Testosterone Undecanoate Maintains Spermatogenic Suppression Induced by Cyproterone Acetate Plus Testosterone Undecanoate in Normal Men

Meriggiola, Maria Cristina; Costantino, Antonietta; Cerpolini, Silvia; Bremner, William J.; Huebler, Doris; Morselli-Labate, Antonio Maria; Kirsch, Bob; Bertaccini, A.; Pelusi, Carlotta; Pelusi, Giuseppe

doi:10.1210/jc.2003-030574

Cited by 51 publications

(18 citation statements)

References 40 publications

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“…No antiandrogenic side effects were noticed in a different study investigating the combination of CPA and testosterone undecanoate 55 . Sperm suppression was induced with a high dose of CPA (20 mg/day) plus injection of 1000 mg testosterone undecanoate every 6 weeks and was maintained with only a low dose of CPA (2 mg/day) plus TU or by placebo plus TU.…”

Section: Y P R O T E R O N E a C E T A T Ementioning

confidence: 85%

Male contraception: A realistic option?

Nieschlag

2006

The European Journal of Contraception & Reproductive Health

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This review illustrates the principle of hormonal male contraception and gives an overview of current trials aiming at the development of a marketable hormonal contraceptive for men. The principle of male hormonal contraception is based on strong suppression of gonadotropins in order to arrest spermatogenesis at the spermatogonial stem cell level, thus leading to azoospermia or severe oligozoospermia. Until now, it has not been possible to interrupt spermatogenesis effectively without simultaneously inhibiting the production of androgens by Leydig cells, resulting in a deficiency of extra-testicular androgens. Therefore, testosterone needs to be replaced. By administering exogenous testosterone alone azoospermia can be reached in East Asians, whereas azoospermia is only achieved in two-thirds of Caucasian volunteers so that in these men an additional agent is required. Currently injectable testosterone combined with gestagens or administered as implants are being tested for possible licensing. Although scrotal and non-scrotal testosterone patches, orally administered testosterone undecanoate and testosterone gels are generally well tolerated and provide stable testosterone levels in the normal range, their use showed generally disappointing efficacy due to insufficient gonadotropin suppression. Further large multi-centre studies are required to establish the contraceptive efficacy of the most promising steroid combinations.

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Section: Y P R O T E R O N E a C E T A T Ementioning

confidence: 85%

Male contraception: A realistic option?

Nieschlag

2006

The European Journal of Contraception & Reproductive Health

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“…The gonadotropin suppression by progestins in the human male is mediated by genomic progesterone receptors, whereas the androgenicity of some progestins seems to contribute only minimally to gonadotropin inhibition 63 . Since excellent reviews on hormonal male contraception have been published recently; this indication for progestins in fertile men will not be treated in greater detail here [64][65][66][67][68][69] .…”

Section: Use Of Progestins In Male Contraceptionmentioning

confidence: 99%

Progesterone: the forgotten hormone in men?

Oettel¹,

Mukhopadhyay²

2004

The Aging Male

175

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'Classical' genomic progesterone receptors appear relatively late in phylogenesis, i.e. it is only in birds and mammals that they are detectable. In the different species, they mediate manifold effects regarding the differentiation of target organ functions, mainly in the reproductive system. Surprisingly, we know little about the physiology, endocrinology, and pharmacology of progesterone and progestins in male gender or men respectively, despite the fact that, as to progesterone secretion and serum progesterone levels, there are no great quantitative differences between men and women (at least outside the luteal phase). In a prospective cohort study of 1026 men with and without cardiovascular disease, we were not able to demonstrate any age-dependent change in serum progesterone concentrations. Progesterone influences spermiogenesis, sperm capacitation/acrosome reaction and testosterone biosynthesis in the Leydig cells. Other progesterone effects in men include those on the central nervous system (CNS) (mainly mediated by 5alpha-reduced progesterone metabolites as so-called neurosteroids), including blocking of gonadotropin secretion, sleep improvement, and effects on tumors in the CNS (meningioma, fibroma), as well as effects on the immune system, cardiovascular system, kidney function, adipose tissue, behavior, and respiratory system. A progestin may stimulate weight gain and appetite in men as well as in women. The detection of progesterone receptor isoforms would have a highly diagnostic value in prostate pathology (benign prostatic hypertrophy and prostate cancer). The modulation of progesterone effects on typical male targets is connected with a great pharmacodynamic variability. The reason for this is that, in men, some important effects of progesterone are mediated non-genomically through different molecular biological modes of action. Therefore, the precise therapeutic manipulation of progesterone actions in the male requires completely new endocrine-pharmacological approaches.

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“…In fact, the new reference values may not be reflective of the 'global' population, as they fail to include representatives of three continents inhabited by millions of fertile men: Asia, South America and Africa. Moreover, in evaluating morphology, the reference studies included in the WHO 2010 guideline resorted to various methods, including both Tygerberg 'strict' criteria and the David classification system (Meriggiola et al, 1996(Meriggiola et al, , 2003(Meriggiola et al, , 2005Bonde et al, 1998;Buchter et al, 1999;McLachlan et al, 2000;Auger et al, 2001;Guzick et al, 2001;Jensen et al, 2001Slama et al, 2002;Gonzalo et al, 2002;Swan et al, 2003;Turner et al, 2003;von Eckardstein et al, 2003;Brady et al, 2004;Brady et al, 2006;Haugen et al, 2006;Qoubaitary et al, 2006;Wang et al, 2006). Another issue with this new edition relates to the fact that the reference studies used only one single ejaculate to characterize each man, despite the significant biological In no cases was the P-value statistically significant when any of the three groups were compared for each parameter.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy rates with intrauterine insemination: comparing 1999 and 2010 World Health Organization semen analysis norms

Papillon-Smith

Baker²,

Agbo

et al. 2015

Reproductive BioMedicine Online

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Over the past 30 years, The World Health Organization has serially measured norms for human sperm. In this study, 1999 and 2010 semen analysis norms as predictors of pregnancy were compared during intrauterine insemination (IUI). A retrospective cohort study was conducted using data collected from the Stanford Fertility Center, between 2005 and 2007, with 981 couples undergoing 2231 IUI cycles. Collected semen was categorized according to total motile sperm counts (TMSC): 'normal (N.) 1999 TMSC', 'abnormal (AbN.) 1999/N. 2010 TMSC', or 'AbN. 2010 TMSC'. Sample comparison was also based on individual semen parameters: 'N. 1999 WHO', 'AbN. 1999/N. 2010 WHO', or 'AbN. 2010 WHO'. Pregnancy (defined by beta-HCG concentration) rates were calculated. Data were compared using correlation coefficients, t-tests and chi-squared tests, with and without adjusting for confounders. Pregnancy rate comparison based on TMSC ('N. 1999 TMSC', 'AbN. 1999/N. 2010 TMSC' and 'AbN. 2010 TMSC') showed a negative correlation (r = -0.41, P = 0.05). Pregnancy rate did not differ when comparisons were based on the presence of abnormal parameters, even when controlling for confounders. Therefore, TMSC based on the 1999 parameters shows best correlation with pregnancy rate for IUI; updating these norms in 2010 has little clinical implication in infertile populations.

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Testosterone Undecanoate Maintains Spermatogenic Suppression Induced by Cyproterone Acetate Plus Testosterone Undecanoate in Normal Men

Cited by 51 publications

References 40 publications

Male contraception: A realistic option?

Male contraception: A realistic option?

Progesterone: the forgotten hormone in men?

Pregnancy rates with intrauterine insemination: comparing 1999 and 2010 World Health Organization semen analysis norms

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