Management of Male Fertility in Hypogonadal Patients on Testosterone Replacement Therapy

Abstract

Testosterone is crucial in regulating several body functions in men, including metabolic, sexual, and cardiovascular functions, bone and muscle mass, and mental health. Therefore, optimizing testosterone levels in men is an important step to maintaining a healthy body and mind, especially as we age. However, traditional testosterone replacement therapy has been shown to lead to male infertility, caused by negative feedback in the hypothalamic–pituitary–gonadal (HPG) axis. Recent advances in research have led to the discovery of many new methods of administration, which can have more or less suppressive effects on the HPG axis. Also, the usage of ancillary medications instead of or after testosterone administration might help maintain fertility in hypogonadal patients. The goal of this narrative review is to summarize the newest methods for optimizing fertility parameters in patients undergoing treatment for hypogonadism and to provide the necessary information for healthcare providers to make the right treatment choices.

Oxidative Stress-Associated Male Infertility: Current Diagnostic and Therapeutic Approaches

“…These drugs primarily aim to inhibit or reverse the activity of the hypothalamic–pituitary–gonadal axis to enhance spermatogenesis. Hormonal treatments have demonstrated significant efficacy, particularly in individuals with IHH [ 111 ]. While both SERMs and aromatase inhibitors hold promise for off-label use in the treatment of idiopathic male infertility, further large-scale randomized controlled trials incorporating data on pregnancy outcomes are needed to provide more conclusive evidence.…”