A SYNDROME OF EUNUCHOIDISM WITH SPERMATOGENESIS, NORMAL URINARY FSH AND LOW OR NORMAL ICSH: (“FERTILE EUNUCHS”)*

Abstract

WHETHER androgen deficiency is of the severest grade, as in eunuchism, or of less severe grade, as in eunuchoidism, and whether it is of testicular or of hypophyseal origin, the testes are almost invariably aplastic or atrophic and in consequence distinctly small. To find normalsized testes in an individual who otherwise has all the attributes of a eunuch is an impressive sight and is the key to the syndrome to be described: The finding of normal or nearly normal-sized testes under such circumstances indicates two simple facts: a) that eunuchism is not testicular failure, but androgen deficiency; and b) that testicular mass depends largely on the bulk of the tubules present. Eunuchs and eunuchoids are almost invariably sterile and, so far as we can judge from our experience and that of others, there is seldom spermatogenesis to be demonstrated by testicular biopsy. In the 5 patients described here, there were moderate numbers of spermatozoa in almost all tubules prior to treatment; and in 2 there were normal numbers of sperm in the semen.