Testosterone use in the male infertility population: prescribing patterns and effects on semen and hormonal parameters
Samplaski MK, Loai Y, Wong K, Lo KC, Grober ED, Jarvi KA. Fertil Steril. 2013 Oct 1. pii: S0015-0282(13)03053-7. doi: 10.1016/j.fertnstert.2013.09.003. [Epub ahead of print]

Source

Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.

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.