Infertility is considered problem healthy great; it happens non ability the couple non activists sexually on pregnancy after 12 months on the least from connection sexual abuse non protected. Impact infertility on each from men and women [2]. Referring to the term Infertility in women to me non ability absolute on pregnancy [44]. While it is done definition of infertility at male not ability the male on investigation pregnancy in a female fertile after year or More from Intercourse Sexual abuse non protected [25]. As the fertility male she results the final for several from processes regular which Must be that working all of them in a manner integral to allow by inserting the sperms Sound to the system reproductive female, and that any defect in any from this is steps may result in an occurrence infertility [40].

Can be evaluated infertility at male from thorough analysis liquid Semen and some hormones [20]. Where they include the reasons Hormonal Infertility Male Diseases Congenital or Acquired in an area Hypothermia or Pituitary gland or Testicular which lead to a change axis Hypothermia the Pituitary [1]. Reacts testosterone and androgens Other with Collection big and varied from cells targeted, and so for development occupation nationality and stimulation formation the animals sperm Support Motivation Sexual abuse male, The hormone Lutein (LH) stimulates secretion steroids nationality from glands genital, either in a Testicles, is linked this hormone to receptors on cells called Leydig cells, and its activates Synthesis Testosterone, works Hormone Stimulated of the Follicle (FSH) on stimulation Production the animals sperm and maturity, Either prolactin Overload Linked Gynecomastia and disability sexual [1].

That axis glands Hypothermic - Pituitary - Testicular importance in a fertility Men [34]. That is gonadotropins and testosterone they organizers presidents for evolution cells germ [38]. Testosterone Necessary for growth and division cells germ in a formation the Sperms [34]. Indicates   height   FSH in the blood   in  a  manner marked to me Existence defect in a formation the animals Sperm, in what is considered the focus the above for FSH an indicator reliable with it for damage epithelium seminiferous tubule, as help relations between concentrations hormone Testosterone, LH, FSH and PRL on provide Understanding for source hormone Testosterone non-natural [5]. As considered provide quantity enough from Testosterone an order decisive to stay cells Sertoli and the process of differentiation continues for Spermatogenesis [45]. Ghrelin it is hormone derivative from the channel gastrointestinal   and   linked   in   the origin behavior mission in a carrier’s biological variety like appetite, memory, functions of blood vessels and neurological protection after brain injury [24], as that ghrelin he is also organizer main for a response glands deafness for stress [42] and reproduction [22].

The present study aims to evaluation of sex hormones levels (Testosterone, LH, FSH and prolactin) in blood samples from sterile men.

Patients

A study carried out in Salah Alden and Al-Shirqat hospitals, through year 2019. Sixty blood samples have been taken from infertile men aged [18-50] years, divided into three categories its less than 30, 31-40 and more than 40 years. Also taken information about the period infertility, smoking and family history. In addition to thirty samples from apparently healthy persons as control group.

Serum Hormonal Assessment

Blood samples were obtained following 12 h of fasting. The level of hormones, FSH, LH, Testosterone, prolactin was measured for all patients and controls, according to the manufacturing kits (Monobind Inc lakeforst), CA92630, USA), and Ghrelin by (RAY Biotech, USA) using Elisa Technique.

Statistical Analysis

After collection the data done arrangement and sorting by Microsoft Excel (2007). The statistical analysis was done using the statistic package for Social Science (SPSS) version (19) (SPSS, 2010).

The results of Table [1] show significant differences in the concentration of serum ghrelin, testosterone, FSH and Prolactin hormones between my patients and control group at a probability level of 0.01, except LH differences in his concentration did not reach the limits of statistical significance. We note that the concentrations of the hormone ghrelin and testosterone in the group of patients to lower levels testosterone 1.881 and 4.920 ng/ml for patients and consecutive control. On the other hand, we observe a high concentration of hormones FSH, LH and Prolactin than in the group of healthy, as the concentrations of ghrelin 2.169 and 5.433 mμ/ml in the two groups of patients and control respectively, while total in the group of infertility patients with a value of 17.830 and 5.111 mμ/ml and 21.665 ng/ml Respectively, while the concentrations of the control group reached 7.863 and 4.386 mμ/ ml and 6.303 ng/ ml. 

