BACKGROUND
With type 2 diabetes, hypogonadism often develops, which requires the use of testosterone replacement therapy, which can suppress spermatogenesis. It is of interest to assess the severity of this suppression and the possibility of spontaneous recovery of spermatogenesis when therapy is discontinued.
AIMS
Evaluation of the quality of ejaculate and gonadotropic secretion of the pituitary gland against the background of testosterone replacement therapy of hypogonadism and its cancellation in men with type 2 diabetes mellitus.
MATERIALS AND METHODS
A pilot observational prospective study included 50 men with type 2 diabetes receiving testosterone replacement therapy. The study period is from November 2020 to December 2021. The level of blood gonadotropins, and spermogram parameters were determined initially and after cancellation of therapy after 6 months. The differences were considered statistically significant at p< 0.05.
RESULTS
Suppression of the gonadotropic function of the pituitary gland and spermatogenesis was noted in all patients. The prevalence of azoospermia was more often observed in men on the background of therapy with injectable testosterone drugs. After discontinuation of testosterone replacement therapy, there was a statistically significant increase in gonadotropin secretion and improvement in spermogram parameters. In 32% of men, oligozoospermia was restored to normal parameters. Restoration of sperm production was noted with duration of therapy of no more than 3 years and in the presence of incomplete suppression of gonadotropin production by the pituitary gland. Among patients with recovered oligozoospermia, there were more men receiving transdermal testosterone therapy than in the group with persistent oligozoospermia.
CONCLUSIONS
Transdermal testosterone therapy has less effect on the gonadotropic function of the pituitary gland and spermogram parameters. Spontaneous recovery of oligozoospermia is possible with the cancellation of testosterone replacement therapy, depending on its duration and the type of drug used.
