The treatment of hypogonadism in men of reproductive age

Edward Kim, Lindsey Crosnoe, Natan Bar-Chama, Mohit Khera, Larry I. Lipshultz

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Objective: To review the mechanisms of T replacement therapy's inhibition of spermatogenesis and current therapeutic approaches in reproductive aged men. Design: Review of published literature. Setting: PubMed search from 1990-2012. Patient(s): PubMed search from 1990-2012. Intervention(s): A literature review was performed. Main Outcome Measure(s): Semen analysis and pregnancy outcomes, time to recovery of spermatogenesis, serum and intratesticular T levels. Result(s): Exogenous T suppresses intratesticular T production, which is an absolute prerequisite for normal spermatogenesis. Therapies that protect the testis involve hCG therapy or selective estrogen receptor (ER) modulators, but may also include low-dose hCG with exogenous T. Off-label use of selective ER modulators, such as clomiphene citrate (CC), are effective for maintaining T production long term and offer the convenience of representing a safe, oral therapy. At present, routine use of aromatase inhibitors is not recommended based on a lack of long-term data. Conclusion(s): Exogenous T supplementation decreases sperm production. Studies of hormonal contraception indicate that most men have a return of normal sperm production within 1 year after discontinuation. Clomiphene citrate is a safe and effective therapy for men who desire to maintain future potential fertility. Although less frequently used in the general population, hCG therapy with or without T supplementation represents an alternative treatment.

Original languageEnglish (US)
Pages (from-to)718-724
Number of pages7
JournalFertility and Sterility
Volume99
Issue number3
DOIs
StatePublished - Mar 1 2013

Fingerprint

Hypogonadism
Spermatogenesis
Selective Estrogen Receptor Modulators
Clomiphene
Therapeutics
PubMed
Spermatozoa
Off-Label Use
Aromatase Inhibitors
Semen Analysis
Pregnancy Outcome
Contraception
Fertility
Testis
Outcome Assessment (Health Care)
Serum

All Science Journal Classification (ASJC) codes

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

The treatment of hypogonadism in men of reproductive age. / Kim, Edward; Crosnoe, Lindsey; Bar-Chama, Natan; Khera, Mohit; Lipshultz, Larry I.

In: Fertility and Sterility, Vol. 99, No. 3, 01.03.2013, p. 718-724.

Research output: Contribution to journalArticle

Kim, E, Crosnoe, L, Bar-Chama, N, Khera, M & Lipshultz, LI 2013, 'The treatment of hypogonadism in men of reproductive age', Fertility and Sterility, vol. 99, no. 3, pp. 718-724. https://doi.org/10.1016/j.fertnstert.2012.10.052
Kim, Edward ; Crosnoe, Lindsey ; Bar-Chama, Natan ; Khera, Mohit ; Lipshultz, Larry I. / The treatment of hypogonadism in men of reproductive age. In: Fertility and Sterility. 2013 ; Vol. 99, No. 3. pp. 718-724.
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