Anabolic steroid use may lead to persistent sperm damage

Most men with a history of anabolic steroid use have severe oligospermia, with only a few of them achieving normal semen parameters after 6 months of treatment, according to a study.

The study included 45 men (median age 37 years) with a prior history of anabolic steroid use and infertility complaints. These men underwent a standardized treatment approach, which involved discontinuing testosterone replacement therapy and administering a combination regimen of clomiphene citrate and human chorionic gonadotropin (hCG) for 3 to 6 months.

The median duration of prior testosterone use was 4 years, with the most common modalities being injection therapy (43.5 percent) and oral therapy (34.8 percent). A total of 23 men (51.1 percent) presented with azoospermia, and the median sperm concentration for the entire sample at baseline was 0 million/cc. The median duration of combination hCG/clomiphene citrate therapy was 5 months.

Among the group of men who initially presented with azoospermia, six (33.3 percent) had severe oligospermia (<5 million/cc), six (33.3 percent) had oligospermia (<15 million/cc), one (5.6 percent) had normozoospermia (>15 million/cc), and five (27.8 percent) remained azoospermic following 6 months of combination treatment. Five men were lost to follow-up.

Of the 24 couples who responded to the follow-up call, nine achieved a successful subsequent pregnancy (37.5 percent). Of these nine, three couples (33.3 percent) used assisted reproductive technology while six (66.7 percent) conceived naturally. Logistic regression analysis showed no significant predictors for improved sperm parameters or successful pregnancy following treatment with the combination of hCG/clomiphene citrate.