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Fertil Steril. 2017 Feb;107(2):351-357.e1. doi: 10.1016/j.fertnstert.2016.10.004. Epub 2016 Nov 14.

Age and duration of testosterone therapy predict time to return of sperm count after human chorionic gonadotropin therapy.

Author information

1
Baylor College of Medicine, Houston, Texas.
2
Department of Economics, Rice University, Houston, Texas.
3
University of Oklahoma College of Medicine, Department of Urology, Oklahoma City, Oklahoma.
4
Center for Reproductive Medicine, Houston, Texas; Scott Department of Urology, Baylor College of Medicine, Houston, Texas.
5
Center for Reproductive Medicine, Houston, Texas; Scott Department of Urology, Baylor College of Medicine, Houston, Texas. Electronic address: larryl@bcm.edu.

Abstract

OBJECTIVE:

To determine factors that influence sperm recovery after T-associated infertility.

DESIGN:

Clinical retrospective study.

SETTING:

Academic male-infertility urology clinic.

PATIENT(S):

Sixty-six men who presented with infertility after T use.

INTERVENTION(S):

T cessation and combination high-dose hCG and selective estrogen modulator (SERM) therapy.

MAIN OUTCOME MEASURE(S):

Whether patients successfully achieved or failed to achieve a total motile count (TMC) of greater than 5 million sperm within 12 months of T cessation and initiation of therapy.

RESULT(S):

A TMC of greater than 5 million sperm was achieved by 46 men (70%). Both increased age and duration of T use directly correlated with time to sperm recovery at both 6 and 12 months of hCG/SERM therapy. Age more consistently limited sperm recovery, while duration of T use had less influence at 12 months than at 6 months. Only 64.8% of azoospermic men achieved a TMC greater than 5 million sperm at 12 months, compared with 91.7% of cryptozoospermic men, yet this did not predict a failure of sperm recovery.

CONCLUSION(S):

Increasing age and duration of T use significantly reduce the likelihood of recovery of sperm in the ejaculate, based on a criterion of a TMC of 5 million sperm, at 6 and 12 months. Physicians should be cautious in pursuing long-term T therapy, particularly in men who still desire fertility. Using these findings, physicians can counsel men regarding the likelihood of recovery of sperm at 6 and 12 months.

KEYWORDS:

Infertility; azoospermia; human chorionic gonadotropin; sperm; spermatogenesis-blocking agents; testosterone

PMID:
27855957
PMCID:
PMC5292276
DOI:
10.1016/j.fertnstert.2016.10.004
[Indexed for MEDLINE]
Free PMC Article

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