Journal of Andrology, Vol 22, Issue 1 88-95, Copyright © 2001 by The American Society of Andrology

JOURNAL ARTICLE

Suppression of spermatogenesis with desogestrel and testosterone pellets is not enhanced by addition of finasteride

D. Kinniburgh, R. A. Anderson and D. T. Baird
Contraceptive Development Network, Centre for Reproductive Biology, University of Edinburgh, United Kingdom.

Conversion of testosterone to dihydrotestosterone (DHT) by the action of 5alpha-reductase can amplify androgen action. This may be of particular importance in the presence of low testosterone concentrations and may contribute to maintenance of spermatogenesis in a proportion of men receiving male contraceptive regimens. We therefore investigated whether the addition of finasteride, a 5alpha-reductase inhibitor, to a prototype male hormonal contraceptive regimen consisting of desogestrel (150 microg orally daily) and repeated administration of testosterone pellets (2 x 200 mg per 12 weeks) would enhance suppression of spermatogenesis. Sixteen normal men were randomized to receive either the standard androgen/progestogen treatment alone (control group) or with finasteride (5 mg orally daily-FIN group) for 24 weeks. Both groups showed profound suppression of spermatogenesis with azoospermia being obtained in 6 of 8 subjects in the control group and in 5 of 7 in the FIN group. There were no significant differences between the groups with respect to sperm concentrations. Significant suppression of luteinizing hormone and follicle-stimulating hormone was achieved within 2 weeks of treatment in both groups, while testosterone concentrations were maintained in the normal physiological range. DHT concentrations fell in both groups but were significantly lower in the FIN group. Gonadotropin and testosterone concentrations were similar for both regimens throughout the study. This study demonstrates the potential for long-term suppression of spermatogenesis using a combination of an oral progestogen with repeated administration of a depot preparation of testosterone. However, these data do not support the involvement of 5alpha-reductase in maintaining residual spermatogenesis during gonadotropin suppression for hormonal male contraception.

This article has been cited by other articles:

				S. T. Page, J. K. Amory, and W. J. Bremner Advances in Male Contraception Endocr. Rev., June 1, 2008; 29(4): 465 - 493. [Abstract] [Full Text] [PDF]

				S. T. Page, T. F. Kalhorn, W. J. Bremner, B. D. Anawalt, A. M. Matsumoto, and J. K. Amory Intratesticular Androgens and Spermatogenesis During Severe Gonadotropin Suppression Induced by Male Hormonal Contraceptive Treatment J Androl, September 1, 2007; 28(5): 734 - 741. [Abstract] [Full Text] [PDF]

				J. K. Amory, S. T. Page, B. D. Anawalt, A. D. Coviello, A. M. Matsumoto, and W. J. Bremner Elevated End-of-Treatment Serum INSL3 Is Associated With Failure to Completely Suppress Spermatogenesis in Men Receiving Male Hormonal Contraception J Androl, July 1, 2007; 28(4): 548 - 554. [Abstract] [Full Text] [PDF]

				K. L. Matthiesson and R. I. McLachlan Male hormonal contraception: concept proven, product in sight? Hum. Reprod. Update, July 1, 2006; 12(4): 463 - 482. [Abstract] [Full Text] [PDF]

				K. L. Matthiesson, P. G. Stanton, L. O'Donnell, S. J. Meachem, J. K. Amory, R. Berger, W. J. Bremner, and R. I. McLachlan Effects of Testosterone and Levonorgestrel Combined with a 5{alpha}-Reductase Inhibitor or Gonadotropin-Releasing Hormone Antagonist on Spermatogenesis and Intratesticular Steroid Levels in Normal Men J. Clin. Endocrinol. Metab., October 1, 2005; 90(10): 5647 - 5655. [Abstract] [Full Text] [PDF]

				K. L. Matthiesson, J. K. Amory, R. Berger, A. Ugoni, R. I. McLachlan, and W. J. Bremner Novel Male Hormonal Contraceptive Combinations: The Hormonal and Spermatogenic Effects of Testosterone and Levonorgestrel Combined with a 5{alpha}-Reductase Inhibitor or Gonadotropin-Releasing Hormone Antagonist J. Clin. Endocrinol. Metab., January 1, 2005; 90(1): 91 - 97. [Abstract] [Full Text] [PDF]

