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ABSTRACT: Objective
To determine factors that influence sperm recovery after T-associated infertility.Design
Clinical retrospective study.Setting
Academic 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.
SUBMITTER: Kohn TP
PROVIDER: S-EPMC5292276 | biostudies-literature | 2017 Feb
REPOSITORIES: biostudies-literature
Kohn Taylor P TP Louis Matthew R MR Pickett Stephen M SM Lindgren Mark C MC Kohn Jaden R JR Pastuszak Alexander W AW Lipshultz Larry I LI
Fertility and sterility 20161114 2
<h4>Objective</h4>To determine factors that influence sperm recovery after T-associated infertility.<h4>Design</h4>Clinical retrospective study.<h4>Setting</h4>Academic male-infertility urology clinic.<h4>Patient(s)</h4>Sixty-six men who presented with infertility after T use.<h4>Intervention(s)</h4>T cessation and combination high-dose hCG and selective estrogen modulator (SERM) therapy.<h4>Main outcome measure(s)</h4>Whether patients successfully achieved or failed to achieve a total motile co ...[more]