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Determinants of the Rate and Extent of Spermatogenic Suppression during Hormonal Male Contraception: An Integrated Analysis
Open accessAbstract
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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“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]
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“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]
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“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]
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“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]
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Metadata
- 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
- 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
- bronze
- doi.org
- 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 › Medicine › Urology › 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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