Endocrine Abstracts

JOINT1140

Background and Aims: Former use of anabolic androgenic steroids (AAS) may result in irreversible damage on testicular Leydig cell function. Impaired semen quality was reported in current AAS users but, the impact of long-term AAS usage is unclear. The primary aim of the current study was to assess semen quality in current and former AAS users compared with nonusers who had never used AAS.

Methods: Cross-sectional study including men involved in recreational training, grouped according to their AAS history. Medical records and AAS history were obtained during personal interviews. Each participant provided a semen sample to assess classical semen parameters. Impaired semen quality was defined as total sperm count below 39 million sperm, and oligospermia by a cutoff below 15 million sperm per milliliter semen, according to the World Health Organization 2021 guidelines.

Results: We included 46 former, 59 current AAS users, and 46 nonusers as controls. The mean (SD) age of all participants was 34.7 (8.5) years. The accumulated duration of AAS use, among current users was 153 weeks (114;207) (geometric mean (95% CI)), and among former users, 106 (77;145) weeks, P = 0.092. The elapsed duration since AAS cessation, was 1.3 (0.9;1.9) (geometric mean (95% CI) years in former users. A total sperm count < 39 million was more prevalent among current and former users than in nonusers, 45 (76%) vs 13 (28%) vs 2 (4%), P < 0.001. Furthermore, sperm concentration <15 million/ml was observed in 48 (81%) current vs 16 (35%) former users vs 5 (11%) nonusers, P < 0.001. Azoospermia was only present in current and former users (25 (42%) vs 2 (4%) vs 0 (0%), P < 0.001. The frequency of sperm immotility was increased among current 43 (23%) and former users 36 (20%) compared with nonusers, 26 (14%) (respectively P < 0.001, and P = 0.005) In a multivariable logistic regression model using men with previous use of AAS every doubling of duration since AAS cessation (log2) was associated with almost 50% reduction in the risk of total semen count below < 39 million (odds ratio, 0.55, 95% CI, (0.33; 0.92), P = 0.022) when adjusting for age and accumulated duration of AAS.

Conclusions: Anabolic androgenic steroids use is associated with impaired sperm count and motility among younger men with previous use more than one year after cessation. A potential improvement of sperm count over time following cessation was observed.