SHBG estimation by radioimmunometric method. The subjects were divided into five age groups and the mean serum concentrations of each parameter were compared among the groups. No significant difference in the mean serum concentrations of total testosterone, SHBG, LH and FSH was found among the different age groups[p> 0.05 by Anova]. Significant age related decrease was found in the serum estradiol concentration [p< 0.05] by both Anova and Pearson's Correlation test. There is no significant age related change in serum total testosterone, gonadotrophin and SHBG concentrations in healthy males beyond forty years. Significant age related decrease in serum estradiol needs further studies

Estrogenic action of tamoxifen in women treated with leutinizing hormone releasing-hormone agonist goserelin [zoladex]: lack of shrinkage of uterine fibroids

Six premenopausal women with uterine fibroids were treated with a combination of tamoxifen 20mg/d and Zoladex 3.6mg every 28 days for a total of 24 weeks. Results were compared with those from six women matched for pretreatmented uterine volume who had been treated with zoladex alone. During combined therapy, plasma and urinary estrogen concentrations were significantly lower than during Zoladex alone, whereas sex hormone binding globulin concentrations were significantly higher. Plasma LH and FSH concentration were both suppressed in contrast with results during Zoladex alone when FSH levels remained with the pretreatment range. None of the women on combined therapy bled in response to the endocrine change of the internal treatment cycle. Despite this profound pituitary-ovarian suppression. There was no significant change in uterine volume during combined therapy. The results suggest that tamoxifen is acting as an estrogen agonist in women rendered hypoestrogenic with luteinizing releasing hormone agonist. We failed to demonstrate any decrease in size of uterine fibroids when the antiestrogen tamoxifen was administered continuosly as a single agent. However, this lack of response was attributable to significant elevation of estrogen concentration during tamoxifen therapy

Reference intervals for important serum sex steroid hormones, prostate specific antigen, insulin like growth factor 1 and IGF binding protein 3 concentration in a normal Kuwaiti adult male population

The purpose of this study was to determine the age-specific reference ranges for some important male sex steroid hormones, prostate-specific antigen [PSA], insulin-like growth factor-1 [IGF-1], and IGF binding protein-3 [IGFBP-3], for the Kuwaiti population. Blood samples were taken from 398 consenting, fasting, healthy Kuwaiti males aged 15-80 years between 8.00 a.m. and 12.00 noon. The serum concentrations of total testosterone [TT], dehydro-epiandrosterone sulfate [DHEAS], androstenedione [ADT], sex hormone binding globulin, luteinizing hormone [LH], follicle-stimulating hormone [FSH], prolactin, PSA, IGF-1 and IGFBP-3 were determined. A distribution curve was plotted and age-specific reference levels were determined for each analyte. The reference interval for parameters with a normal distribution [Gaussian] was mean +/- 2 SD, while for the non-normal distribution [non-Gaussian], it was 2.5-97.5 percentile. The reference intervals for the analytes obtained from this study were compared with those suggested by the kit manufacturers and currently used by the Ministry of Health, Kuwait Laboratories [MOHKL]. Serum IGFBP-3 and ADT had normal distribution while other analytes had non-normal distribution. The reference intervals from this study, manufacturers kit and MOHKL were as follows: TT 3-31, 9-60, 8-35 nmol/l; DHEAS 0.9-11, 1.0-7.3, 2.2- 15.2 micro mol/l; ADT 0.5-4.3, 0.8-2.8, 2.0-9.2 nmol/l; LH 1-11, 0.8-7.6, 0.4-5.7 mIU/l; FSH 0.5-11, 0.7-11.1, 1.1-13.5 mIU/l; prolactin 42-397, 53-360, 80-230 nmol/l; IGF-1 41-542, 78-956, 71-261 ng/ml; IGFBP-3 88- 2,090, 900-4,000, 900-4,000 ng/ml, and PSA 0-3.1, 0-4, 0-4 ng/ml, respectively. These data indicate that for Kuwaitis lower reference ranges must be used for serum TT, DHEAS, ADT, IGFBP-3 and PSA. There is no need to change the currently used reference interval for FSH whereas higher values must be used for LH, prolactin, and IGF-1