Research · PMID 39820213 · Landmark study
Reviewed by Neal Rouzier, MD, Preventive Medicine · Sep 2026
Clinician's guide to the management of azoospermia induced by exogenous testosterone or anabolic-androgenic steroids.
Asian journal of andrology · May 2025 · Manaf Al Hashimi, Germar-Michael Pinggera, Rupin Shah, Ashok Agarwal
What this study found
Azoospermia, defined as the absence of sperm in the ejaculate, is a well-documented consequence of exogenous testosterone (ET) and anabolic-androgenic steroid (AAS) use. These agents suppress the hypothalamic-pituitary-gonadal (HPG) axis, leading to reduced intratesticular testosterone levels and impaired spermatogenesis.
Why this trial matters
TRT fertility and spermatogenesis review
How RAGMD uses this study
Clinical questions this paper informs
Synthesis lives on the evidence question — this page shows where the study sits in that analysis.
Primary study
Does testosterone therapy suppress fertility in men?
Exogenous testosterone suppresses the hypothalamic-pituitary-gonadal axis and reliably reduces spermatogenesis. Recovery after discontinuation is variable and may be incomplete in some men.
Open evidence analysis