Preserving fertility in the hypogonadal patient: an update.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic methodology or primary human trial data
PubMed 25337850 · doi:10.4103/1008-682X.142772
What was done
This review evaluates strategies for preserving fertility and managing impaired spermatogenesis in young and middle-aged men experiencing hypogonadal symptoms or androgen-induced suppression of the hypothalamic-pituitary-gonadal axis from exogenous testosterone or anabolic steroid use.
What was found
The abstract reports no numerical values, sample sizes, or quantitative outcome measures. It qualitatively notes that exogenous testosterone therapy suppresses the hypothalamic-pituitary-gonadal axis and can cause azoospermia. It highlights that human chorionic gonadotropin (hCG) can reverse testosterone-induced azoospermia and maintain intratesticular testosterone, while selective estrogen receptor modulators (SERMs), alone or combined with hCG, elevate total testosterone and maintain spermatogenesis.
Why it matters
Exogenous testosterone acts as a male contraceptive by halting gonadotropin secretion; outlining regimens using hCG and SERMs offers clinical strategies to manage androgen deficiency while preserving reproductive capacity.
Limits
As a narrative review, it lacks a systematic search strategy, defined study selection criteria, and quantitative synthesis. The abstract reports no primary clinical data, participant counts, specific dosing protocols, or recovery rates.
Cited by
- supports Co-administering human chorionic gonadotropin (hCG) alongside exogenous testosterone therapy can partially to completely prevent or offset the depletion of sperm count.