Efficacy of human chorionic gonadotropin hormone in restoring spermatogenesis in men using non-prescribed androgens: a retrospective analysis of real-world data

Abstract

Objective

To study the efficacy of human chorionic gonadotropin (hCG) in restoring spermatogenesis in men using non-prescribed androgens who are unwilling to discontinue their use.

Design

Retrospective analysis.

Patients

Nineteen men attending a harm reduction clinic in the Netherlands from April 2023 to July 2024, who had been using androgens for at least three months and were treated with hCG without ceasing androgen use.

Exposure

Continuous use of non-prescribed androgens and hCG therapy administered as part of a harm reduction strategy.

Main Outcome Measures

Change in total sperm count (TSC) and total motile sperm counts (TMSC) from baseline to after three to six months of hCG treatment.

Results

The mean TSC increased significantly from 18.0 million to 146.9 million after hCG treatment and TMSC increased from 1.1 million at baseline to 66.9 million post-treatment. The number of men with a normal TMSC increased from 5% to 58%. No statistically significant predictors of TSC change were identified through regression analysis.

Conclusion

Human chorionic gonadotropin appears to be effective in improving spermatogenesis in the majority of men who continue non-prescribed androgen use, whereas some men remain oligospermic or azoospermic. These findings support the cautious inclusion of hCG in harm reduction strategies, while emphasizing the need for further research and individualized counseling.