Sex steroid-based male contraceptive regimens do not induce consistent azoospermia. The reason for this variable response is obscure. We used normal adult male monkeys, Macaca fascicularis (n ؍ 9) as a model of testosterone (T)-induced gonadotropin suppression to understand the basis for variability in spermatogenic suppression during hormonal contraception. As observed in men, T administration to these monkeys induced azoospermia in some animals and variable degrees of spermatogenic suppression in others. Based on their sperm counts, we divided these animals into two groups: azoospermic (azoo; n ؍ 4) and nonazoospermic (nonazoo; n ؍ 5) groups. Sperm density, testis volumes, and serum T, bioassayable LH (bioLH), immunoassayable FSH (immunoFSH), bioassayable FSH (bioFSH), and inhibin B were examined every 2 wk during the control period, 20 wk of T administration using SILASTIC brand (Dow Corning Corp.) implants, and recovery. Testes were biopsied for estimation of intratesticular T, dihydrotestosterone, and 5␣-androstane-3␣,17-diol. Serum T levels increased 1.5-to 2-fold, leading to decreased bioLH levels (48% of control) and intratesticular T levels (15% of control); neither LH nor intratesticular T levels differed between the azoo and nonazoo groups. In contrast, serum levels of FSH, by both bio-and immunoassay, during T administration were significantly lower in the azoo than in the nonazoo group. These results suggest that the degree of suppression of spermatogenesis is closely related to the degree of suppression of FSH levels and not to the levels of intratesticular androgens or to serum LH. These results imply that FSH plays a key role in supporting spermatogenesis in monkeys in this experimental regimen and suggest that maximal suppression of FSH may be essential to ensure consistent azoospermia in men during hormonal contraception. (J Clin Endocrinol Metab 87: 3399 -3406, 2002) A DMINISTRATION OF exogenous testosterone (T), either alone or in combination with other agents, produces profound suppression of spermatogenesis by inhibition of pituitary gonadotropins and depletion of testosterone within the testis (1-5). This approach is currently being investigated as a method of hormonal contraception for men. A consistent problem associated with T-based contraceptive regimens is that azoospermia is achieved in 40 -90% of men, but a varying degree of spermatogenic suppression is seen within and between various ethnic groups (6, 7). The reason for this variation remains unknown, but it is a critical question in designing and developing future hormonal contraceptives for men.A possible mechanism for such variation could be differences in residual testicular steroidogenesis (8); it remains controversial whether FSH levels in blood are important (5, 9) or not (10, 11) in the maintenance of sperm production in some men. There is a lack of evidence about the potential role of intratesticular androgens in the maintenance of spermatogenesis during hormonal contraceptive regimens. Also, there are very limited ...