Comparison of two androgens plus depot-medroxyprogesterone acetate for suppression to azoospermia in indonesian men. World Health Organization. Task Force on Methods for the Regulation of Male Fertility.
OBJECTIVE
To compare the sperm suppression in Indonesian men achieved by combination treatment with either T enanthate or 19-nortestosterone ester) with depot-medroxyprogesterone acetate (depot-MPA).


METHODS
Prospective multicenter parallel group randomized trial.


METHODS
Five centers in Faculties of Medicine in Indonesia.


METHODS
Ninety-six normal healthy volunteers.


METHODS
Seven weekly injections of T enanthate or 19-nortestosterone ester, 200 mg IM, followed by injections every 3 weeks to week 24. In both groups 250 mg depot-MPA was injected IM at 0, 6, 12, and 18 weeks.


METHODS
Sperm suppression by semen analysis at 3-week intervals and clinical chemistry, hematology, and gonadotrophin hormones monitored at 6-week intervals. Recovery assessed monthly until return to normal sperm concentration (> or = 20 x 10(6)/mL).


RESULTS
Eighty-seven of 90 men (96.7%) achieved consistent azoospermia; 95.6% (43/45) and 97.8% (44/45) in the T and 19-nortestosterone groups, respectively. The remaining three men also suppressed to near azoospermic levels. Six of 96 men discontinued injections for failure to attend at the schedule time (3) and for medical reasons (3). Plasma FSH and LH concentrations were suppressed during treatment and returned to baseline levels during the recovery period. Clinical chemistry and hematologic values remained in the normal ranges throughout. More men complained of loss of libido in the 19-nortestosterone group (seven versus two, respectively). Median time to recover to normal sperm concentrations was 6.5 months.


CONCLUSIONS
The two treatments were equally effective in sperm suppression. The rates of azoospermia achieved were higher than in previous studies with non-Indonesian men.
D000328:Adult; D003272:Contraceptive Agents, Male / Q000008:administration & dosage*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007214:Indonesia; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage* / Q000009:adverse effects; D009277:Nandrolone / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D013076:Sperm Count; D013081:Sperm Motility; D013737:Testis / Q000033:anatomy & histology; D013739:Testosterone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
D003272:Contraceptive Agents, Male; D013739:Testosterone; D009277:Nandrolone; C004648:testosterone enanthate; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D017258:Medroxyprogesterone Acetate