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Cited by 47Sperm and Testicular FunctionHormonal and reproductive studiesHypothalamic control of reproductive hormones

Frontiers in hormone therapy for male infertility

Open access
Khourdaji, Iyad, Lee, Haerin, Smith, Ryan P.·2018·Translational Andrology and Urology
DOI 10.21037/tau.2018.04.03PMC PMC6087845
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Abstract

For a significant number of couples worldwide, infertility is a harsh reality. As specialists in male infertility, much of our armamentarium lacks definitive, evidence-based therapies. For years, we have relied on manipulation of the male hormonal axis to treat those men who help carry the burden of infertility in their partnerships. Indeed, male factor infertility is the sole component of infertility in at least 20% of couples. Further compounding this dilemma is that 25% to 50% of males with infertility have no identifiable etiology and thus present a true management conundrum. This manuscript is an attempt to clarify what therapies exist for the treatment of male factor infertility. We have reviewed the relevant infertility literature honing, our focus on hormonal anomalies and their subsequent impact on fertility. Many of the therapies discussed have been utilized in practice for generations. Thus, this article attempts to provide the evidence-based literature to support the continued use of the current treatment paradigm. Furthermore, we recognize that any review beckons a discussion of what challenges and therapies await on the horizon. For instance, there has been significant interest in restoring spermatogenesis after testosterone replacement therapy (TRT). We explore the adverse long-term spermatogenic outcomes associated with TRT, which with the widespread use of TRT, will inevitably present a great challenge for male infertility specialists. Moreover, we discuss the role of varicocelectomy in the treatment of hypogonadism and infertility, review the association between growth hormone (GH) and male fertility and address the challenges presented by the rising prevalence of obesity.

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  • Whether improvements in serum testosterone levels after varicocelectomy translate into clinically meaningful improvements in symptoms of hypogonadism remains controversial.

    “However, whether those improvements in serum testosterone levels translate into clinically meaningful improvements in symptoms of hypogonadism remains controversial (29).”

    From Non-testosterone management of male hypogonadism: an examination of the existing literature (2020) · cites this paper as [29]

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Authors
Khourdaji, I., Lee, H., & Smith, R. P.
Affiliations
University of Virginia Health System (US)
Corresponding author
Khourdaji, Iyad
ORCID
Smith, Ryan P.
Venue
Translational Andrology and Urology
Publisher
AME Publishing Company
Published
2018-07
Volume
7
Issue
S3
Pages
S353-S366
ISSN
  • 2223-4683 (ISSN-L)
  • 2223-4691
DOI
10.21037/tau.2018.04.03
PMC
PMC6087845
OpenAlex
W2799781292
Cited by
47
References
114
Citations by year
2026: 2 · 2025: 5 · 2024: 11 · 2023: 3 · 2022: 8 · 2021: 5 · 2020: 8 · 2019: 3 · 2018: 2
FWCI
0.68
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Translational Andrology and Urology (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Keywords
male infertility, hormone therapy, male factor infertility, testosterone replacement therapy, spermatogenesis, varicocelectomy, hypogonadism, growth hormone, obesity, evidence-based treatment

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