Choosing Wisely:

Don’t prescribe testosterone or testosterone products to men contemplating/ attempting to initiate pregnancy.

Rationale and Comments: Testosterone therapy is widely used as treatment for hypoandrogenemia and associated symptoms such as sexual dysfunction. However, it is well established that exogenous testosterone and other androgens can lead to decreased or absent sperm production, low sperm count, and infertility. Furthermore, this is not always reversible, even after removing the exogenous androgens.
Sponsoring Organizations:
  • American Society for Reproductive Medicine
  • Sources:
  • Randomized controlled trials
  • Disciplines:
  • Urologic
  • Endocrinologic
  • References: • Amory JK. Progress and prospects in male hormonal contraception. Curr Opin Endocrinol Diabetes Obes. 2008 Jun;15(3):255–60.
    • Gu Y, Liang X, Wu W, Liu M, Song S, Cheng L, Bo L, Xiong C, Wang X, Liu X, Peng L, Yao K. Multicenter contraceptive efficacy trial of injectable testosterone undecanoate in Chinese men. J Clin Endocrinol Metab. 2009;94(6):1910–5.
    • Moss JL, Crosnoe LE, Kim ED. Effect of rejuvenation hormones on spermatogenesis. Fertil Steril. 2013 jun;99(7):1814–20.

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