Azoospermia With Testosterone Therapy Despite Concomitant Intramuscular Human Chorionic Gonadotropin: NYU Case of the Month, July 2018.

Abstract

Past Medical History The patient’s past medical history was notable for a diagnosis of hypogonadism a year earlier. The patient had complained of fatigue and difficulty recovering from sports injuries. A morning total testosterone level was 250 ng/dL (normal, 30-1100 ng/dL). The patient was started on intramuscular testosterone cypionate, 100 mg weekly. In addition, he was prescribed oral anastrozole, 1 mg, and intramuscular human chorionic gonadotropin (HCG), 500 IU, both twice weekly. The patient had been assured that this regimen would allow for fertility while he was taking exogenous testosterone. The rest of the patient’s medical and surgical history was significant for anxiety and left knee surgery for a torn meniscus. His medications included trazadone and clonazepam. He denied smoking or using illicit drugs and had no relevant family history. He was an investment banker and denied genital trauma or exposure to toxic or radioactive agents.