Was levels hormone the ghrelin low in a manner marked by individual's collection infertility comparison with the control, and agree this is Results with (Furuta et al., 2001), whose they reported that hormone The ghrelin discouraged secretion LH and FSH. As it may be the influence directly from Through GnRH -LH and GnRH- FSH or in a manner non direct from through hormone release about corticosteroids (CRH), As agreed with studies of both [23, 26], whose they found that hormone ghrelin discouraged secretion LH Spring, noted [8] to that expression ghrelin relies on the influence motivational for 

Table 1: Shown comparison between hormonal levels of patients and control group

** = significant at P≤0.01, * = significant at P≤0.05, NS= Non-significant.

Table 2: Hormonal levels of the patients according to Age

** = significant at P≤0.01, * = significant at P≤0.05, NS= Non-significant.

Table 3: Hormonal levels of the patients according to Infertility period

** = significant at P≤0.01, * = significant at P≤0.05, NS= non-significant.

Table 4: Hormonal levels of the patients according to Smoking

** = significant at P≤0.01, * = significant at P≤0.05, NS= non-significant.

Table 5: Hormonal levels of the patients and control according to Family history

** = significant at P≤0.01, * = significant at P≤0.05, NS= non-significant.

LH. El - [14] existence impact negative for hormone the ghrelin on levels hormone Testosterone, LH and FSH which seen also Human beings. Got [19] on levels low from hormone the ghrelin in some men whose suffer from failure glands genital comparison healthy people.

The level of testosterone for members of the infertility group in the current study is close to the minimum range of natural, and this indicates that a high proportion of members of this group had testosterone values have less than the normal minimum of 1.68 ng/ml. Reflecting evaluation LH And FSH the imbalance in function testicular it produces about him change in a relationship nutrition natural between testicular gesticulate Hypothermia, as it relates Infertility at men with concentrations directed for gonadotropins which different in a manner large about levels natural [18] . The increase achieved in a levels FSH and LH she stimulates cells Sertoli and Leydig from synthesis proportional and excretion hormone testosterone and therefore improvement formation the Sperms. It is at high levels FSH and LH plasma they will exert influence reply verb passive on axis testicular - hypothalamopituitary - testicular and therefore become Testosterone plasmodium low or natural [15]. These agree results with what I approve Fakhrildin [16] in a height and/or oscillation atheism FSH and/or LH for them effect direct on some standards the Sperms. The results of the study showed Bhale and Mahat [9] although from nonexistence drop large in a levels hormone Testosterone in a male suffering from Infertility Compared to the control group, the observed height is in levels FSH and LH she to stimulate cells Sertoli and Leydig from synthesis proportional and excretion hormone testosterone and therefore improvement formation the sperms. He got both Al- Nahi and [38] on testosterone values in the group of infertility patients within the normal range but less than the healthy control group.

That hyperactivity Prolactin the blood it weakens male fertility by suppressing synthesis Testosterone, as it's a form known well that hyperactivity Prolactin the blood decreases the desire nationality it causes shortage in the production of sperm [33]. From Hand Other, might happen hyperactivity Prolactin blood is due collection variety from factors pathological, such as pituitary tumor and disorders Hypothermia and palaces glands genital and palaces gland Thyroid, and this is my Indicates to me some turbulence in a Process formation the sperms in the patients whose suffer from infertility [39]. The results of the present study are consistent with their findings Al- Nahi of the existence of differences related indication statistic (P 0.05 0.05) in hormones FSH, Testosterone and Prolactin in a group male who suffer from infertility comparison with the control group fertile, while the differences between the hormone mediators did not reach LH for the two groups of study to the limits of statistical significance. As you got AL- Shammaa showed significant differences in levels of testosterone hormones FSH and LH and non-significant for prolactin between the two groups of infertility and the control they studied.

Shown in Table (2) The effect of the age category on the mean concentrations of Ghrelin, testosterone, FSH, LH and Prolactin hormones in the group of infertility, and note that there are no significant differences in the concentrations of these hormones according to the age of people. For Ghrelin hormone, the differences were clear and increased with age, with averages of 0.376, 1.995 and 2.01 mμ/ml for age groups of less than 30, 31-40 and more than 40 years, respectively.

