{ "name": "Sperm Recovery After Testosterone Evidence Map", "version": "2.0", "verified_date": "2026-09-03", "scope_note": "Transparent anchor-study evidence map; not an exhaustive systematic review or meta-analysis.", "study_count": 11, "record_count": 73, "field_count": 28, "records": [ { "record_id": "SRAT-001", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "liu-2006", "citation_short": "Liu et al. 2006", "year": 2006, "title": "Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis", "journal": "The Lancet", "doi": "10.1016/S0140-6736(06)68614-5", "pmid": "16650651", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16650651/", "evidence_group": "Controlled hormonal male-contraception benchmark", "study_design": "Integrated participant-level analysis of 30 prospective studies", "setting": "Controlled male hormonal-contraception research", "population": "1,549 healthy eugonadal men ages 18–51", "exposure": "Androgen-only or androgen-plus-progestin regimens designed to suppress spermatogenesis", "sample_size": "1549", "testosterone_during_recovery": "Study regimen stopped", "recovery_treatment": "Observation after planned regimen cessation", "record_type": "study scope", "endpoint_or_finding": "Primary studies included", "threshold_or_definition": "Male hormonal-contraception studies", "time_point": "", "numerator": "", "denominator": "", "reported_value": "30 studies", "interpretation": "Defines the source set behind the recovery model.", "main_limit": "Healthy volunteers in time-limited research regimens; not a typical long-term TRT cohort; modeled recovery curve; no pregnancy endpoint." }, { "record_id": "SRAT-002", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "liu-2006", "citation_short": "Liu et al. 2006", "year": 2006, "title": "Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis", "journal": "The Lancet", "doi": "10.1016/S0140-6736(06)68614-5", "pmid": "16650651", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16650651/", "evidence_group": "Controlled hormonal male-contraception benchmark", "study_design": "Integrated participant-level analysis of 30 prospective studies", "setting": "Controlled male hormonal-contraception research", "population": "1,549 healthy eugonadal men ages 18–51", "exposure": "Androgen-only or androgen-plus-progestin regimens designed to suppress spermatogenesis", "sample_size": "1549", "testosterone_during_recovery": "Study regimen stopped", "recovery_treatment": "Observation after planned regimen cessation", "record_type": "sample", "endpoint_or_finding": "Participants analyzed", "threshold_or_definition": "Healthy eugonadal men ages 18–51", "time_point": "", "numerator": "", "denominator": "", "reported_value": "1,549 men", "interpretation": "Largest quantitative recovery dataset in this evidence map.", "main_limit": "Healthy volunteers in time-limited research regimens; not a typical long-term TRT cohort; modeled recovery curve; no pregnancy endpoint." }, { "record_id": "SRAT-003", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "liu-2006", "citation_short": "Liu et al. 2006", "year": 2006, "title": "Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis", "journal": "The Lancet", "doi": "10.1016/S0140-6736(06)68614-5", "pmid": "16650651", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16650651/", "evidence_group": "Controlled hormonal male-contraception benchmark", "study_design": "Integrated participant-level analysis of 30 prospective studies", "setting": "Controlled male hormonal-contraception research", "population": "1,549 healthy eugonadal men ages 18–51", "exposure": "Androgen-only or androgen-plus-progestin regimens designed to suppress spermatogenesis", "sample_size": "1549", "testosterone_during_recovery": "Study regimen stopped", "recovery_treatment": "Observation after planned regimen cessation", "record_type": "time-to-threshold", "endpoint_or_finding": "Median time to threshold", "threshold_or_definition": "≥3 million sperm/mL", "time_point": "After regimen stopped", "numerator": "", "denominator": "", "reported_value": "2.5 months (95% CI 2.4–2.7)", "interpretation": "Modeled median; not a pregnancy result.", "main_limit": "Healthy volunteers in time-limited research regimens; not a typical long-term TRT cohort; modeled recovery curve; no pregnancy endpoint." }, { "record_id": "SRAT-004", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "liu-2006", "citation_short": "Liu et al. 2006", "year": 2006, "title": "Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis", "journal": "The Lancet", "doi": "10.1016/S0140-6736(06)68614-5", "pmid": "16650651", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16650651/", "evidence_group": "Controlled hormonal male-contraception benchmark", "study_design": "Integrated participant-level analysis of 30 prospective studies", "setting": "Controlled male hormonal-contraception research", "population": "1,549 healthy eugonadal men ages 18–51", "exposure": "Androgen-only or androgen-plus-progestin regimens designed to suppress spermatogenesis", "sample_size": "1549", "testosterone_during_recovery": "Study regimen stopped", "recovery_treatment": "Observation after planned regimen cessation", "record_type": "time-to-threshold", "endpoint_or_finding": "Median time to threshold", "threshold_or_definition": "≥10 million sperm/mL", "time_point": "After regimen stopped", "numerator": "", "denominator": "", "reported_value": "3.0 months (95% CI 2.9–3.1)", "interpretation": "Modeled median; not a pregnancy result.", "main_limit": "Healthy volunteers in time-limited research regimens; not a typical long-term TRT cohort; modeled recovery curve; no pregnancy endpoint." }, { "record_id": "SRAT-005", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "liu-2006", "citation_short": "Liu et al. 2006", "year": 2006, "title": "Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis", "journal": "The Lancet", "doi": "10.1016/S0140-6736(06)68614-5", "pmid": "16650651", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16650651/", "evidence_group": "Controlled hormonal male-contraception benchmark", "study_design": "Integrated participant-level analysis of 30 prospective studies", "setting": "Controlled male hormonal-contraception research", "population": "1,549 healthy eugonadal men ages 18–51", "exposure": "Androgen-only or androgen-plus-progestin regimens designed to suppress spermatogenesis", "sample_size": "1549", "testosterone_during_recovery": "Study regimen stopped", "recovery_treatment": "Observation after planned regimen cessation", "record_type": "time-to-threshold", "endpoint_or_finding": "Median time to threshold", "threshold_or_definition": "≥20 million sperm/mL", "time_point": "After regimen stopped", "numerator": "", "denominator": "", "reported_value": "3.4 months (95% CI 3.2–3.5)", "interpretation": "Modeled median; not return to a personal baseline.", "main_limit": "Healthy volunteers in time-limited research regimens; not a typical long-term TRT cohort; modeled recovery curve; no