World J Mens Health.  2020 Apr;38(2):141-150. 10.5534/wjmh.190002.

Management of Anabolic Steroid-Induced Infertility: Novel Strategies for Fertility Maintenance and Recovery

• Tatem AJ
• Beilan J
• Kovac JR
• Lipshultz

• KMID: 2471821
• DOI: http://doi.org/10.5534/wjmh.190002

Abstract

There is often inherent conflict in the overlapping fields of male fertility and andrology. While the goal of all male fertility specialists is to facilitate and preserve biologic paternity, many practitioners also care for a significant number of patients suffering from hypogonadism. Exogenous testosterone administration, the gold standard for the management of these patients, almost universally impairs spermatogenesis and can even completely eradicate it in some men. With steady increases in both the incidence of hypogonadism and average paternal age, practitioners are now encountering hypogonadal men who desire future fertility or men suffering the effects of earlier androgenic anabolic steroid use with increasing frequency. In this manuscript, we review management strategies for these complex patients and explore novel medications that may be of use in this population.

Keyword

Anabolic steroids; Clomiphene citrate; Human chorionic gonadotropin; Hypogonadism; Infertility; Testosterone

MeSH Terms

Andrology
Chorionic Gonadotropin
Clomiphene
Fertility*
Humans
Hypogonadism
Incidence
Infertility*
Male
Paternal Age
Paternity
Specialization
Spermatogenesis
Testosterone
Chorionic Gonadotropin
Clomiphene
Testosterone

Figure

• 

  Fig. 1 Algorithm for the treatment of steroid induced infertility. TTh: testosterone therapy, AAS: androgenic-anabolic steroids, SA: semen analysis, T: testosterone, LH: luteinizing hormone, FSH: follicle stimulating hormone, HCG: human chorionic gonadotropin, SQ: subcutaneous, QOD: quaqua altera die (every other day), QD: quaque die (once a daily), Q7 days: quaque 7 days, rhFSH: recombinant human follicle stimulating hormone, TESE: testicular sperm extraction, m-TESE: microdissection testicular sperm extraction.

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