In a nutshell
This study investigated the rate of testosterone replacement therapy (TRT) in men undergoing assisted reproduction (AR). They found that men undergoing AR were more likely to need TRT.
Low testosterone (T) is becoming increasingly common worldwide. Low T in men is associated with a number of conditions. This includes cardiovascular disease and diabetes. It is also associated with higher mortality. Low T can be caused by other conditions including obesity. T replacement therapy (TRT) is used to treat this.
Infertile men are more likely to have low T. Up to 30% of infertile men have low T. Men undergoing assisted reproduction (AR) such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cannot take TRT. This is because T can block sperm production. However, TRT for low T is important once fertility treatment is complete. It is unclear if TRT is more commonly prescribed to infertile men with low T after AR.
Methods & findings
This study included 418,847 men trying to conceive. 17,695 underwent AR such as IVF or ICSI to father children. The authors compared TRT prescription rates between men that underwent AR and men with normal fertility (control group).
TRT prescription rates were higher in men that underwent AR compared to those who conceived naturally. Men that underwent ICSI were 3.81-times more likely to need TRT compared to controls. Men that underwent IVF were 1.54-times more likely to need TRT compared to controls. The average time between fathering a child and TRT prescription was 4.41 years.
The bottom line
The authors concluded that men undergoing AR were more likely to need TRT later in life. The authors suggest routine hormonal testing of such men to avoid complications of low T.
The fine print
This was an observational study. The causes of low T were not examined. It is unclear if TRT was common in men that did not father a child. These men were excluded from the study.
If you have any concerns regarding infertility please consult with your physician.
Published By :
European journal of endocrinology
Apr 01, 2020