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dc.creatorMatsumoto, Alvin M.
dc.creatorBremner, William J.
dc.creatorAnawalt, Bradley D.
dc.creatorBebb, Richard A.
dc.date2008-10-17T20:40:35Z
dc.date2008-10-17T20:40:35Z
dc.date1999-05
dc.date.accessioned2012-06-12T05:12:50Z
dc.date.available2012-06-12T05:12:50Z
dc.date.issued2012-06-12
dc.identifierJ Androl. 1999 May-Jun;20(3):407-14
dc.identifierhttp://hdl.handle.net/1773/4314
dc.identifier.urihttps://repositorio.leon.uia.mx/xmlui/1773/4314
dc.descriptionStudies using exogenous high-dosage testosterone (T) or a combination regimen of physiologic T plus high-dosage levonorgestrel (LNG) administration in normal men have shown that oligoazoospermia (<3 million/mL) or azoospermia can be achieved in the majority of the men. However, these hormonal regimens have been associated with significant weight gain and suppression of serum high-density lipoprotein (HDL) cholesterol levels. We hypothesized that a combination of physiologic exogenous testosterone and lower dosage LNG would result in uniform severe oligoazoospermia or azoospermia in normal men but would cause fewer adverse metabolic side effects. We conducted a randomized, placebo-controlled, single-blind trial comparing 6 months of T enanthate (100 mg IM, weekly) plus LNG, 125 microg by mouth, daily (LNG 125; n = 18) or LNG, 250 microg by mouth, daily (LNG 250; n = 18) and compared these regimens with our previous study of the same dosage of T enanthate combined with placebo LNG (LNG 0; n = 18) or with 500 mg of LNG (LNG= 500; n = 18). All three combination regimens of T enanthate and LNG suppressed spermatogenesis more rapidly and resulted in significantly more uniform severe oligoazoospermia (<1 million/mL) than the T-alone regimen. Severe oligoazoospermia was achieved in 89% of the LNG 125, 89% of the LNG 250, and 78% of the LNG 500 groups, respectively, versus 56% of the men in LNG 0 (P < 0.05 for the combination groups vs. LNG 0), but there were no significant differences between the combination regimens (P = NS). All four groups gained significant weight compared with their baselines, although the gain tended to be greater as the dosage of LNG increased (2.0+/-0.9, 2.9+/-1.1, 3.6+/-1.0, and 5.4+/-1.0 kg gained, compared with baseline in the LNG 0, 125, 250, and 500 groups respectively; P < 0.05 compared with baseline). Serum levels of HDL cholesterol decreased in all of the groups, but the effect was larger as the dosage of LNG increased (4+/-4% vs. 13+/-4%, 20+/-3%, and 22+/-4% decrease in HDL levels from baseline in the LNG 0, LNG 125, LNG 250, and LNG 500 groups respectively; P = 0.06 for LNG 125 compared with LNG 0, and P < 0.05 for LNG 250 and LNG 500 compared with LNG 0). We conclude that 1) the combination of physiologic exogenous T enanthate and LNG suppresses spermatogenesis more effectively than T enanthate alone and that 2) the combination regimen of T enanthate plus lower dosage LNG suppresses sperm production comparably to T enanthate plus higher dosage LNG, while causing less weight gain and HDL cholesterol suppression. A combination regimen of physiologic testosterone plus a low dosage of levonorgestrel offers great promise as a safe and effective male contraceptive regimen.
dc.languageen_US
dc.publisherAmerican Society of Andrology
dc.subjectmale contraception
dc.subjectspermatogenesis
dc.subjecttestosterone
dc.subjectgonadotropins
dc.subjectlevonorgestrel
dc.subjectGonadotropins, Pituitary, blood
dc.subjectDrug Therapy, Combination
dc.subjectHumans
dc.subjectMale
dc.subjectGynecomastia, chemically induced
dc.subjectBody Weight, drug effects
dc.subjectSingle-Blind Method
dc.subjectResearch Support, Non-U.S. Gov't
dc.subjectResearch Support, U.S. Gov't, Non-P.H.S.
dc.subjectAcne Vulgaris, chemically induced
dc.subjectSpermatogenesis, drug effects
dc.subjectLevonorgestrel, administration & dosage, adverse effects, blood
dc.subjectContraceptive Agents, Male, administration & dosage, adverse effects, blood
dc.subjectDose-Response Relationship, Drug
dc.subjectCholesterol, blood
dc.subjectResearch Support, U.S. Gov't, P.H.S.
dc.subjectAdult
dc.subjectApolipoprotein A-I, blood
dc.subjectTestosterone, administration & dosage, adverse effects, analogs & derivatives, blood
dc.subjectSperm Count, drug effects
dc.titleA lower dosage levonorgestrel and testosterone combination effectively suppresses spermatogenesis and circulating gonadotropin levels with fewer metabolic effects than higher dosage combinations
dc.typeArticle


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