pregnancy endpoint." }, { "record_id": "SRAT-006", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "liu-2006", "citation_short": "Liu et al. 2006", "year": 2006, "title": "Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis", "journal": "The Lancet", "doi": "10.1016/S0140-6736(06)68614-5", "pmid": "16650651", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16650651/", "evidence_group": "Controlled hormonal male-contraception benchmark", "study_design": "Integrated participant-level analysis of 30 prospective studies", "setting": "Controlled male hormonal-contraception research", "population": "1,549 healthy eugonadal men ages 18–51", "exposure": "Androgen-only or androgen-plus-progestin regimens designed to suppress spermatogenesis", "sample_size": "1549", "testosterone_during_recovery": "Study regimen stopped", "recovery_treatment": "Observation after planned regimen cessation", "record_type": "modeled probability", "endpoint_or_finding": "Share reaching threshold", "threshold_or_definition": "≥20 million sperm/mL", "time_point": "6 months", "numerator": "", "denominator": "", "reported_value": "67% (95% CI 61%–72%)", "interpretation": "Applies to the controlled-study population, not every long-term TRT user.", "main_limit": "Healthy volunteers in time-limited research regimens; not a typical long-term TRT cohort; modeled recovery curve; no pregnancy endpoint." }, { "record_id": "SRAT-007", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "liu-2006", "citation_short": "Liu et al. 2006", "year": 2006, "title": "Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis", "journal": "The Lancet", "doi": "10.1016/S0140-6736(06)68614-5", "pmid": "16650651", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16650651/", "evidence_group": "Controlled hormonal male-contraception benchmark", "study_design": "Integrated participant-level analysis of 30 prospective studies", "setting": "Controlled male hormonal-contraception research", "population": "1,549 healthy eugonadal men ages 18–51", "exposure": "Androgen-only or androgen-plus-progestin regimens designed to suppress spermatogenesis", "sample_size": "1549", "testosterone_during_recovery": "Study regimen stopped", "recovery_treatment": "Observation after planned regimen cessation", "record_type": "modeled probability", "endpoint_or_finding": "Share reaching threshold", "threshold_or_definition": "≥20 million sperm/mL", "time_point": "12 months", "numerator": "", "denominator": "", "reported_value": "90% (95% CI 85%–93%)", "interpretation": "Does not mean 90% returned to baseline or caused pregnancy.", "main_limit": "Healthy volunteers in time-limited research regimens; not a typical long-term TRT cohort; modeled recovery curve; no pregnancy endpoint." }, { "record_id": "SRAT-008", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "liu-2006", "citation_short": "Liu et al. 2006", "year": 2006, "title": "Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis", "journal": "The Lancet", "doi": "10.1016/S0140-6736(06)68614-5", "pmid": "16650651", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16650651/", "evidence_group": "Controlled hormonal male-contraception benchmark", "study_design": "Integrated participant-level analysis of 30 prospective studies", "setting": "Controlled male hormonal-contraception research", "population": "1,549 healthy eugonadal men ages 18–51", "exposure": "Androgen-only or androgen-plus-progestin regimens designed to suppress spermatogenesis", "sample_size": "1549", "testosterone_during_recovery": "Study regimen stopped", "recovery_treatment": "Observation after planned regimen cessation", "record_type": "modeled probability", "endpoint_or_finding": "Share reaching threshold", "threshold_or_definition": "≥20 million sperm/mL", "time_point": "16 months", "numerator": "", "denominator": "", "reported_value": "96% (95% CI 92%–98%)", "interpretation": "Modeled controlled-study result.", "main_limit": "Healthy volunteers in time-limited research regimens; not a typical long-term TRT cohort; modeled recovery curve; no pregnancy endpoint." }, { "record_id": "SRAT-009", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "liu-2006", "citation_short": "Liu et al. 2006", "year": 2006, "title": "Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis", "journal": "The Lancet", "doi": "10.1016/S0140-6736(06)68614-5", "pmid": "16650651", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16650651/", "evidence_group": "Controlled hormonal male-contraception benchmark", "study_design": "Integrated participant-level analysis of 30 prospective studies", "setting": "Controlled male hormonal-contraception research", "population": "1,549 healthy eugonadal men ages 18–51", "exposure": "Androgen-only or androgen-plus-progestin regimens designed to suppress spermatogenesis", "sample_size": "1549", "testosterone_during_recovery": "Study regimen stopped", "recovery_treatment": "Observation after planned regimen cessation", "record_type": "modeled probability", "endpoint_or_finding": "Share reaching threshold", "threshold_or_definition": "≥20 million sperm/mL", "time_point": "24 months", "numerator": "", "denominator": "", "reported_value": "100% modeled; confidence interval not stated in abstract", "interpretation": "Modeled group result, not a personal guarantee.", "main_limit": "Healthy volunteers in time-limited research regimens; not a typical long-term TRT cohort; modeled recovery curve; no pregnancy endpoint." }, { "record_id": "SRAT-010", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "liu-2006", "citation_short": "Liu et al. 2006", "year": 2006, "title": "Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis", "journal": "The Lancet", "doi": "10.1016/S0140-6736(06)68614-5", "pmid": "16650651", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16650651/", "evidence_group": "Controlled hormonal male-contraception benchmark", "study_design": "Integrated participant-level analysis of 30 prospective studies", "setting": "Controlled male hormonal-contraception research", "population": "1,549 healthy eugonadal men ages 18–51", "exposure": "Androgen-only or androgen-plus-progestin regimens designed to suppress spermatogenesis", "sample_size": "1549", "testosterone_during_recovery": "Study regimen stopped", "recovery_treatment": "Observation after planned regimen cessation", "record_type": "modifier", "endpoint_or_finding": "Age association", "threshold_or_definition": "Older age within study range", "time_point": "", "numerator": "", "denominator": "", "reported_value": "Associated with faster modeled recovery", "interpretation": "This direction differs from Kohn 2017, so age has no universal effect across settings.", "main_limit": "Healthy volunteers in time-limited research regimens; not a typical long-term TRT cohort; modeled recovery curve; no pregnancy endpoint." }, { "record_id": "SRAT-011", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "liu-2006", "citation_short": "Liu et al. 2006", "year": 