Fertility outcomes in men with prior history of anabolic steroid use

madman

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10:49-12:30

Listen to this interview featuring Dr. Ranjith Ramasamy and Dr. Braian Ledesma, who discuss their recent article "Fertility outcomes in men with prior history of anabolic steroid use." A medical researcher and urologist, Dr. Ramasamy is known for academic contributions to reproductive medicine, including testosterone deficiency, regenerative therapy, erectile dysfunction, and prostate cancer studies. He is the recipient of the American Society for Reproductive Medicine's Rosenwaks Young Investigator Award. He published a study in JAMA on the impact of COVID-19 vaccines on male fertility. He is the Director of the Reproductive Urology Fellowship program at the University of Miami's Miller School of Medicine.
 
*A significant proportion of men with a prior history of anabolic steroid use continue to exhibit severe oligospermia, with approximately 50% failing to demonstrate substantial improvement even after undergoing a six-month treatment protocol.

 
So always use HCG when on TRT?

If your goal is to preserve/maintain fertility or minimize/prevent testicular atrophy then yes.

Would always be wise to have a baseline SA (semen analysis) done before jumping on exogenous T.

When it comes to fertility the gold standard would be hCG + rFSH as they work synergistically.

Even then one may achieve a better effect when it comes to testicular atrophy when adding in FSH.

Unfortunately, FSH is expensive.






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Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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