Mary K Samplaski1, Yasir Loai1, Kimberly Wong1, Kirk C Lo2, Ethan D Grober1, Keith A Jarvi3. 1. Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada. 2. Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. 3. Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Lunenfeld-Tannenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada. Electronic address: kjarvi@mtsinai.on.ca.
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.
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.