2006, "title": "Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis", "journal": "The Lancet", "doi": "10.1016/S0140-6736(06)68614-5", "pmid": "16650651", "source_url": "https://pubmed.ncbi.nlm.nih.gov/16650651/", "evidence_group": "Controlled hormonal male-contraception benchmark", "study_design": "Integrated participant-level analysis of 30 prospective studies", "setting": "Controlled male hormonal-contraception research", "population": "1,549 healthy eugonadal men ages 18–51", "exposure": "Androgen-only or androgen-plus-progestin regimens designed to suppress spermatogenesis", "sample_size": "1549", "testosterone_during_recovery": "Study regimen stopped", "recovery_treatment": "Observation after planned regimen cessation", "record_type": "modifier", "endpoint_or_finding": "Other recovery modifiers", "threshold_or_definition": "Baseline and regimen features", "time_point": "", "numerator": "", "denominator": "", "reported_value": "Shorter treatment, shorter-acting testosterone, higher baseline sperm concentration, faster suppression, lower baseline LH, and Asian origin were associated with faster recovery", "interpretation": "Associations from controlled studies, not a personal calculator.", "main_limit": "Healthy volunteers in time-limited research regimens; not a typical long-term TRT cohort; modeled recovery curve; no pregnancy endpoint." }, { "record_id": "SRAT-012", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "kaminetsky-2013", "citation_short": "Kaminetsky et al. 2013", "year": 2013, "title": "Oral enclomiphene citrate stimulates the endogenous production of testosterone and sperm counts in men with low testosterone: comparison with testosterone gel", "journal": "The Journal of Sexual Medicine", "doi": "10.1111/jsm.12116", "pmid": "23530575", "source_url": "https://pubmed.ncbi.nlm.nih.gov/23530575/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Randomized, open-label, fixed-dose, active-control, two-center phase IIB proof-of-principle study", "setting": "Two clinical study centers", "population": "12 men with secondary hypogonadism previously treated with topical testosterone", "exposure": "Prior topical testosterone; then enclomiphene or testosterone gel", "sample_size": "12", "testosterone_during_recovery": "Prior topical testosterone stopped; active-control group then received testosterone gel", "recovery_treatment": "Enclomiphene citrate or testosterone gel", "record_type": "sample", "endpoint_or_finding": "Participants randomized", "threshold_or_definition": "Previously treated with topical testosterone", "time_point": "", "numerator": "", "denominator": "", "reported_value": "12 men", "interpretation": "Small active-control trial.", "main_limit": "Only 12 men; open-label active-control study; no untreated arm; not an infertility-clinic cohort; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-013", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "kaminetsky-2013", "citation_short": "Kaminetsky et al. 2013", "year": 2013, "title": "Oral enclomiphene citrate stimulates the endogenous production of testosterone and sperm counts in men with low testosterone: comparison with testosterone gel", "journal": "The Journal of Sexual Medicine", "doi": "10.1111/jsm.12116", "pmid": "23530575", "source_url": "https://pubmed.ncbi.nlm.nih.gov/23530575/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Randomized, open-label, fixed-dose, active-control, two-center phase IIB proof-of-principle study", "setting": "Two clinical study centers", "population": "12 men with secondary hypogonadism previously treated with topical testosterone", "exposure": "Prior topical testosterone; then enclomiphene or testosterone gel", "sample_size": "12", "testosterone_during_recovery": "Prior topical testosterone stopped; active-control group then received testosterone gel", "recovery_treatment": "Enclomiphene citrate or testosterone gel", "record_type": "sperm result", "endpoint_or_finding": "Enclomiphene participants with elevated sperm counts", "threshold_or_definition": "Reported concentrations 75–334 million/mL", "time_point": "3 months", "numerator": "7", "denominator": "7", "reported_value": "7 of 7", "interpretation": "Every measured participant in this arm had elevated sperm counts.", "main_limit": "Only 12 men; open-label active-control study; no untreated arm; not an infertility-clinic cohort; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-014", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "kaminetsky-2013", "citation_short": "Kaminetsky et al. 2013", "year": 2013, "title": "Oral enclomiphene citrate stimulates the endogenous production of testosterone and sperm counts in men with low testosterone: comparison with testosterone gel", "journal": "The Journal of Sexual Medicine", "doi": "10.1111/jsm.12116", "pmid": "23530575", "source_url": "https://pubmed.ncbi.nlm.nih.gov/23530575/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Randomized, open-label, fixed-dose, active-control, two-center phase IIB proof-of-principle study", "setting": "Two clinical study centers", "population": "12 men with secondary hypogonadism previously treated with topical testosterone", "exposure": "Prior topical testosterone; then enclomiphene or testosterone gel", "sample_size": "12", "testosterone_during_recovery": "Prior topical testosterone stopped; active-control group then received testosterone gel", "recovery_treatment": "Enclomiphene citrate or testosterone gel", "record_type": "sperm result", "endpoint_or_finding": "Enclomiphene participants with elevated sperm counts", "threshold_or_definition": "Reported concentrations 75–334 million/mL", "time_point": "6 months", "numerator": "6", "denominator": "6", "reported_value": "6 of 6", "interpretation": "One fewer participant had a reported six-month measure.", "main_limit": "Only 12 men; open-label active-control study; no untreated arm; not an infertility-clinic cohort; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-015", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "kaminetsky-2013", "citation_short": "Kaminetsky et al. 2013", "year": 2013, "title": "Oral enclomiphene citrate stimulates the endogenous production of testosterone and sperm counts in men with low testosterone: comparison with testosterone gel", "journal": "The Journal of Sexual Medicine", "doi": "10.1111/jsm.12116", "pmid": "23530575", "source_url": "https://pubmed.ncbi.nlm.nih.gov/23530575/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Randomized, open-label, fixed-dose, active-control, two-center phase IIB proof-of-principle study", "setting": "Two clinical study centers", "population": "12 men with secondary hypogonadism previously treated with topical testosterone", "exposure": "Prior topical testosterone; then enclomiphene or testosterone gel", "sample_size": "12", "testosterone_during_recovery": "Prior topical testosterone stopped; active-control group then received testosterone gel", "recovery_treatment": "Enclomiphene citrate or testosterone gel", "record_type": "active-control