Preserving fertility in the hypogonadal patient: An update

Ranjith Ramasamy, Joseph M. Armstrong, Larry I. Lipshultz

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations


An increasing number of young and middle-aged men are seeking treatment for symptoms related to deficient levels of androgens (hypogonadism) including depression, loss of libido, erectile dysfunction, and fatigue. The increase in prevalence of testosterone supplementation in general and anabolic steroid-induced hypogonadism specifically among younger athletes is creating a population of young men who are uniquely impacted by the testicular end-organ negative consequences of exogenous steroid use. Exogenous testosterone therapy can alter the natural regulation of the hypothalamic-pituitary-gonadal axis leading to impaired spermatogenesis with azoospermia being a serious possible result, thus rendering the individual infertile. For men of reproductive age who suffer from hypogonadal symptoms, preservation of fertility is an important aspect of their treatment paradigm. Treatment with human chorionic gonadotropin (hCG) has shown the ability not only to reverse azoospermia brought on by testosterone supplementation therapy but also to help maintain elevated intratesticular testosterone levels. In addition, selective estrogen receptor modulators, often used with hCG have been shown both to elevate total testosterone levels and to maintain spermatogenesis in hypogonadal men.

Original languageEnglish (US)
Pages (from-to)197-200
Number of pages4
JournalAsian Journal of Andrology
Issue number2
StatePublished - Mar 1 2015
Externally publishedYes


  • human chorionic gonadotropin
  • selective estrogen receptor modulators
  • spermatogenesis
  • testosterone supplementation therapy

ASJC Scopus subject areas

  • Urology


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