Optimal restoration of spermatogenesis after testosterone therapy using human chorionic gonadotropin and follicle-stimulating hormone.

Objective: To study improvements in spermatogenesis in men with a history of testosterone therapy using a novel fertility treatment regimen.

Design: A single-center retrospective cohort analysis.

Setting: Clinic.

Patient(s): Seventy-seven men with previous testosterone use seeking fertility treatment from January 2020 to March 2024.

Intervention(s): A treatment regimen of 3,000 IU of human chorionic gonadotropin (hCG) and 75 IU of follicle-stimulating hormone (FSH) three times a week was used.

Main Outcome Measures(s): The primary outcome measured was change in sperm concentration during hCG/FSH therapy. The secondary outcome measured was whether concurrent testosterone therapy during hCG/FSH therapy affected recovery of spermatogenesis.

Result(s): Within the entire cohort (n = 77), 74% of men demonstrated improvements in their sperm concentrations. There was not a significant difference in recovery of sperm concentration in men who stayed on testosterone therapy during hCG/FSH reboot (no testosterone therapy [n = 50], 74% improved, vs. concurrent testosterone therapy [n = 27], 74% improved).

Conclusion(s): We report optimal recovery of spermatogenesis with hCG/FSH therapy in men with infertility with a history of testosterone use. Concurrent testosterone therapy does not impede hCG/FSH-mediated spermatogenic recovery.