result", "endpoint_or_finding": "Testosterone-gel participants above threshold", "threshold_or_definition": ">20 million/mL", "time_point": "3 months", "numerator": "0", "denominator": "5", "reported_value": "0 of 5", "interpretation": "Active-control result, not untreated natural recovery.", "main_limit": "Only 12 men; open-label active-control study; no untreated arm; not an infertility-clinic cohort; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-016", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "kaminetsky-2013", "citation_short": "Kaminetsky et al. 2013", "year": 2013, "title": "Oral enclomiphene citrate stimulates the endogenous production of testosterone and sperm counts in men with low testosterone: comparison with testosterone gel", "journal": "The Journal of Sexual Medicine", "doi": "10.1111/jsm.12116", "pmid": "23530575", "source_url": "https://pubmed.ncbi.nlm.nih.gov/23530575/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Randomized, open-label, fixed-dose, active-control, two-center phase IIB proof-of-principle study", "setting": "Two clinical study centers", "population": "12 men with secondary hypogonadism previously treated with topical testosterone", "exposure": "Prior topical testosterone; then enclomiphene or testosterone gel", "sample_size": "12", "testosterone_during_recovery": "Prior topical testosterone stopped; active-control group then received testosterone gel", "recovery_treatment": "Enclomiphene citrate or testosterone gel", "record_type": "active-control result", "endpoint_or_finding": "Testosterone-gel participants above threshold", "threshold_or_definition": ">20 million/mL", "time_point": "6 months", "numerator": "2", "denominator": "5", "reported_value": "2 of 5", "interpretation": "Tiny active-control result, not a population estimate.", "main_limit": "Only 12 men; open-label active-control study; no untreated arm; not an infertility-clinic cohort; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-017", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "wenker-2015", "citation_short": "Wenker et al. 2015", "year": 2015, "title": "The use of HCG-based combination therapy for recovery of spermatogenesis after testosterone use", "journal": "The Journal of Sexual Medicine", "doi": "10.1111/jsm.12890", "pmid": "25904023", "source_url": "https://pubmed.ncbi.nlm.nih.gov/25904023/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective case series", "setting": "Male infertility clinic", "population": "49 men with azoospermia or severe oligospermia while using exogenous testosterone", "exposure": "Exogenous testosterone before specialist fertility care", "sample_size": "49", "testosterone_during_recovery": "Withdrawn in the reported recovery approach", "recovery_treatment": "hCG-based combination care with clinician-selected added medicines", "record_type": "sample", "endpoint_or_finding": "Men in treated case series", "threshold_or_definition": "Azoospermia or severe oligospermia during testosterone use", "time_point": "", "numerator": "", "denominator": "", "reported_value": "49 men", "interpretation": "Selected infertility-clinic patients.", "main_limit": "Small retrospective treated case series; broad combined endpoint; mixed medicines; no untreated control; no causal treatment estimate." }, { "record_id": "SRAT-018", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "wenker-2015", "citation_short": "Wenker et al. 2015", "year": 2015, "title": "The use of HCG-based combination therapy for recovery of spermatogenesis after testosterone use", "journal": "The Journal of Sexual Medicine", "doi": "10.1111/jsm.12890", "pmid": "25904023", "source_url": "https://pubmed.ncbi.nlm.nih.gov/25904023/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective case series", "setting": "Male infertility clinic", "population": "49 men with azoospermia or severe oligospermia while using exogenous testosterone", "exposure": "Exogenous testosterone before specialist fertility care", "sample_size": "49", "testosterone_during_recovery": "Withdrawn in the reported recovery approach", "recovery_treatment": "hCG-based combination care with clinician-selected added medicines", "record_type": "combined recovery endpoint", "endpoint_or_finding": "Sperm returned or a very low count improved", "threshold_or_definition": "Combined endpoint", "time_point": "During follow-up", "numerator": "47", "denominator": "49", "reported_value": "47 of 49 (95.9%)", "interpretation": "Improvement during care, not a 95.9% cure rate or causal drug effect.", "main_limit": "Small retrospective treated case series; broad combined endpoint; mixed medicines; no untreated control; no causal treatment estimate." }, { "record_id": "SRAT-019", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "wenker-2015", "citation_short": "Wenker et al. 2015", "year": 2015, "title": "The use of HCG-based combination therapy for recovery of spermatogenesis after testosterone use", "journal": "The Journal of Sexual Medicine", "doi": "10.1111/jsm.12890", "pmid": "25904023", "source_url": "https://pubmed.ncbi.nlm.nih.gov/25904023/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective case series", "setting": "Male infertility clinic", "population": "49 men with azoospermia or severe oligospermia while using exogenous testosterone", "exposure": "Exogenous testosterone before specialist fertility care", "sample_size": "49", "testosterone_during_recovery": "Withdrawn in the reported recovery approach", "recovery_treatment": "hCG-based combination care with clinician-selected added medicines", "record_type": "time", "endpoint_or_finding": "Mean time to recovery/improvement", "threshold_or_definition": "Combined endpoint", "time_point": "During follow-up", "numerator": "", "denominator": "", "reported_value": "4.6 months", "interpretation": "A mean does not show the full range.", "main_limit": "Small retrospective treated case series; broad combined endpoint; mixed medicines; no untreated control; no causal treatment estimate." }, { "record_id": "SRAT-020", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "wenker-2015", "citation_short": "Wenker et al. 2015", "year": 2015, "title": "The use of HCG-based combination therapy for recovery of spermatogenesis after testosterone use", "journal": "The Journal of Sexual Medicine", "doi": "10.1111/jsm.12890", "pmid": "25904023", "source_url": "https://pubmed.ncbi.nlm.nih.gov/25904023/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective case series", "setting": "Male infertility clinic", "population": "49 men with azoospermia or severe oligospermia while using exogenous testosterone", "exposure": "Exogenous testosterone before specialist fertility care", "sample_size": "49", "testosterone_during_recovery": "Withdrawn in the reported recovery approach", "recovery_treatment": "hCG-based combination care with clinician-selected added medicines", "record_type": "sperm concentration", "endpoint_or_finding": "Mean first sperm density after recovery approach", "threshold_or_definition": "First