Males azoospermia

High dosages of alkylating agents can cause prolonged azoospermia in greater than 90% of men, whereas platinum drugs can cause it in up to 50% of men. Cyropreservation of semen before treatment starts should be discussed with males at risk for treatment-induced infertility.52... 

The one product obtained from cottonseed oil, Gossypol which is categorized as non-hormonal selective spermatogenesis suppressant, is effective in producing azoospermia or severe oligospermia but it is not widely used as male contraceptive. Mechanism of action is not known. Adverse effects are edema, diarrhoea, hypokalemia, neuritis. 

Following the hearings, work by Whorton et al. (ref. 24a) showed that reversibility of the azoospermia experienced by exposed workers was probably dose-dependent and a function of individual sensitivity. OSHA then reduced the MAC to 1 ppb (ref. 25). See table on p. 167 of ref. 47 for reproductive effects on males. All registrations of end use products except for use on pineapples in Hawaii have been cancelled (EPA, ref. 103, p. 3). 

Cyclophosphamide, or testicular and cranial irradiation, in the treatment of childhood malignancies can lead to small testicular size and decreased sperm production in adulthood (58). Of 17 adult male survivors of childhood sarcomas treated before puberty with high-dose cyclophosphamide, only two had normal sperm counts, 10 had azoospermia, and five had oligospermia (34). The two patients with normal sperm counts had taken the lowest doses of cyclophosphamide. 

Rantonen J, Koskimies AI, Siimes MA. Vincristine is associated with the risk of azoospermia in adult male survivors of childhood malignancies. Eur J Cancer 1992 28A(11) 1837 1. 

Repeated exposures have resulted in increased oligospermia (low sperm counts) and azoospermia (dead sperm) in male shipyard workers, but there has been some skepticism about these reports due to small sample size. One case controlled study found significant ethoxyacetic acid presence in infertile men. An increased risk of spontaneous abortion and lowered fertility was shown in an epidemiological study of women exposed to mixtures of ethylene glycol ethers. 

Progestins A synthetic progestin, medroxyprogesterone acetate (Provera), has been used for male contraceptive trials alone or in combination with nandrolone (a synthetic androgen). When given once monthly for 2-3 months, the combined treatment caused azoospermia in about one-half of the subjects. 

Finally, control of male fertihty represents also an important option. The ideal reversible contraceptive would induce azoospermia (absence of sperm cells in semen), without influencing a man s libido or sexual potency. The current best prospect for success is the combination of testosterone and a progestin with or without a GnRH-antagonist. This regimen has shown efficient suppression of spermatogenesis and no serious adverse effects. 

In several instances severe bone marrow depression occurred, characterized by neutropenia and thrombocytopenia. The clinical chemistry profile of these cases revealed hypocholesterolemia, hyperuricemia, and hypoproteinemia. In a few cases, slight disturbance of liver function was found with mild elevations of aminotransferases. In male subjects, azoospermia or abnormal spermatozoa and reduced motility of spermatozoa were observed. Some cases presented with postexposure lacrimation, hyperemia, and edema of the conjunctiva. There were instances of protracted reduction in visual capacity and reports of retinal abnormalities [45]. Lymphocytes from exposed subjects showed a considerable number of chromosomal aberrations [46,47]. 

Sexual function Adverse effects of finasteride on male sexual function are not uncommon (SEDA-30, 480). These effects are dose related, and in the low doses used to treat hair loss (1 mg/day) they are unusual. However, they can occur in certain instances, as in two patients with azoospermia and severe oligospermia resulting in infertility when they took finasteride 1 mg/ day for hair loss the drug was withdrawn and the sperm count recovered within 3-6 months [112 ]. 

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