Desogestrel plus testosterone effectively suppresses spermatogenesis but also causes modest weight gain and high-density lipoprotein suppression.
OBJECTIVE
To test the hypothesis that oral desogestrel (DSG) plus testosterone would uniformly and rapidly suppress sperm concentrations in young men as effectively as levonorgestrel (LNG) plus testosterone and cause less high-density lipoprotein (HDL) suppression and weight gain.


METHODS
Single-blind, randomized trial.


METHODS
VA Puget Sound and University of Washington, Seattle, Washington.


METHODS
Twenty-four healthy young men, aged 20-49.


METHODS
Subjects were randomized to three groups of men who were administered 6 months of therapy with oral DSG plus im testosterone enanthate: 150 microg of DSG plus 50 mg of testosterone (DSG 150-T 50), 150 microg of DSG plus 100 mg of testosterone (DSG 150-T 100) or 300 microg of DSG plus 100 mg of testosterone (DSG 300-T 100). We compared these three groups to two groups of historical controls of 100 mg of im testosterone alone or 150 microg of oral LNG plus 100 mg of im testosterone (LNG 125-T 100 group) enrolled in similar studies.


METHODS
Suppression of sperm counts to severe oligoazoospermia (sperm counts <1 x 10(6)/mL) and azoospermia, weight gain, and serum high-density cholesterol (HDL) suppression.


RESULTS
Azoospermia was achieved in all eight men receiving DSG 150-T 100 and seven of the eight men in the DSG 300-T 100 group. DSG 150 or 300 plus T 100 suppressed spermatogenesis as effectively as LNG 125-T 100 and more effectively than DSG 50-T 100 or testosterone alone. All groups tended to gain weight compared with their baseline, but the weight gain was greatest (and statistically significant) in the DSG 150-T 100, DSG 300-T 100, and LNG 125-T 100 groups. Serum HDL levels were modestly suppressed in all groups, and this effect was greatest in the DSG 300-T 100 and LNG 125-T 100 groups.


CONCLUSIONS
The combination of DSG plus testosterone is a very effective regimen for suppression of spermatogenesis and has acceptably low side effects.
Anawalt
B D
BD
Department of Medicine, University of Washington, Seattle, Washington, USA.
Herbst
K L
KL
Matsumoto
A M
AM
Mulders
T M
TM
Coelingh-Bennink
H J
HJ
Bremner
W J
WJ
D000152:Acne Vulgaris / Q000139:chemically induced; D000328:Adult; D001774:Blood Chemical Analysis; D002784:Cholesterol / Q000097:blood; D003272:Contraceptive Agents, Male / Q000494:pharmacology*; D003278:Contraceptives, Oral, Hormonal / Q000494:pharmacology*; D003280:Contraceptives, Oral, Synthetic / Q000494:pharmacology*; D017135:Desogestrel / Q000494:pharmacology*; D006177:Gynecomastia / Q000139:chemically induced; D006801:Humans; D016912:Levonorgestrel / Q000494:pharmacology*; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009845:Oligospermia / Q000139:chemically induced; D013076:Sperm Count; D013091:Spermatogenesis / Q000187:drug effects*; D013739:Testosterone / Q000097:blood / Q000494:pharmacology*; D015430:Weight Gain / Q000187:drug effects*
D003272:Contraceptive Agents, Male; D003278:Contraceptives, Oral, Hormonal; D003280:Contraceptives, Oral, Synthetic; D008075:Lipoproteins, HDL; D013739:Testosterone; D016912:Levonorgestrel; D017135:Desogestrel; D002784:Cholesterol