Yonsei Med J.  2013 May;54(3):702-706. 10.3349/ymj.2013.54.3.702.

Reversible Infertility Associated with Testosterone Therapy for Symptomatic Hypogonadism in Infertile Couple

• Bang JK
• Lim JJ
• Choi J
• Won HJ
• Yoon TK
• Hong JY
• Park DS
• Song SH

• KMID: 1727886
• DOI: http://doi.org/10.3349/ymj.2013.54.3.702

Abstract

PURPOSE
Androgen replacement therapy has been shown to be safe and effective for most patients with testosterone deficiency. Male partners of infertile couples often report significantly poorer sexual activity and complain androgen deficiency symptoms. We report herein an adverse effect on fertility caused by misusage of androgen replacement therapy in infertile men with hypogonadal symptoms.
MATERIALS AND METHODS
The study population consisted of 8 male patients referred from a local clinic for azoospermia or severe oligozoospermia between January 2008 and July 2011. After detailed evaluation at our andrology clinic, all patients were diagnosed with iatrogenic hypogonadism associated with external androgen replacement. We evaluated changes in semen parameters and serum hormone level, and fertility status.
RESULTS
All patients had received multiple testosterone undecanoate (NebidoR) injections at local clinic due to androgen deficiency symptoms combined with lower serum testosterone level. The median duration of androgen replacement therapy prior to the development of azoospermia was 8 months (range: 4-12 months). After withdrawal of androgen therapy, sperm concentration and serum follicle-stimulating hormone level returned to normal range at a median 8.5 months (range: 7-10 months).
CONCLUSION
Misusage of external androgen replacement therapy in infertile men with poor sexual function can cause temporary spermatogenic dysfunction, thus aggravating infertility.

Keyword

Androgen; male infertility; hypogonadism

MeSH Terms

Adult
Androgens/administration & dosage/adverse effects/*therapeutic use
Azoospermia/*drug therapy
Erectile Dysfunction/drug therapy
Humans
Hypogonadism/*drug therapy
Infertility, Male/*chemically induced/drug therapy
Male
Oligospermia/*drug therapy
Testosterone/administration & dosage/adverse effects/*analogs & derivatives/therapeutic use
Androgens
Testosterone

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