title: Treatment of the Hypogonadal Infertile Male-A Review.
abstract: BACKGROUND
  Testosterone treatment for hypogonadism is detrimental for men in reproductive age as it impairs spermatogenesis, and therefore affects fertility. It is, therefore, not indicated in men with hypogonadism and infertility.
  
  
  OBJECTIVE
  The aim of this review is to analyze current data regarding options of treatment for men with hypogonadism and infertility.
  
  
  METHODS
  A comprehensive review of the current literature on management of infertility among hypogonadal men.
  
  
  METHODS
  A literature search using PubMed from 1980 to 2012 was done on articles published in the English language. The following medical subject heading terms were used: "infertility," "infertile," "hypogonadism;" "testosterone deficiency" and "men" or "male;" and "treatment" or "management."
  
  
  RESULTS
  The options for hypogonadal testicular failure are limited. Hormonal treatment is by and large ineffective. For secondary hypogonadism (hypogonadotropic/normogonadotropic hypogonadism), the options include gonadotropin-releasing hormone, human chorionic gonadotropin (hCG), human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), and anti-estrogens and aromatase inhibitors. Dopamine antagonist is indicated for prolactinoma. Artificial reproductive technique is indicated for primary testicular failure and also when medical therapy fails.
  
  
  CONCLUSIONS
  The most suitable option with the current data available is hCG with or without hMG/FSH. Testosterone supplementation should be avoided, but if they are already on it, it is still possible for a return of normal sperm production within 1 year after discontinuing testosterone. Ho CCK and Tan HM. Treatment of the hypogonadal infertile male-A review. Sex Med Rev 2013;1:42-49.
authors: Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia. Electronic address: chrisckho2002@yahoo.com.
authors: Christopher Chee Kong
authors: CC
authors: Ho
authors: Department of Primary Care, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Urology, Sime Darby Medical Centre, Petaling Jaya, Malaysia.
authors: Hui Meng
authors: HM
authors: Tan
keywords: Hormonal; Hypogonadism; Infertility; Men; Treatment