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

Capsule:
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.

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.

Translate »