Testosterone concentrations were few differences and trod concentrations behavior is not clear, certain testosterone is not affected by the age of people, reaching values of 1.866 and 1.917 and 1.84 ng/ml for age groups of less than 30, 31-40 and more than 40 years, respectively.

Table (2) shows that the mean concentrations of the follicle stimulating hormone FSH high differences showed different age group, although aware of the moral boundaries reached statistical, but it gave less value to the level of probability, as we find that the average concentrations increased with age, reaching values 16.688 and 18.173 and 20.12 mμ/ml for age groups of less than 30, 31-40 and more than 40 years, respectively.

For the effect of age on the mean concentrations of lutein LH the differences were minor, and the behavior of the hormone concentrations was not clear. Concentration decreased in the middle class to rise again in the upper category, with values of 4.911, 4.873 and 6.2 mμ/ml for age groups of less than 30, 31-40 and more than 40 years, respectively.

For prolactin, concentrations have behaved similarly to hormone behavior LH, where the concentration in the age group (less than 30 years) was 21,796 ng/ml, then dropped in the middle category (31-40 years) to score 20,834 ng/ml, then increased in the upper category (more than 40 years) to 23.22 ng/ml.

The effect of the age factor infertility differently and interferes with a lot of genetic, psychological and social factors and general health condition of the patient, in a study Mossa [30] did not appear relationship or influence for the worker Age on the indicators of infertility, as the effect was simple and not statistically significant. While the results of the study Khadhim et al. [21] that higher rate for males infected infertility it was between age 20-29 years (46 %), followed by category age 30-39 years (40 %), as mentioned Mostafa [31] in his study that higher rate for men infected infertility in an age less from 30 years, followed by age 30-34 years and low with progress in age. Done get on results similar from a study done in an Iran founded that the majority of the patients they were within category Age 20-29 years [29]. The be this is results because marriage early. While reported studies other about a plus number men infected infertility at age 26-35 years (63.50 %) because smaller categories age be in need to get on more from tips medical and they more focus on reproduction child, in addition to me that they face more from pressure psychological and tension About family and working conditions of these active groups. As shown by evaluation quality liquid semen frequency ejaculation careers the Sperms are decreasing gradually with progress age It starts in a decline after 35 years old [35]. And if there is an effect of some genetic diseases as in a chromosome X additional can that ranging degree Testosterone in a plasma from natural to me low, but it is are decreasing with progress in an Age [37].

Table (3) shows the effect of infertility on concentrations of Ghrelin, testosterone, FSH, LH and Prolactin hormones in the group of infertility, and there are no significant differences in the length of infertility at the levels of these hormones. We note that for Ghrelin hormone the average concentration was 2.174 mμ/ml when the period of infertility was less than 5 years, then rose to 2.409 mμ/ml when the period of infertility 5-10 years, then decreased at a period of infertility more than 10 years to record 1.883 mμ/ml.

The concentrations of testosterone reached a high of 2.090 ng/ml, when the period of infertility less than 5 years, while the periods 5-10 and more than 10 years averaged close to 1.757 and 1.783 ng/ml Respectively.

The effect of infertility on the concentration of the hormone FSH. The concentration of the hormone was low during the period of infertility micro (less than 5 years), reaching 16,095 mμ/ml, and increased concentration with an increase in the period of infertility, reaching 18.747 and 18.743 mμ/ml at intervals of 5-10 and over 10 years respectively.

Note from Table (3) that the concentration of the hormone LH his behavior was unclear at different periods of infertility, with an average concentration of 5.513 mμ/ml when the infertility period is less than 5 years, then dropped to score 4.976 mμ/ ml when the period of infertility 5-10 years, then rose to reach 5.344 mμ/ ml when infertility period more than 10 years.

The effect of the period of infertility on the concentration of the hormone prolactin, notes that hormone concentrations were close at periods of infertility studied, reaching 21.904 and 21.214, and 21.911 ng/ml at periods of infertility less than 5, 5-10 and over 10 years, with no regularity in concentration behavior.

