Endocrine Abstracts

The prevalence of LOH among middle-aged men, who want to have kids, is increasing. According to HIM study (Mulligan T, Frick MF 2006), the prevalence of LOH is 34% in men, aged 45–54. There are 3 wide-spread forms of testosterone treatment of LOH: oral, i/m forms, and gels. Oral forms of treatment are known to have a rather weak effect. I/m forms of testosterone treatment have a significant negative effect on spermatogenesis down to azoospermia, causing decrease in LH and FSH levels. The effect transdermal forms of testosterone treatment on spermatogenesis is not studied.

Objective: To evaluate the influence of testosterone-gel (Androgel) therapy in men with LOH on the parameters of spermatogenesis.

Material and methods: Of 16 men with clinically and laboratory approved LOH, aged 45–58 years old were included in the study. All the patients were receiving Androgel (testogel) 50 mg daily. Spermatogenesis was assessed after 6 months of treatment. Total and calculated free testosterone levels were evaluated after 1 and 6 moths of treatment. Spermatogenesis was assessed according to WHO recommendations: sperm count (millions/ml), motility, percent normal forms and viability of spermatozoa were used. Categorical variables were presented as median and quartile range.

Results: Total and calculated free testosterone levels were normal in all the patients after 1 and 6 months. After 6 moths of therapy sperm count was 37.5 (11.0;55.0) millions/ml, motility (a+b) – 14.0 (6.0;28.0) %, percent of normal forms – 7.0 (1.0;12.0), viability – 86.0 (61.0;96.0) %.

Conclusion: AndroGel treatment has some negative effect on motility and morphology of spermatozoa, though it might have only a slight effect on sperm count. Further investigation with a bigger amount of patients, spermatogenesis assessment before and during the therapy is needed. Androgel treatment might be preferable to using i/m forms in such patients.