reported density after sperm return or improvement", "time_point": "During follow-up", "numerator": "", "denominator": "", "reported_value": "22.6 million/mL", "interpretation": "Group mean; not a pregnancy threshold.", "main_limit": "Small retrospective treated case series; broad combined endpoint; mixed medicines; no untreated control; no causal treatment estimate." }, { "record_id": "SRAT-021", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "kohn-2017", "citation_short": "Kohn et al. 2017", "year": 2017, "title": "Age and duration of testosterone therapy predict time to return of sperm count after human chorionic gonadotropin therapy", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2016.10.004", "pmid": "27855957", "source_url": "https://pubmed.ncbi.nlm.nih.gov/27855957/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "66 men with azoospermia or cryptozoospermia after testosterone therapy", "exposure": "Testosterone therapy before specialist fertility care", "sample_size": "66", "testosterone_during_recovery": "Stopped", "recovery_treatment": "hCG plus a selective estrogen receptor modulator", "record_type": "sample", "endpoint_or_finding": "Men in treated cohort", "threshold_or_definition": "Azoospermia or cryptozoospermia after testosterone therapy", "time_point": "", "numerator": "", "denominator": "", "reported_value": "66 men", "interpretation": "Direct clinic cohort but selected and treated.", "main_limit": "Retrospective selected treated cohort; no untreated control; TMC threshold is not pregnancy, live birth, or return to baseline." }, { "record_id": "SRAT-022", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "kohn-2017", "citation_short": "Kohn et al. 2017", "year": 2017, "title": "Age and duration of testosterone therapy predict time to return of sperm count after human chorionic gonadotropin therapy", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2016.10.004", "pmid": "27855957", "source_url": "https://pubmed.ncbi.nlm.nih.gov/27855957/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "66 men with azoospermia or cryptozoospermia after testosterone therapy", "exposure": "Testosterone therapy before specialist fertility care", "sample_size": "66", "testosterone_during_recovery": "Stopped", "recovery_treatment": "hCG plus a selective estrogen receptor modulator", "record_type": "threshold recovery", "endpoint_or_finding": "Reached total motile sperm count target", "threshold_or_definition": ">5 million total motile sperm", "time_point": "Within 12 months", "numerator": "46", "denominator": "66", "reported_value": "46 of 66 (69.7%; rounded to 70%)", "interpretation": "Whole-sample moving-sperm threshold, not pregnancy or live birth.", "main_limit": "Retrospective selected treated cohort; no untreated control; TMC threshold is not pregnancy, live birth, or return to baseline." }, { "record_id": "SRAT-023", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "kohn-2017", "citation_short": "Kohn et al. 2017", "year": 2017, "title": "Age and duration of testosterone therapy predict time to return of sperm count after human chorionic gonadotropin therapy", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2016.10.004", "pmid": "27855957", "source_url": "https://pubmed.ncbi.nlm.nih.gov/27855957/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "66 men with azoospermia or cryptozoospermia after testosterone therapy", "exposure": "Testosterone therapy before specialist fertility care", "sample_size": "66", "testosterone_during_recovery": "Stopped", "recovery_treatment": "hCG plus a selective estrogen receptor modulator", "record_type": "subgroup recovery", "endpoint_or_finding": "Azoospermia subgroup reached TMC target", "threshold_or_definition": ">5 million total motile sperm", "time_point": "Within 12 months", "numerator": "", "denominator": "", "reported_value": "64.8%", "interpretation": "Lower 12-month target rate than the cryptozoospermia subgroup.", "main_limit": "Retrospective selected treated cohort; no untreated control; TMC threshold is not pregnancy, live birth, or return to baseline." }, { "record_id": "SRAT-024", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "kohn-2017", "citation_short": "Kohn et al. 2017", "year": 2017, "title": "Age and duration of testosterone therapy predict time to return of sperm count after human chorionic gonadotropin therapy", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2016.10.004", "pmid": "27855957", "source_url": "https://pubmed.ncbi.nlm.nih.gov/27855957/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "66 men with azoospermia or cryptozoospermia after testosterone therapy", "exposure": "Testosterone therapy before specialist fertility care", "sample_size": "66", "testosterone_during_recovery": "Stopped", "recovery_treatment": "hCG plus a selective estrogen receptor modulator", "record_type": "subgroup recovery", "endpoint_or_finding": "Cryptozoospermia subgroup reached TMC target", "threshold_or_definition": ">5 million total motile sperm", "time_point": "Within 12 months", "numerator": "", "denominator": "", "reported_value": "91.7%", "interpretation": "Higher 12-month target rate than the azoospermia subgroup.", "main_limit": "Retrospective selected treated cohort; no untreated control; TMC threshold is not pregnancy, live birth, or return to baseline." }, { "record_id": "SRAT-025", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "kohn-2017", "citation_short": "Kohn et al. 2017", "year": 2017, "title": "Age and duration of testosterone therapy predict time to return of sperm count after human chorionic gonadotropin therapy", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2016.10.004", "pmid": "27855957", "source_url": "https://pubmed.ncbi.nlm.nih.gov/27855957/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "66 men with azoospermia or cryptozoospermia after testosterone therapy", "exposure": "Testosterone therapy before specialist fertility care", "sample_size": "66", "testosterone_during_recovery": "Stopped", "recovery_treatment": "hCG plus a selective estrogen receptor modulator", "record_type": "predictor", "endpoint_or_finding": "Age association", "threshold_or_definition": "Older age", "time_point": "6- and 12-month models", "numerator": "", "denominator": "", "reported_value": "Older age predicted slower recovery to the study target", "interpretation": "Cohort association, not a fixed age cutoff.", "main_limit": "Retrospective selected treated cohort; no untreated control; TMC threshold is not pregnancy, live birth, or return to baseline." }, { "record_id": "SRAT-026", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "kohn-2017", "citation_short": "Kohn et al. 2017", "year": 2017, "title": "Age and duration of testosterone therapy predict time to return of sperm count after human chorionic gonadotropin therapy", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2016.10.004", "pmid": "27855957", "source_url": "https://pubmed.ncbi.nlm.nih.gov/27855957/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "66 