The effect of the period of infertility after marriage was differentiated behavior on the hormones studied, although there are no studies on the effect of this factor on the levels of these hormones, it may be based on the effect of age factor mainly, it is noted for the hormones and testosterone ghrelin has tended to decline with the increase period Postpartum infertility, as well as high levels of FSH and prolactin hormones. These are negative indicators that exacerbate infertility with an increased period of postpartum illness. These results can also be attributed to the deterioration of patients' mental state.

The effect of the smoking factor on the mean concentrations of Ghrelin and testosterone hormones is shown in Table (4) FSH, LH And Prolactin In the group of infertility patients, and there is no significant differences between the categories of smokers and non-smokers in the concentrations of all hormones studied, as it turns out that the mental smokers have recorded averages for concentrations of hormones and Ghrelin, FSH, LH and Prolactin higher than that of non-smokers, while the average testosterone in smokers decreased compared with nonsmokers .

For the effect worker smoking showed a study [30] this occurs decline in a rate the natural sperms and get distortions in a form the sperms have category of person's smokers. [30] stated that smoking cigarettes chronic increases from process the acting food for hormone Testosterone in the liver, while lead in a time himself to me defect functional in a secretion cells Leydig and Sertoli. While sound it's a no exist consensus public on effects smoking on production hormone FSH and LH. Showed some studies decline levels each from directed glands genital between smokers, in a when note researchers different a plus concentration LH and/or FSH as well as about a plus concentration hormone Testosterone in the blood after consumption tobacco [10]. View to me frequent factors influencing and overlapping, hard making sure in a manner large from concentration Testosterone between smokers, he pointed out [17] to an increase levels hormone Testosterone in the blood has smokers, in a when pointed out others to me that levels medium from Testosterone no different great between smokers and not smokers [36]. reduction levels LH and/or FSH [41].

Table (5) shows the effect of family history on mean concentrations of Ghrelin, Testosterone, FSH, LH and Prolactin hormones in the group of infertility patients. There was no statistically significant effect on this factor. The group of patients with a family history had higher mean scores than those who did not have a family history in the concentrations of Ghrelin hormones, LH, Testosterone and prolactin values were 2.209 and 5.138 mμ/ml and 1.898 and 21.856 ng/ml for each of them respectively, while the average hormone concentration decreased.

FSH in patients with a family history was lower than in patients with no family history, with values of 17.658 and 18.69 mμ/ml for the two categories respectively.

Family history is important in cases of genetic disorders and chromosomal anomalies, in case of injury delete in a chromosome Y within family history, this leads to similar genetic defects in the offspring, so before submission for any techniques help on reproduction, must be submit test genetic appropriate for those individuals [12]. As the syndrome Kleinfelter which is considered reason common to palaces glands which is a disorder hereditary output about existence chromosome X additional in a male [11]. So it is the pattern nuclear weapons for every cells he is XXY as a result for disorder material congenital from the mother or the father during process formation the apparitions [7]. Among its most prominent symptoms are high levels glands genital in a manner special, especially FSH. Can that be ranging degree Testosterone in a plasma from Natural to me low, but it is are decreasing with progress in an age. frequently what Increasing levels LH in serum, as that Levels High estradiol in a Serum is encouraged the increase in a SHBG. Results SHBG high in a Levels high from hormone testosterone associated with and low levels hormone testosterone free, he is what explains non consistency between levels hormone testosterone total in the blood and degree androgenic. That's high levels hormone estrogen rate to me hormone testosterone it causes the appearance feminine and gynecomastia [37]. Either syndrome Sertoli that has been impact secondary for defects genetic, in which levels hormone Testosterone serum and serum LH Natural, but FSH serum usually high [28]. Studies on the impact of family history are very few, as most researchers avoid them because of differences and overlaps and the need for large genetic assessments, in the study [15] which included several subgroups of infertile persons indicating no date familial infertility in an all cases which done study, and therefore may attributable infertility observed factors hormonal initial or secondary schools, and their results showed increases Morality in a FSH and LH. As he pointed out [38]. In their study, which included chromosomal analysis of members of the infertility group they studied, there was no family history of infertility.

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