Age and duration of testosterone therapy predict time to return of sperm count after human chorionic gonadotropin therapy

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• 作者：Taylor P. Kohn ; M.Phil.^a ; Matthew R. Louis ; B.S.^a ; Stephen M. Pickett ; B.B.A.^b ; Mark C. Lindgren ; M.D.^c ; Jaden R. Kohn ; B.S.^a ; Alexander W. Pastuszak ; M.D. Ph.D.^d ; ^e ; Larry I. Lipshultz ; M.D.^d ; ^e ; ^{larryl@bcm.edu}
• 关键词：Infertility ; testosterone ; sperm ; azoospermia ; human chorionic gonadotropin ; spermatogenesis-blocking agents
• 刊名：Fertility and Sterility
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：107
• 期：2
• 页码：351-357.e1
• 全文大小：352 K
• 卷排序：107

文摘

To determine factors that influence sperm recovery after T-associated infertility.DesignClinical retrospective study.SettingAcademic male-infertility urology clinic.Patient(s)Sixty-six men who presented with infertility after T use.Intervention(s)T cessation and combination high-dose hCG and selective estrogen modulator (SERM) therapy.Main Outcome Measure(s)Whether patients successfully achieved or failed to achieve a total motile count (TMC) of greater than 5 million sperm within 12 months of T cessation and initiation of therapy.Result(s)A TMC of greater than 5 million sperm was achieved by 46 men (70%). Both increased age and duration of T use directly correlated with time to sperm recovery at both 6 and 12 months of hCG/SERM therapy. Age more consistently limited sperm recovery, while duration of T use had less influence at 12 months than at 6 months. Only 64.8% of azoospermic men achieved a TMC greater than 5 million sperm at 12 months, compared with 91.7% of cryptozoospermic men, yet this did not predict a failure of sperm recovery.Conclusion(s)Increasing age and duration of T use significantly reduce the likelihood of recovery of sperm in the ejaculate, based on a criterion of a TMC of 5 million sperm, at 6 and 12 months. Physicians should be cautious in pursuing long-term T therapy, particularly in men who still desire fertility. Using these findings, physicians can counsel men regarding the likelihood of recovery of sperm at 6 and 12 months.