men with azoospermia or cryptozoospermia after testosterone therapy", "exposure": "Testosterone therapy before specialist fertility care", "sample_size": "66", "testosterone_during_recovery": "Stopped", "recovery_treatment": "hCG plus a selective estrogen receptor modulator", "record_type": "predictor", "endpoint_or_finding": "Duration-of-use association", "threshold_or_definition": "Longer prior testosterone therapy", "time_point": "6- and 12-month models", "numerator": "", "denominator": "", "reported_value": "Longer use predicted slower recovery to the study target", "interpretation": "No exact personal number of extra months can be calculated.", "main_limit": "Retrospective selected treated cohort; no untreated control; TMC threshold is not pregnancy, live birth, or return to baseline." }, { "record_id": "SRAT-027", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "stocks-2025", "citation_short": "Stocks et al. 2025", "year": 2025, "title": "Optimal restoration of spermatogenesis after testosterone therapy using human chorionic gonadotropin and follicle-stimulating hormone", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2024.10.019", "pmid": "39442683", "source_url": "https://pubmed.ncbi.nlm.nih.gov/39442683/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective cohort", "setting": "Specialist fertility care, January 2020–March 2024", "population": "77 men with infertility and a history of testosterone use", "exposure": "Prior testosterone use; some continued testosterone during recovery care", "sample_size": "77", "testosterone_during_recovery": "Mixed: 50 without concurrent testosterone and 27 with concurrent testosterone", "recovery_treatment": "hCG plus FSH", "record_type": "sample", "endpoint_or_finding": "Men in treated cohort", "threshold_or_definition": "History of testosterone use and infertility", "time_point": "", "numerator": "", "denominator": "", "reported_value": "77 men", "interpretation": "Newest direct prescribed/prior-testosterone clinic cohort in this map.", "main_limit": "Retrospective selected treated cohort; no randomization or untreated control; category improvement was not pregnancy or live birth." }, { "record_id": "SRAT-028", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "stocks-2025", "citation_short": "Stocks et al. 2025", "year": 2025, "title": "Optimal restoration of spermatogenesis after testosterone therapy using human chorionic gonadotropin and follicle-stimulating hormone", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2024.10.019", "pmid": "39442683", "source_url": "https://pubmed.ncbi.nlm.nih.gov/39442683/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective cohort", "setting": "Specialist fertility care, January 2020–March 2024", "population": "77 men with infertility and a history of testosterone use", "exposure": "Prior testosterone use; some continued testosterone during recovery care", "sample_size": "77", "testosterone_during_recovery": "Mixed: 50 without concurrent testosterone and 27 with concurrent testosterone", "recovery_treatment": "hCG plus FSH", "record_type": "category improvement", "endpoint_or_finding": "Sperm concentration moved into a better category", "threshold_or_definition": "Study-defined concentration category", "time_point": "During follow-up", "numerator": "", "denominator": "", "reported_value": "74% of 77", "interpretation": "Category improvement is not return to baseline, pregnancy, or live birth.", "main_limit": "Retrospective selected treated cohort; no randomization or untreated control; category improvement was not pregnancy or live birth." }, { "record_id": "SRAT-029", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "stocks-2025", "citation_short": "Stocks et al. 2025", "year": 2025, "title": "Optimal restoration of spermatogenesis after testosterone therapy using human chorionic gonadotropin and follicle-stimulating hormone", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2024.10.019", "pmid": "39442683", "source_url": "https://pubmed.ncbi.nlm.nih.gov/39442683/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective cohort", "setting": "Specialist fertility care, January 2020–March 2024", "population": "77 men with infertility and a history of testosterone use", "exposure": "Prior testosterone use; some continued testosterone during recovery care", "sample_size": "77", "testosterone_during_recovery": "Mixed: 50 without concurrent testosterone and 27 with concurrent testosterone", "recovery_treatment": "hCG plus FSH", "record_type": "time", "endpoint_or_finding": "Median time to highest recorded sperm concentration", "threshold_or_definition": "Highest value recorded during follow-up", "time_point": "During follow-up", "numerator": "", "denominator": "", "reported_value": "4.7 months", "interpretation": "Not necessarily time to full recovery.", "main_limit": "Retrospective selected treated cohort; no randomization or untreated control; category improvement was not pregnancy or live birth." }, { "record_id": "SRAT-030", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "stocks-2025", "citation_short": "Stocks et al. 2025", "year": 2025, "title": "Optimal restoration of spermatogenesis after testosterone therapy using human chorionic gonadotropin and follicle-stimulating hormone", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2024.10.019", "pmid": "39442683", "source_url": "https://pubmed.ncbi.nlm.nih.gov/39442683/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective cohort", "setting": "Specialist fertility care, January 2020–March 2024", "population": "77 men with infertility and a history of testosterone use", "exposure": "Prior testosterone use; some continued testosterone during recovery care", "sample_size": "77", "testosterone_during_recovery": "Mixed: 50 without concurrent testosterone and 27 with concurrent testosterone", "recovery_treatment": "hCG plus FSH", "record_type": "subgroup result", "endpoint_or_finding": "Category improvement without concurrent testosterone", "threshold_or_definition": "No concurrent testosterone; hCG plus FSH", "time_point": "During follow-up", "numerator": "", "denominator": "50", "reported_value": "74%", "interpretation": "Nonrandomized treated subgroup.", "main_limit": "Retrospective selected treated cohort; no randomization or untreated control; category improvement was not pregnancy or live birth." }, { "record_id": "SRAT-031", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "stocks-2025", "citation_short": "Stocks et al. 2025", "year": 2025, "title": "Optimal restoration of spermatogenesis after testosterone therapy using human chorionic gonadotropin and follicle-stimulating hormone", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2024.10.019", "pmid": "39442683", "source_url": "https://pubmed.ncbi.nlm.nih.gov/39442683/", "evidence_group": "Prior/prescribed testosterone", "study_design": "Retrospective cohort", "setting": "Specialist fertility care, January 2020–March 2024", "population": "77 