				Y.-L. Gui, C.-H. He, J. K. Amory, W. J. Bremner, E-X. Zheng, J. Yang, P.-J. Yang, and E.-S. Gao Male Hormonal Contraception: Suppression of Spermatogenesis by Injectable Testosterone Undecanoate Alone or With Levonorgestrel Implants in Chinese Men J Androl, September 1, 2004; 25(5): 720 - 727. [Abstract] [Full Text] [PDF]

				R. I. McLachlan, D. M. Robertson, E. Pruysers, A. Ugoni, A. M. Matsumoto, B. D. Anawalt, W. J. Bremner, and C. Meriggiola Relationship between Serum Gonadotropins and Spermatogenic Suppression in Men Undergoing Steroidal Contraceptive Treatment J. Clin. Endocrinol. Metab., January 1, 2004; 89(1): 142 - 149. [Abstract] [Full Text] [PDF]

				M. C. Meriggiola, A. Costantino, S. Cerpolini, W. J. Bremner, D. Huebler, A. M. Morselli-Labate, B. Kirsch, A. Bertaccini, C. Pelusi, and G. Pelusi Testosterone Undecanoate Maintains Spermatogenic Suppression Induced by Cyproterone Acetate Plus Testosterone Undecanoate in Normal Men J. Clin. Endocrinol. Metab., December 1, 2003; 88(12): 5818 - 5826. [Abstract] [Full Text] [PDF]

				M. C. Meriggiola, T. M.M. Farley, and M. T. Mbizvo A Review of Androgen-Progestin Regimens for Male Contraception J Androl, July 1, 2003; 24(4): 466 - 483. [Full Text] [PDF]

				R. A. Anderson and D. T. Baird Male Contraception Endocr. Rev., December 1, 2002; 23(6): 735 - 762. [Abstract] [Full Text] [PDF]

				M. C. Meriggiola, A. Costantino, W. J. Bremner, and A. M. Morselli-Labate Higher Testosterone Dose Impairs Sperm Suppression Induced by a Combined Androgen-Progestin Regimen J Androl, September 1, 2002; 23(5): 684 - 690. [Abstract] [Full Text] [PDF]

				I. T. G. Gonzalo, R. S. Swerdloff, A. L. Nelson, B. Clevenger, R. Garcia, N. Berman, and C. Wang Levonorgestrel Implants (Norplant II) for Male Contraception Clinical Trials: Combination with Transdermal and Injectable Testosterone J. Clin. Endocrinol. Metab., August 1, 2002; 87(8): 3562 - 3572. [Abstract] [Full Text] [PDF]

				R. A. Anderson, D. Kinniburgh, and D. T. Baird Suppression of Spermatogenesis by Etonogestrel Implants with Depot Testosterone: Potential for Long-Acting Male Contraception J. Clin. Endocrinol. Metab., August 1, 2002; 87(8): 3640 - 3649. [Abstract] [Full Text] [PDF]

				D. Kinniburgh, H. Zhu, L. Cheng, A.T. Kicman, D.T. Baird, and R.A. Anderson Oral desogestrel with testosterone pellets induces consistent suppression of spermatogenesis to azoospermia in both Caucasian and Chinese men Hum. Reprod., June 1, 2002; 17(6): 1490 - 1501. [Abstract] [Full Text] [PDF]

				M. C. Meriggiola, W. J. Bremner, A. Costantino, A. Bertaccini, A. M. Morselli-Labate, D. Huebler, G. Kaufmann, M. Oettel, and C. Flamigni Twenty-One Day Administration of Dienogest Reversibly Suppresses Gonadotropins and Testosterone in Normal Men J. Clin. Endocrinol. Metab., May 1, 2002; 87(5): 2107 - 2113. [Abstract] [Full Text] [PDF]

				A. Kamischke, T. Heuermann, K. Kruger, S. von Eckardstein, I. Schellschmidt, A. Rubig, and E. Nieschlag An Effective Hormonal Male Contraceptive Using Testosterone Undecanoate with Oral or Injectable Norethisterone Preparations J. Clin. Endocrinol. Metab., February 1, 2002; 87(2): 530 - 539. [Abstract] [Full Text] [PDF]

				R.I. McLachlan, L. O'Donnell, S.J. Meachem, P.G. Stanton, D.M. de Kretser, K. Pratis, and D.M. Robertson Identification of Specific Sites of Hormonal Regulation in Spermatogenesis in Rats, Monkeys, and Man Recent Prog. Horm. Res., January 1, 2002; 57(1): 149 - 179. [Abstract] [Full Text] [PDF]