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Cited by 126Reproductive Health and ContraceptionSperm and Testicular FunctionMale Reproductive Health Studies

Determinants of the Rate and Extent of Spermatogenic Suppression during Hormonal Male Contraception: An Integrated Analysis

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Liu, Peter Y., Swerdloff, Ronald S., Anawalt, Bradley D., Anderson, Richard A., Bremner, William J., Elliesen, Joerg, Gu, Yi-Qun, Kersemaekers, Wendy M. +10 more·2008·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2007-2768PMC PMC5393365
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Abstract

CONTEXT: Male hormonal contraceptive methods require effective suppression of sperm output. OBJECTIVE: The objective of the study was to define the covariables that influence the rate and extent of suppression of spermatogenesis to a level shown in previous World Health Organization-sponsored studies to be sufficient for contraceptive purposes (< or =1 million/ml). DESIGN: This was an integrated analysis of all published male hormonal contraceptive studies of at least 3 months' treatment duration. SETTING: Deidentified individual subject data were provided by investigators of 30 studies published between 1990 and 2006. PARTICIPANTS: A total of 1756 healthy men (by physical, blood, and semen exam) aged 18-51 yr of predominantly Caucasian (two thirds) or Asian (one third) descent were studied. This represents about 85% of all the published data. INTERVENTION(S): Men were treated with different preparations of testosterone, with or without various progestins. MAIN OUTCOME MEASURE: Semen analysis was the main measure. RESULTS: Progestin coadministration increased both the rate and extent of suppression. Caucasian men suppressed sperm output faster initially but ultimately to a less complete extent than did non-Caucasians. Younger age and lower initial blood testosterone or sperm concentration were also associated with faster suppression, but the independent effect sizes for age and baseline testicular function were relatively small. CONCLUSION: Male hormonal contraceptives can be practically applied to a wide range of men but require coadministration of an androgen with a second agent (i.e. progestin) for earlier and more complete suppression of sperm output. Whereas considerable progress has been made toward defining clinically effective combinations, further optimization of androgen-progestin treatment regimens is still required.

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Crossref · 10.1210/jc.2007-2768

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85 of 85 references verified0 citation errors · 0 not checkable

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  • Two-thirds of males in contraceptive studies recovered sperm in the ejaculate within six months of exogenous testosterone therapy cessation.

    “While two-thirds of males in contraceptive studies recovered sperm in the ejaculate within six months of exogenous testosterone therapy cessation”

    From Evaluation and Management of Testosterone Deficiency: AUA Guideline (2018) · cites this paper as [32]

    The paper’s introductory text says sperm output can be expected to recover after hormonal male contraception, and the Data collection section notes that recovery after treatment cessation was documented in a subgroup. It does not report that two-thirds of men had sperm in the ejaculate within six months; its analysis focuses on the rate of sperm suppression during treatment. Page numbers were not provided in our copy. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • The degree to which spermatogenesis returns after stopping exogenous testosterone is variable.

    “and the variable degree to which spermatogenesis returns after stopping exogenous testosterone.”

    From Evaluation and Management of Testosterone Deficiency: AUA Guideline (2018) · cites this paper as [32]

    The paper's introductory passage (indexed under Abstract; page unavailable) says sperm output can be expected to recover to levels consistent with normal fertility after hormonal contraception. The Data collection section also notes that recovery after treatment cessation was documented in a subgroup. Neither passage says that the degree of recovery varies between men; this analysis focuses on variability in suppression, not recovery. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Ten percent of males in contraceptive studies failed to recover sperm until the second year after cessation of exogenous testosterone therapy.

    “10% failed to do so until the second year after cessation.”

    From Evaluation and Management of Testosterone Deficiency: AUA Guideline (2018) · cites this paper as [32]

    The introduction says the authors previously analyzed recovery after hormonal contraception ceased, but gives no percentage or recovery time. The current paper analyzes suppression during treatment; searches for 10%, 90%, and recovery in the second year found no passage establishing the claim. (LLM, conf=0.73)

    Experimental — accuracy not yet measured

  • The time course to recover sperm in the ejaculate after stopping exogenous testosterone is highly variable.

    “Patients need to be made aware of the highly variable time course to recover sperm in the ejaculate”

    From Evaluation and Management of Testosterone Deficiency: AUA Guideline (2018) · cites this paper as [32]

    The introduction (page unavailable) says sperm output can recover after hormonal contraception, and the paper notes that a separate analysis examined recovery after treatment ceased. This paper’s reported endpoint is time to sperm suppression, not recovery; its passages do not establish that the time to recover sperm in the ejaculate is highly variable (searched: recovery, cessation, and variability in recovery time). (LLM, conf=0.74)

    Experimental — accuracy not yet measured

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Cites

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Research works printed but not linked: 1

  1. World Health Organization 1999 WHO laboratory manual for the examina- tion of human semen and sperm-cervical mucus interaction. 4th ed. Cam- bridge, UK: Cambridge University Press

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Authors
Liu, P. Y., Swerdloff, R. S., Anawalt, B. D., Anderson, R. A., Bremner, W. J., Elliesen, J., Gu, Y.-Q., Kersemaekers, W. M., McLachlan, R. I., Meriggiola, M. C., Nieschlag, E., Sitruk-Ware, R., Vogelsong, K., Wang, X.-H., Wu, F. C. W., Zitzmann, M., Handelsman, D. J., & Wang, C.
Affiliations
  • Concord Repatriation General Hospital (AU)
  • University of California, Los Angeles (US)
  • University of Washington (US)
  • The Queen's Medical Research Institute (GB)
  • Bayer (Germany) (DE)
  • Department of Endocrinology (Y.-Q.G.), National Research Institute for Family Planning, Beijing 100081, China
  • Organon (Netherlands) (NL)
  • Monash Medical Centre (AU)
  • IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
  • University Hospital Münster (DE)
  • Population Council (US)
  • World Bank (US)
  • Department of Jiangsu Family Planning Research Institute (X.-H.W.), Jiangsu 210029, China
  • Manchester Royal Infirmary (GB)
Corresponding author
  • Liu, Peter Y.
  • Wang, Christina
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2008-05-01
Volume
93
Issue
5
Pages
1774-1783
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2007-2768
PMC
PMC5393365
OpenAlex
W2148017821
Cited by
126
References
85
Citations by year
2026: 4 · 2025: 9 · 2024: 7 · 2023: 13 · 2022: 6 · 2021: 5 · 2020: 8 · 2019: 3 · 2018: 8 · 2017: 5 · 2016: 6 · 2015: 5 · 2014: 6 · 2013: 9 · 2012: 6
FWCI
8.61
Type
journal article
Language
en
Open access
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
Funders
  • University of Sydney
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (U54HD029990)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
  • Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
  • Health Sciences › Health Professions › General Health Professions › Male Reproductive Health Studies
Keywords
male hormonal contraception, testosterone, progestins, semen analysis, sperm count, racial differences, age effects, testicular function
MeSH terms
Adolescent, Adult, Contraceptive Agents, Male, Humans, Male, Middle Aged, Progestins, Spermatogenesis, Testosterone, Body Mass Index, White People, Asian People

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