Systematic review of hormone replacement therapy in the infertile man.
Level 2 - randomized trial
Systematic review of heterogeneous studies without restriction to randomized controlled trials
PubMed 29713545 · doi:10.1016/j.aju.2017.11.011
What was done
Authors conducted a systematic review following PRISMA criteria, searching PubMed and major urological/surgical conference abstracts from 1978 to 2017 using search terms related to testosterone replacement therapy and male infertility. English-language studies with abstracts involving adult men were screened; 91 manuscripts were identified and 56 were included in the final review.
What was found
The abstract provides no numerical data, effect estimates, or statistical comparisons. It reports qualitatively that exogenous testosterone inhibits spermatogenesis. It notes that selective oestrogen receptor modulators or testosterone combined with low-dose human chorionic gonadotrophin (hCG) can be used to preserve fertility in hypogonadal men, and that hypogonadotrophic hypogonadism can be managed with hCG alone or in combination with follicle-stimulating hormone preparations.
Why it matters
Exogenous testosterone induces azoospermia or severe oligospermia, limiting its use in men of reproductive age. Summarizing non-testosterone alternatives helps guide androgen replacement strategies that maintain or restore spermatogenesis.
Limits
The abstract contains no quantitative outcomes, pooled effect sizes, or pregnancy rates. Details on the design, risk of bias, and quality of the 56 included studies are not reported in the abstract.
Cited by
- supports Primary hypogonadism cannot be treated or resolved with clomiphene, hCG, or hMG because the testes cannot produce testosterone in response to signaling.