men with infertility and a history of testosterone use", "exposure": "Prior testosterone use; some continued testosterone during recovery care", "sample_size": "77", "testosterone_during_recovery": "Mixed: 50 without concurrent testosterone and 27 with concurrent testosterone", "recovery_treatment": "hCG plus FSH", "record_type": "subgroup result", "endpoint_or_finding": "Category improvement with concurrent testosterone", "threshold_or_definition": "Concurrent testosterone; hCG plus FSH", "time_point": "During follow-up", "numerator": "", "denominator": "27", "reported_value": "74%", "interpretation": "Nonrandomized selected subgroup; does not prove equivalence or safety for fertility goals.", "main_limit": "Retrospective selected treated cohort; no randomization or untreated control; category improvement was not pregnancy or live birth." }, { "record_id": "SRAT-032", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "shankara-2020", "citation_short": "Shankara-Narayana et al. 2020", "year": 2020, "title": "Rate and Extent of Recovery from Reproductive and Cardiac Dysfunction Due to Androgen Abuse in Men", "journal": "The Journal of Clinical Endocrinology & Metabolism", "doi": "10.1210/clinem/dgz324", "pmid": "32030409", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32030409/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Cross-sectional observational comparison with modeled recovery times", "setting": "Research assessment after social-media recruitment", "population": "41 current users, 31 past users, and 21 healthy non-users", "exposure": "Androgen abuse", "sample_size": "93", "testosterone_during_recovery": "Past-user group had stopped for at least 3 months", "recovery_treatment": "No standardized recovery treatment reported for the comparison", "record_type": "sample", "endpoint_or_finding": "Current androgen users", "threshold_or_definition": "Current-use group", "time_point": "Single assessment", "numerator": "", "denominator": "", "reported_value": "41 men", "interpretation": "Cross-sectional group.", "main_limit": "Cross-sectional groups, not repeated semen testing in the same men; recovery times were modeled; non-prescribed androgen exposure differs from TRT." }, { "record_id": "SRAT-033", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "shankara-2020", "citation_short": "Shankara-Narayana et al. 2020", "year": 2020, "title": "Rate and Extent of Recovery from Reproductive and Cardiac Dysfunction Due to Androgen Abuse in Men", "journal": "The Journal of Clinical Endocrinology & Metabolism", "doi": "10.1210/clinem/dgz324", "pmid": "32030409", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32030409/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Cross-sectional observational comparison with modeled recovery times", "setting": "Research assessment after social-media recruitment", "population": "41 current users, 31 past users, and 21 healthy non-users", "exposure": "Androgen abuse", "sample_size": "93", "testosterone_during_recovery": "Past-user group had stopped for at least 3 months", "recovery_treatment": "No standardized recovery treatment reported for the comparison", "record_type": "sample", "endpoint_or_finding": "Past androgen users", "threshold_or_definition": "At least 3 months since last use", "time_point": "Single assessment", "numerator": "", "denominator": "", "reported_value": "31 men; median 300 days since last use", "interpretation": "Cross-sectional past-user group.", "main_limit": "Cross-sectional groups, not repeated semen testing in the same men; recovery times were modeled; non-prescribed androgen exposure differs from TRT." }, { "record_id": "SRAT-034", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "shankara-2020", "citation_short": "Shankara-Narayana et al. 2020", "year": 2020, "title": "Rate and Extent of Recovery from Reproductive and Cardiac Dysfunction Due to Androgen Abuse in Men", "journal": "The Journal of Clinical Endocrinology & Metabolism", "doi": "10.1210/clinem/dgz324", "pmid": "32030409", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32030409/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Cross-sectional observational comparison with modeled recovery times", "setting": "Research assessment after social-media recruitment", "population": "41 current users, 31 past users, and 21 healthy non-users", "exposure": "Androgen abuse", "sample_size": "93", "testosterone_during_recovery": "Past-user group had stopped for at least 3 months", "recovery_treatment": "No standardized recovery treatment reported for the comparison", "record_type": "sample", "endpoint_or_finding": "Healthy non-users", "threshold_or_definition": "Comparison group", "time_point": "Single assessment", "numerator": "", "denominator": "", "reported_value": "21 men", "interpretation": "Cross-sectional comparison group.", "main_limit": "Cross-sectional groups, not repeated semen testing in the same men; recovery times were modeled; non-prescribed androgen exposure differs from TRT." }, { "record_id": "SRAT-035", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "shankara-2020", "citation_short": "Shankara-Narayana et al. 2020", "year": 2020, "title": "Rate and Extent of Recovery from Reproductive and Cardiac Dysfunction Due to Androgen Abuse in Men", "journal": "The Journal of Clinical Endocrinology & Metabolism", "doi": "10.1210/clinem/dgz324", "pmid": "32030409", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32030409/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Cross-sectional observational comparison with modeled recovery times", "setting": "Research assessment after social-media recruitment", "population": "41 current users, 31 past users, and 21 healthy non-users", "exposure": "Androgen abuse", "sample_size": "93", "testosterone_during_recovery": "Past-user group had stopped for at least 3 months", "recovery_treatment": "No standardized recovery treatment reported for the comparison", "record_type": "modeled recovery time", "endpoint_or_finding": "Anti-Müllerian hormone recovery", "threshold_or_definition": "Modeled from cross-sectional data", "time_point": "After stopping", "numerator": "", "denominator": "", "reported_value": "7.3 months", "interpretation": "Hormone recovery, not semen recovery in the same men over time.", "main_limit": "Cross-sectional groups, not repeated semen testing in the same men; recovery times were modeled; non-prescribed androgen exposure differs from TRT." }, { "record_id": "SRAT-036", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "shankara-2020", "citation_short": "Shankara-Narayana et al. 2020", "year": 2020, "title": "Rate and Extent of Recovery from Reproductive and Cardiac Dysfunction Due to Androgen Abuse in Men", "journal": "The Journal of Clinical Endocrinology & Metabolism", "doi": "10.1210/clinem/dgz324", "pmid": "32030409", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32030409/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Cross-sectional observational comparison with modeled recovery