title: Reversible infertility associated with testosterone therapy for symptomatic hypogonadism in infertile couple.
abstract: OBJECTIVE
  Androgen replacement therapy has been shown to be safe and effective for most patients with testosterone deficiency. Male partners of infertile couples often report significantly poorer sexual activity and complain androgen deficiency symptoms. We report herein an adverse effect on fertility caused by misusage of androgen replacement therapy in infertile men with hypogonadal symptoms.
  
  
  METHODS
  The study population consisted of 8 male patients referred from a local clinic for azoospermia or severe oligozoospermia between January 2008 and July 2011. After detailed evaluation at our andrology clinic, all patients were diagnosed with iatrogenic hypogonadism associated with external androgen replacement. We evaluated changes in semen parameters and serum hormone level, and fertility status.
  
  
  RESULTS
  All patients had received multiple testosterone undecanoate (NebidoR) injections at local clinic due to androgen deficiency symptoms combined with lower serum testosterone level. The median duration of androgen replacement therapy prior to the development of azoospermia was 8 months (range: 4-12 months). After withdrawal of androgen therapy, sperm concentration and serum follicle-stimulating hormone level returned to normal range at a median 8.5 months (range: 7-10 months).
  
  
  CONCLUSIONS
  Misusage of external androgen replacement therapy in infertile men with poor sexual function can cause temporary spermatogenic dysfunction, thus aggravating infertility.
authors.affiliation: Department of Urology, CHA Gangnam Medical Center, CHA University, 566 Nonhyeon-ro, Gangnam-gu, Seoul 135-913, Korea.
authors.forename: Jeong Kyoon
authors.initials: JK
authors.lastname: Bang
authors.forename: Jung Jin
authors.initials: JJ
authors.lastname: Lim
authors.forename: Jin
authors.initials: J
authors.lastname: Choi
authors.forename: Hyung Jae
authors.initials: HJ
authors.lastname: Won
authors.forename: Tae Ki
authors.initials: TK
authors.lastname: Yoon
authors.forename: Jae Yup
authors.initials: JY
authors.lastname: Hong
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Park
authors.forename: Seung-Hun
authors.initials: SH
authors.lastname: Song
mesh_terms: D000328:Adult; D000728:Androgens / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D053713:Azoospermia / Q000188:drug therapy*; D007172:Erectile Dysfunction / Q000188:drug therapy; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy*; D007248:Infertility, Male / Q000139:chemically induced* / Q000188:drug therapy; D008297:Male; D009845:Oligospermia / Q000188:drug therapy*; D013739:Testosterone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000728:Androgens; D013739:Testosterone; C010792:testosterone undecanoate
keywords: Androgen; hypogonadism; male infertility
references.citation: Endocrinol Metab Clin North Am. 1994 Dec;23(4):857-75
references.pmid: 7705324
references.citation: J Androl. 2004 Sep-Oct;25(5):720-7
references.pmid: 15292101
references.citation: Mol Cell Endocrinol. 2006 May 16;250(1-2):2-7
references.pmid: 16580772
references.citation: J Clin Endocrinol Metab. 1979 Jun;48(6):955-8
references.pmid: 447801
references.citation: Urology. 2004 Jan;63(1):126-30
references.pmid: 14751363
references.citation: Fertil Steril. 2004 Sep;82 Suppl 1:S46-50
references.pmid: 15363693
references.citation: J Endocrinol Invest. 2003;26(3 Suppl):72-6
references.pmid: 12834026
references.citation: Curr Psychiatry Rep. 2000 Jun;2(3):201-5
references.pmid: 11122956
references.citation: J Urol. 2005 Nov;174(5):1932-4; discussion 1934
references.pmid: 16217348
references.citation: Andrologia. 2012 May;44 Suppl 1:823-5
references.pmid: 21762190
references.citation: Clin Endocrinol (Oxf). 1981 Jan;14(1):49-61
references.pmid: 7014044
references.citation: Lancet. 1978 Aug 12;2(8085):366
references.pmid: 79723
references.citation: J Urol. 2004 Aug;172(2):658-63
references.pmid: 15247755
references.citation: Expert Opin Pharmacother. 2005 Aug;6(10):1751-9
references.pmid: 16086661
references.citation: Lancet. 1992 Jul 4;340(8810):17-8
references.pmid: 1351601