Management of Male Fertility in Hypogonadal Patients on Testosterone Replacement Therapy

• Published in: Medicina (Kaunas, Lithuania) Vol. 60; no. 2; p. 275
• Main Authors: Fink, Julius, Ide, Hisamitsu, Horie, Shigeo
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.02.2024
• Subjects: Drug dosages; Enzymes; Estrogens; Fertility; Health care industry; Hormone Replacement Therapy; Humans; hypogonadism; Hypogonadism - chemically induced; Hypogonadism - complications; Hypogonadism - drug therapy; Hypothalamus; Infertility; Infertility, Male - drug therapy; Male; Medical personnel; Patients; Pituitary gland; Shutdowns; Sperm; Spermatogenesis; Testes; Testosterone; Testosterone - adverse effects; testosterone replacement therapy; infertility; testosterone replacement therapy; hypogonadism
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina60020275

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.