1. Abstract Results Effects of Iron Therapy on Pituitary Gonadal Axis and Sperm Parameters in Adults with Iron Deficiency Anemia (IDA). Ashraf T. Soliman, Mohamed Yassin*, Mohamed O Abdelrahman ** The Departments of Pediatric Endocrinology,Hematology *and Clinical Chemistry**, Hamad Medical Center, Doha, Qatar (ATSOLIMAN@yahoo.com) OBJECTIVE: To evaluate semen parameters and measure serum FSH, LH, Testosterone (T) concentrations before and 6 weeks after intravenous (800-1200 mg elemental iron iron therapy in adults with iron deficiency anemia. Patients and methods: This study investigated 11 adults with iron deficiency anemia (IDA) aged 40+/- 5 years, with full pubertal development (Tanner stage 5, eugonadal) and capacity to ejaculate. They had iron deficiency anemia mainly due to defective intake of iron. Anemia was diagnosed when Hb is = or < 10g/dl. (Serum iron, TIBC and ferritin) concentrations confirmed the diagnosis of IDA. Basal serum concentrations of FSH, LH, and T were evaluated before and 6 weeks after I V iron therapy OBJECTIVE: To evaluate semen parameters and measure serum FSH, LH, Testosterone (T) concentrations before and 6 weeks after intravenous (800-1200 mg elemental iron iron therapy in adults with iron deficiency anemia. Patients and methods: This study investigated 11 adults with iron deficiency anemia (IDA) aged 40+/- 5 years, with full pubertal development (Tanner stage 5, eugonadal) and capacity to ejaculate. They had iron deficiency anemia mainly due to defective intake of iron. Anemia was diagnosed when Hb is = or < 10g/dl. (Serum iron, TIBC and ferritin) concentrations confirmed the diagnosis of IDA. Basal serum concentrations of FSH, LH, and T were evaluated before and 6 weeks after I V iron therapy After IV iron therapy : A)Significant increase of hemoglobin from 8.1 ± 01.17 g/dL to 13.1 ± 0.7 g/dL was associated with B)Increased T (from 12.22 ± 1.4 nmol/L to 15.9 ± 0.96 nmol/L), FSH (from 2.82 +/- 0.87 to 3.82 +/- 1.08 IU/L) and LH (from 2.27 +/- 0.9 to 3.82 +/- 1.5 IU/L) C)Total sperm count (TSC) increased significantly from 72 +/- 17.5 M/ml to 158 ± 49 M//mL (p < 0.001) D) Rapid progressive sperm motility (RPM) increased from 22+/- 9.4 to 69 ± 30 M/ml (p, 0.001) E) Sperms with normal morphology (NM) increased from 33 +/- 5 to 56 +/- 7 M/ml (p < 0.001). Correlations: Hemoglobin concentrations were correlated significantly with T (r = 0.75, p < 0.001) total sperm count (r = 0.81, p < 0.001), total progressive motility (r = 0.78, p < 0.001), rapid progressive motility (r = 0.74, p < 0.001) and sperms with normal morphology (0.88, p < 0.001). Testosterone concentrations were correlated with total sperm count (TSC) (0.52, p < 0.001), total progressive motility (0.55, p < 0.001) and RPM (0.55, p <0.001) and NM (0.78, p 0.001). After IV iron therapy : A)Significant increase of hemoglobin from 8.1 ± 01.17 g/dL to 13.1 ± 0.7 g/dL was associated with B)Increased T (from 12.22 ± 1.4 nmol/L to 15.9 ± 0.96 nmol/L), FSH (from 2.82 +/- 0.87 to 3.82 +/- 1.08 IU/L) and LH (from 2.27 +/- 0.9 to 3.82 +/- 1.5 IU/L) C)Total sperm count (TSC) increased significantly from 72 +/- 17.5 M/ml to 158 ± 49 M//mL (p < 0.001) D) Rapid progressive sperm motility (RPM) increased from 22+/- 9.4 to 69 ± 30 M/ml (p, 0.001) E) Sperms with normal morphology (NM) increased from 33 +/- 5 to 56 +/- 7 M/ml (p < 0.001). Correlations: Hemoglobin concentrations were correlated significantly with T (r = 0.75, p < 0.001) total sperm count (r = 0.81, p < 0.001), total progressive motility (r = 0.78, p < 0.001), rapid progressive motility (r = 0.74, p < 0.001) and sperms with normal morphology (0.88, p < 0.001). Testosterone concentrations were correlated with total sperm count (TSC) (0.52, p < 0.001), total progressive motility (0.55, p < 0.001) and RPM (0.55, p <0.001) and NM (0.78, p 0.001). Conclusions This study proved that correction of anemia with IV iron therapy is associated with significant enhancement of sperm parameters and increased concentrations of serum T, LH, and FSH. These effects on spermatogenesis are reached by an unknown mechanism and suggest a number of pathways that need further human and/or experimental studies. Before TreatmentAfter Treatment Sperm count (Million/ml)2Mean 72.0158.2* SD 17.649.6 Volume (ml)Mean 2.32.5 SD 0.60.7 Total PM (M/ml)Mean 32.9100.3* SD 8.640.0 RPM (M/ml)Mean 22.269.8* SD 9.430.2 SPM (M/ml)Mean 10.530.45* SD 5.113.4 NPM (M/ml)Mean 18.223.2* SD 12.412.3 Immotile (M/ml)Mean 21.134.8* SD 8.714.3 Normal Morphology (%)Mean 33.056.8* SD 5.27.1 Total PM = total progressive motility, RPM = rapid progressive motility NPM = normal progressive motility