Male fertility before and after androgen abuse.

Previous research has found that male users of androgens are diagnosed, approximately, twice as often with infertility. We therefore set out to investigate the fertility in men using androgens.The study includes the 545 males who were tested positive for androgens in an anti-doping test program in Danish fitness centers during the period January 3 rd, 2006 to March 1 st, 2018. The confirmed users were matched by birth year with 5,450 male controls. We followed this cohort from ten years prior to testing positive and until the end of follow-up in May 2018.During the ten-year period prior to testing positive the group of androgen users experienced a 26% lower fertility rate than the controls (rate ratio: 0.74, 95% CI: (0.60-0.90), p=0.0028). However, in the years following the doping sanction, they made a significant catch-up, and at completed follow-up the total fertility rate was only 7% lower than expected (RR 0.93, 95% CI (0.84-1.03). The prevalence of assisted reproduction was 5.69% in the group of androgen users and 5.28% in the control group (p =0.69).Androgen use was associated with a temporary decline in fertility and most androgen users obtained parenthood without any help from the healthcare system. Overall, the fertility rate and the prevalence of assisted reproduction among androgen users were close to that in the background population.

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