title: Age and duration of testosterone therapy predict time to return of sperm count after human chorionic gonadotropin therapy.
abstract: To determine factors that influence sperm recovery after T-associated infertility.
  
  
  
  Clinical retrospective study.
  
  
  
  Academic male-infertility urology clinic.
  
  
  
  Sixty-six men who presented with infertility after T use.
  
  
  
  T cessation and combination high-dose hCG and selective estrogen modulator (SERM) therapy.
  
  
  
  Whether patients successfully achieved or failed to achieve a total motile count (TMC) of greater than 5 million sperm within 12 months of T cessation and initiation of therapy.
  
  
  
  A TMC of greater than 5 million sperm was achieved by 46 men (70%). Both increased age and duration of T use directly correlated with time to sperm recovery at both 6 and 12 months of hCG/SERM therapy. Age more consistently limited sperm recovery, while duration of T use had less influence at 12 months than at 6 months. Only 64.8% of azoospermic men achieved a TMC greater than 5 million sperm at 12 months, compared with 91.7% of cryptozoospermic men, yet this did not predict a failure of sperm recovery.
  
  
  
  Increasing age and duration of T use significantly reduce the likelihood of recovery of sperm in the ejaculate, based on a criterion of a TMC of 5 million sperm, at 6 and 12 months. Physicians should be cautious in pursuing long-term T therapy, particularly in men who still desire fertility. Using these findings, physicians can counsel men regarding the likelihood of recovery of sperm at 6 and 12 months.
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Taylor P
authors.initials: TP
authors.lastname: Kohn
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Louis
authors.affiliation: Department of Economics, Rice University, Houston, Texas.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Pickett
authors.affiliation: University of Oklahoma College of Medicine, Department of Urology, Oklahoma City, Oklahoma.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Lindgren
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Jaden R
authors.initials: JR
authors.lastname: Kohn
authors.affiliation: Center for Reproductive Medicine, Houston, Texas; Scott Department of Urology, Baylor College of Medicine, Houston, Texas.
authors.forename: Alexander W
authors.initials: AW
authors.lastname: Pastuszak
authors.affiliation: Center for Reproductive Medicine, Houston, Texas; Scott Department of Urology, Baylor College of Medicine, Houston, Texas. Electronic address: larryl@bcm.edu.
authors.forename: Larry I
authors.initials: LI
authors.lastname: Lipshultz
mesh_terms: D000328:Adult; D000367:Age Factors; D000728:Androgens / Q000009:adverse effects*; D053713:Azoospermia / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D005303:Fertility Agents, Male / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013076:Sperm Count; D013081:Sperm Motility / Q000187:drug effects; D013091:Spermatogenesis / Q000187:drug effects*; D013094:Spermatozoa / Q000187:drug effects* / Q000473:pathology; D013739:Testosterone / Q000009:adverse effects* / Q000097:blood / Q000172:deficiency; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000728:Androgens; D006063:Chorionic Gonadotropin; D005303:Fertility Agents, Male; D013739:Testosterone
keywords: Infertility; azoospermia; human chorionic gonadotropin; sperm; spermatogenesis-blocking agents; testosterone