Evidence map›Paper›PMID 37769866›Full record

ArticleFertility and sterility2023

Fertility outcomes in men with prior history of anabolic steroid use.

Braian R Ledesma, Alexander Weber, Greeshma Venigalla, Akhil Muthigi, Jamie Thomas, Manish Narasimman, Joshua White, Ranjith Ramasamy

Open access · bronzeAbstract read
In one paragraph

Article in Fertility and sterility, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
3.0field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 15 citations in OpenAlex.

  1. Health consequences of anabolic steroids: a sexual-medicine perspective.International journal of impotence research · 2026
    Review
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Braian R LedesmaDesai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida.
Alexander WeberDesai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida.
Greeshma VenigallaDesai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida.
Akhil MuthigiDesai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida.
Jamie ThomasDesai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida.
Manish NarasimmanDesai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida.
Joshua WhiteDesai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida.
Ranjith RamasamyDesai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida. Electronic address: ranjithrama@gmail.com.
University of Miami · US

Funding

Disease Modifying Treatment Using Combined Shockwave Therapy and Platelet Rich Plasma In Microvascular Erectile DysfunctionR01DK130991 · NIDDK · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI IBRAHIM, EMAD · 2021 to 2023
$921k
Workshops and Coaching to Foster Career Skills in Newly Funded NIDDK ScholarsUE5DK137308 · NIDDK · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI Ashutosh Agarwal, ALESSIA FORNONI · 2023 to 2026
$648k
NIDDK NIH HHS R01 DK130991NIDDK NIH HHS UE5 DK137308
6 · The paper itself

Abstract

objectiveTo study sperm parameters recovery and fertility outcomes in men with azoospermia or severe oligospermia caused by anabolic steroid use who underwent a standardized treatment regimen for spermatogenesis recovery. DESIGN AND SUBJECTS: A retrospective analysis of a cohort of men with a prior history of anabolic steroid use and infertility complaints (between 2018 and 2022) was conducted. EXPOSURE: The standardized treatment approach involved discontinuing testosterone replacement therapy and administering a combination regimen of clomiphene citrate and human chorionic gonadotropin for a minimum of 3 to 6 months.

main outcome measuresThe main outcome measures included changes in sperm parameters, predominantly sperm concentration, and subsequent pregnancy outcomes.

resultsA total of 45 men (median age 37 years, IQR 32-45) met the inclusion criteria for this analysis. Median duration of prior T use was 4 years (IQR 1.3-10), with the 2 most common modalities consisting of injection therapy (43.5%) and oral therapy (34.8%). The median initial sperm concentration was 0 million/cc (IQR 0-1.15), and 23 (51.1%) men initially presented with azoospermia. The median duration of combination human chorionic gonadotropin/clomid therapy was 5 months (IQR 3-12). In initially azoospermic men (N: 23), 5 were lost to follow-up, 6 (33.3%) progressed to severe oligospermia (<5 million/cc), 6 (33.3%) to oligospermia (<15 million/cc), 1 (5.6%) to normozoospermia (>15 million/cc), and 5 (27.8%) remained azoospermic after medical treatment for 6 months. Among the 24 couples who responded to the follow-up call, a total of 9 (37.5%) achieved a successful subsequent pregnancy. Of these, 33.3% (3 couples) used assisted reproductive technology, whereas 66.7% (6 couples) conceived naturally. On logistic regression analysis, no significant predictors for improved sperm parameters or successful pregnancy were identified.

conclusionDespite appropriate treatment regimens, a significant proportion of men with a prior history of anabolic steroid use continue to exhibit severe oligospermia, with more than half showing limited improvement in semen parameters after 6 months of treatment. Only a fraction of men achieves normozoospermia after treatment. Further research is needed to explore predictors for improved sperm parameters and successful pregnancy outcomes in men with a history of anabolic steroid use.

Indexed as

AzoospermiaOligospermiaAdultAnabolic Androgenic SteroidsChorionic GonadotropinClomipheneFemaleFertilityHumansMalePregnancyRetrospective StudiesSemenTestosteroneAnabolic Androgenic SteroidsChorionic GonadotropinClomipheneTestosteroneAnabolic steroid abuseinfertilityoligospermia

Identifiers

PMID37769866
PMCPMC10841476
OpenAlexW4387046602

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.