Successful treatment of anabolic steroid–induced azoospermia with human chorionic gonadotropin and human menopausal gonadotropin

Abstract

Objective To document for the first time the successful treatment using human chorionic gonadotropin (hCG) and human menopausal gonadotropins (hMG) of anabolic steroid–induced azoospermia that was persistent despite 1 year of cessation from steroid use. Design Clinical case report. Setting Tertiary referral center for infertility. Patient(s) A married couple with primary subfertility secondary to azoospermia and male hypogonadotropic hypogonadism. The husband was a bodybuilder who admitted to have used the anabolic steroids testosterone cypionate, methandrostenolone, oxandrolone, testosterone propionate, oxymetholone, nandrolone decanoate, and methenolone enanthate. Intervention(s) Twice-weekly injections of 10,000 IU of hCG (Profasi; Serono) and daily injections of 75 IU of hMG (Humegon; Organon) for 3 months. Main outcome measure(s) Semen analyses, pregnancy. Result(s) Semen analyses returned to normal after 3 months of treatment. The couple conceived spontaneously 7 months later. Conclusion(s) Steroid-induced azoospermia that is persistent after cessation of steroid use can be treated successfully with hCG and hMG.