Testosterone use in the male infertility population prescribing patterns and effects on semen and hormonal parameters

In Canada, testosterone is not commonly used by men presenting for fertility investigation (1.3%). Testosterone cessation generally resulted in an increase in sperm counts. A subset of men remained azoospermic.

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Authors

Mary K. Samplaski, M.D., Yasir Loai, B.S., Kimberly Wong, Kirk C. Lo, M.D., Ethan D. Grober, M.D., Keith A. Jarvi, M.D.

Volume 101, Issue 1, Pages 64-69, January 2014

Abstract

Objective:

To analyze how frequently and why men presenting with infertility take testosterone (T) and if negative effects of T on semen parameters are reversed following cessation.

Design:

Analysis of a prospectively collected database.

Setting:

Male Infertility clinic.

Patient(s):

Men presenting for fertility evaluation from 2008 to 2012.

Intervention(s):

None.

Main Outcome Measure(s):

The frequency and reason for T use in the infertile male population, and semen and hormonal parameters while on T and following discontinuation.

Result(s):

A total of 59/4,400 men (1.3%) reported taking T. T was prescribed by a variety of physicians, including endocrinologists (24%), general practitioners (17%), urologists (15%), gynecologists (5%), and reproductive endocrinologists (3%). Only one of the men admitted that he had obtained T from an illicit source. More than 82% of men were prescribed T for the treatment of hypogonadism, but surprisingly, 12% (7/59) were prescribed T to treat their infertility. While on T, 88.4% of men were azoospermic, but by 6 months after T cessation, 65% of the men without other known causes for azoospermia recovered spermatogenesis.

Conclusion(s):

In Canada, T was not commonly used by men presenting for fertility investigation (1.3%). Close to 2/3 of infertile men using T recovered spermatogenesis within 6 months of T discontinuation.

Read the full text at: http://www.fertstert.org/article/S0015-0282(13)03053-7/fulltext


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Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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