Sustained inhibition of sperm production and inhibin secretion induced by a gonadotrophin-releasing hormone antagonist and delayed testosterone substitution in non-human primates (Macaca fascicularis)

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Abstract
Since the concomitant administration of a gonadotrophin-releasing hormone (GnRH) antagonist and testosterone suppresses sperm production only incompletely, the feasibility of treatment with a GnRH antagonist and delayed testosterone supplementation for sustained suppression of sperm production in a non-human primate model was investigated. Adult cynomolgus monkeys (Macaca fascicularis; five/group) received daily s.c. injections of the GnRH antagonist [N-acetyl-d-2-naphthyl-Ala1,d-4-chloro-Phe2,d-pyridyl-Ala3,nicotinyl-Lys5,d- nicotinyl - Lys6, isopropyl-Lys8,d-Ala10]-GnRH of either 450 or 900 μg/kg for 18 weeks. During week 6 of the GnRH antagonist treatment, all monkeys were given a single i.m. injection of 40 mg of a long-acting testosterone ester (testosterone-trans-4-n-butylcyclo-hexanecarboxylate; 20-Aet-1). Within 1 week, serum LH bioactivity was suppressed in both groups and remained low throughout the entire treatment period. Similarly, concentrations of serum testosterone declined precipitously. During week 6, substitution with testosterone restored concentrations of serum testosterone into the pretreatment range. Concentrations of serum inhibin declined within 1 week and remained suppressed during the period of treatment with the GnRH antagonist. Testicular volumes were reduced to approximately 25% of pretreatment values in both groups by week 8 and stayed in that range during the remaining period of administration of the GnRH antagonist. During the first 6 weeks of administration of the GnRH antagonist, the ejaculatory response to electrostimulation and the volume of the ejaculates diminished with time. Supplementation with testosterone during week 6 restored the ejaculatory responses within 2–3 weeks. From week 9 of GnRH antagonist treatment onwards, all monkeys given 450 μg/kg and four monkeys given 900 μg/kg produced azoospermic ejaculates. The fifth animal in the latter group became azoospermic during week 13. Azoospermia persisted throughout the entire period of treatment with the GnRH antagonist and for a further 7–13 weeks. All suppressive effects of administration of GnRH antagonist were reversible. During the recovery phase the increase in testicular volumes paralleled an increase in concentrations of serum inhibin. The suppression of inhibin levels during the period of administration of testosterone indicates that Sertoli cell activity was not restimulated by testosterone. In conclusion, GnRH antagonist treatment with delayed supplementation with testosterone might serve as a model for further research towards the development of an endocrine male contraceptive. The recovery pattern of serum levels of inhibin suggests that inhibin could serve as a marker for Sertoli cell activity. Journal of Endocrinology (1989) 123, 303–310

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