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OCR: Men with sickle cell disease usually ha nt, and incomplete secondary sexual developm The defect testicular atrophy is present in one-third The may either be at the testicular level or a Leydig cell hypothalamic-pituitary level. Decreased m density, function, with or without decreased sper eases; the occurs in a variety of chronic systemic d pled with a lowered plasma testosterone level is cou minimal increase in the plasma LH leve tary and suggesting combined hypothalamic-pitu testicular dei