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Cited by 89Hormonal and reproductive studiesSperm and Testicular FunctionHypothalamic control of reproductive hormones

The treatment of hypogonadism in men of reproductive age

Open access
Kim, Edward D., Crosnoe, Lindsey, Bar-Chama, Natan, Khera, Mohit, Lipshultz, Larry I.·2013·Fertility and Sterility
DOI 10.1016/j.fertnstert.2012.10.052
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Abstract

Objective To review the mechanisms of T replacement therapy's inhibition of spermatogenesis and current therapeutic approaches in reproductive aged men.Design Review of published literature.Setting PubMed search from 1990-2012.Patient(s) PubMed search from 1990-2012.Intervention(s) A literature review was performed.Main outcome measure(s) Semen analysis and pregnancy outcomes, time to recovery of spermatogenesis, serum and intratesticular T levels.Result(s) Exogenous T suppresses intratesticular T production, which is an absolute prerequisite for normal spermatogenesis. Therapies that protect the testis involve hCG therapy or selective estrogen receptor (ER) modulators, but may also include low-dose hCG with exogenous T. Off-label use of selective ER modulators, such as clomiphene citrate (CC), are effective for maintaining T production long term and offer the convenience of representing a safe, oral therapy. At present, routine use of aromatase inhibitors is not recommended based on a lack of long-term data.Conclusion(s) Exogenous T supplementation decreases sperm production. Studies of hormonal contraception indicate that most men have a return of normal sperm production within 1 year after discontinuation. Clomiphene citrate is a safe and effective therapy for men who desire to maintain future potential fertility. Although less frequently used in the general population, hCG therapy with or without T supplementation represents an alternative treatment.

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  • Uncontrolled case series reported increases in testosterone and improvements in self-reported sexual function and androgen deficiency-like symptoms in SERM-treated men.

    “Uncontrolled case series, reviewed elsewhere,111 variously reported not only increases in testosterone, but also improvements in selfreported sexual function and androgen deficiency-like symptoms in SERM-treated men.”

    From Hypogonadism and male obesity: Focus on unresolved questions (2018) · cites this paper as [111]

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Authors
Kim, E. D., Crosnoe, L., Bar-Chama, N., Khera, M., & Lipshultz, L. I.
Affiliations
  • University of Tennessee at Knoxville (US)
  • Baylor College of Medicine (US)
Corresponding author
Kim, Edward D.
ORCID
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2013-03
Volume
99
Issue
3
Pages
718-724
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/j.fertnstert.2012.10.052
OpenAlex
W2080782073
Cited by
89
References
40
Citations by year
2026: 4 · 2025: 7 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 4 · 2020: 7 · 2019: 5 · 2018: 8 · 2017: 8 · 2016: 14 · 2015: 10 · 2014: 8 · 2013: 6 · 2012: 1
FWCI
1.10
Type
journal article
Language
en
Open access
Licence
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Keywords
male hypogonadism, testosterone replacement therapy, spermatogenesis, clomiphene citrate, human chorionic gonadotropin, selective estrogen receptor modulators, aromatase inhibitors, testicular steroidogenesis, fertility preservation, semen analysis, pregnancy outcomes
MeSH terms
Adult, Female, Humans, Hypogonadism, Infertility, Male, Male, Pregnancy, Pregnancy Outcome, Spermatogenesis

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