Consequences of the use of anabolic-androgenic steroids for male athletes' fertility

Abstract

It is well-known that the intake of anabolic-androgenic steroids (AAS) has potential harmful effects on male sexual organs and particularly the testes. The most relevant effects of the abusive use of AAS on the male reproductive system is to affect athletes’ fertility by: reducing the secretion rate and circulating hormones of the hypothalamic–pituitary–testicular axis (endogenous testosterone and its derivatives and inhibin b); spermatogenesis alteration (oligozoospermia, azoospermia, asthenozoospermia, taratozoospermia); testicular atrophy; prostatic hypertrophy; prostatic carcinoma; difficulty/pain during urination; gynecomastia; priapism; and impotence. These and other consequences are aggravated according to the manner in which AAS are used (type of steroid, dose, and time of use). However, except in extreme situations or age at which steroid use started, these changes are usually reversed once drugs are stopped, this reversion process may be accelerated when using gonadotrophins or gonadotrophin analogues (human chorionic gonadotrophin and human menopausal gonadotrophin) to restore the axis functioning. Time to normalization is individual and depends on the type of prior steroid use and the dose and time of intake, sometimes exceeding 12 months after stopping drug use.