The Continued Use of Testosterone Does Not Interfere with Human Chorionic Gonadotropin (hCG) -Mediated Return of Spermatogenesis

[Nelson Vergel]

In the realm of reproductive health, one of the most challenging puzzles has been how to balance the benefits of testosterone therapy with the desire to maintain or restore fertility in men. A recent study published in The Journal of Sexual Medicine, led by J Kassab and team, sheds new light on this conundrum, offering hope and guidance for those affected.

The Dilemma of Testosterone Therapy and Fertility​

For men undergoing testosterone therapy (TTh), a common side effect is the suppression of sperm production, known as spermatogenesis. This can be particularly problematic for those who are hypogonadal, meaning they naturally produce low levels of testosterone. To counteract this effect, doctors often prescribe human chorionic gonadotropin (hCG), a hormone that helps prevent testicular atrophy and maintain some sperm production. When these men want to start a family, the dosage of hCG is increased, and traditionally, testosterone therapy is halted. But is stopping testosterone therapy really necessary?

The Study's Aim​

The research aimed to explore whether men with low testosterone could continue their testosterone therapy while using hCG to boost sperm production. This would be a game-changer, allowing men to avoid the symptoms of low testosterone while also trying to conceive.

Methodology: A Closer Look​

The study was comprehensive, involving 260 patients at a university hospital over two years. Researchers split the patients into two groups: those who took hCG with their testosterone therapy (500 IU 3 times per week) and those who took hCG alone (3,000 IU hCG 3 times per week as monotherapy). They meticulously collected data on medication dosages, other health conditions, demographic details, and lab results, including hormone levels and sperm analysis.

What the Results Tell Us​

The findings were groundbreaking. In both groups - those on testosterone therapy and those not - there were significant improvements in testosterone levels and total sperm count. The statistical analysis showed that these improvements were not just by chance. Interestingly, there was no significant difference between the two groups in terms of sperm motility, suggesting that continuing testosterone therapy does not negatively impact this aspect of sperm health.

Conclusions: A New Horizon in Reproductive Health​

The study concluded that using hCG can effectively increase testosterone and sperm count in hypogonadal men, regardless of whether they continue testosterone therapy. This is a significant breakthrough, offering a new approach for men who wish to maintain their testosterone levels without sacrificing their fertility.

Implications for the Future​

These findings could revolutionize how doctors treat men with low testosterone who wish to conceive. It opens the door to more personalized treatment plans, balancing hormonal health with reproductive goals. The research paves the way for further studies into the long-term effects of this approach and how it can be best utilized in clinical practice.

For Healthcare Professionals and Patients Alike​

This study is a valuable resource for healthcare professionals, providing them with new insights into the efficacy of hCG in conjunction with testosterone therapy. Patients can now have more informed discussions with their doctors about their treatment options, understanding the potential outcomes and timelines of hCG treatment.

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References​

• J Kassab, A Garcia Keeme-sayre, J Lindsey, J Torres-Anguiano, T Garcia, L Lipshultz, "The Continued Use of Testosterone Does Not Interfere with Human Chorionic Gonadotropin-Mediated Return of Spermatogenesis," The Journal of Sexual Medicine, Vol. 21, Issue Suppl 1, Feb 2024, qdae001.089.