times", "setting": "Research assessment after social-media recruitment", "population": "41 current users, 31 past users, and 21 healthy non-users", "exposure": "Androgen abuse", "sample_size": "93", "testosterone_during_recovery": "Past-user group had stopped for at least 3 months", "recovery_treatment": "No standardized recovery treatment reported for the comparison", "record_type": "modeled recovery time", "endpoint_or_finding": "Luteinizing hormone recovery", "threshold_or_definition": "Modeled from cross-sectional data", "time_point": "After stopping", "numerator": "", "denominator": "", "reported_value": "10.7 months", "interpretation": "Hormone recovery, not semen recovery in the same men over time.", "main_limit": "Cross-sectional groups, not repeated semen testing in the same men; recovery times were modeled; non-prescribed androgen exposure differs from TRT." }, { "record_id": "SRAT-037", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "shankara-2020", "citation_short": "Shankara-Narayana et al. 2020", "year": 2020, "title": "Rate and Extent of Recovery from Reproductive and Cardiac Dysfunction Due to Androgen Abuse in Men", "journal": "The Journal of Clinical Endocrinology & Metabolism", "doi": "10.1210/clinem/dgz324", "pmid": "32030409", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32030409/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Cross-sectional observational comparison with modeled recovery times", "setting": "Research assessment after social-media recruitment", "population": "41 current users, 31 past users, and 21 healthy non-users", "exposure": "Androgen abuse", "sample_size": "93", "testosterone_during_recovery": "Past-user group had stopped for at least 3 months", "recovery_treatment": "No standardized recovery treatment reported for the comparison", "record_type": "modeled recovery time", "endpoint_or_finding": "Sperm-output recovery", "threshold_or_definition": "Modeled from cross-sectional data", "time_point": "After stopping", "numerator": "", "denominator": "", "reported_value": "14.1 months", "interpretation": "Modeled group estimate after androgen abuse, not a prescribed-TRT curve.", "main_limit": "Cross-sectional groups, not repeated semen testing in the same men; recovery times were modeled; non-prescribed androgen exposure differs from TRT." }, { "record_id": "SRAT-038", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "shankara-2020", "citation_short": "Shankara-Narayana et al. 2020", "year": 2020, "title": "Rate and Extent of Recovery from Reproductive and Cardiac Dysfunction Due to Androgen Abuse in Men", "journal": "The Journal of Clinical Endocrinology & Metabolism", "doi": "10.1210/clinem/dgz324", "pmid": "32030409", "source_url": "https://pubmed.ncbi.nlm.nih.gov/32030409/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Cross-sectional observational comparison with modeled recovery times", "setting": "Research assessment after social-media recruitment", "population": "41 current users, 31 past users, and 21 healthy non-users", "exposure": "Androgen abuse", "sample_size": "93", "testosterone_during_recovery": "Past-user group had stopped for at least 3 months", "recovery_treatment": "No standardized recovery treatment reported for the comparison", "record_type": "predictor", "endpoint_or_finding": "Duration-of-use association", "threshold_or_definition": "Longer androgen-abuse duration", "time_point": "", "numerator": "", "denominator": "", "reported_value": "Associated with slower recovery of sperm output", "interpretation": "Association from non-prescribed androgen use.", "main_limit": "Cross-sectional groups, not repeated semen testing in the same men; recovery times were modeled; non-prescribed androgen exposure differs from TRT." }, { "record_id": "SRAT-039", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "smit-2021", "citation_short": "Smit et al. 2021 (HAARLEM)", "year": 2021, "title": "Disruption and recovery of testicular function during and after androgen abuse: the HAARLEM study", "journal": "Human Reproduction", "doi": "10.1093/humrep/deaa366", "pmid": "33550376", "source_url": "https://academic.oup.com/humrep/article/36/4/880/6129954", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Prospective observational cohort", "setting": "HAARLEM study of amateur athletes planning an AAS cycle", "population": "100 male amateur athletes", "exposure": "Self-selected anabolic-androgenic steroid cycles", "sample_size": "100", "testosterone_during_recovery": "Stopped after the planned cycle", "recovery_treatment": "Naturalistic follow-up; not a randomized treatment study", "record_type": "sample", "endpoint_or_finding": "Men enrolled", "threshold_or_definition": "Amateur athletes planning an AAS cycle", "time_point": "", "numerator": "", "denominator": "", "reported_value": "100 men", "interpretation": "Prospective naturalistic AAS cohort.", "main_limit": "AAS products, combinations, and doses differ from prescribed TRT; incomplete semen follow-up; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-040", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "smit-2021", "citation_short": "Smit et al. 2021 (HAARLEM)", "year": 2021, "title": "Disruption and recovery of testicular function during and after androgen abuse: the HAARLEM study", "journal": "Human Reproduction", "doi": "10.1093/humrep/deaa366", "pmid": "33550376", "source_url": "https://academic.oup.com/humrep/article/36/4/880/6129954", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Prospective observational cohort", "setting": "HAARLEM study of amateur athletes planning an AAS cycle", "population": "100 male amateur athletes", "exposure": "Self-selected anabolic-androgenic steroid cycles", "sample_size": "100", "testosterone_during_recovery": "Stopped after the planned cycle", "recovery_treatment": "Naturalistic follow-up; not a randomized treatment study", "record_type": "suppression result", "endpoint_or_finding": "Total sperm count below study mark during AAS use", "threshold_or_definition": "<40 million total sperm", "time_point": "During use", "numerator": "", "denominator": "", "reported_value": "77%", "interpretation": "Suppression during exposure, not a post-TRT recovery rate.", "main_limit": "AAS products, combinations, and doses differ from prescribed TRT; incomplete semen follow-up; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-041", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "smit-2021", "citation_short": "Smit et al. 2021 (HAARLEM)", "year": 2021, "title": "Disruption and recovery of testicular function during and after androgen abuse: the HAARLEM study", "journal": "Human Reproduction", "doi": "10.1093/humrep/deaa366", "pmid": "33550376", "source_url": "https://academic.oup.com/humrep/article/36/4/880/6129954", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Prospective observational cohort", "setting": "HAARLEM study of amateur athletes planning an AAS cycle", "population": "100 male amateur athletes", "exposure": "Self-selected anabolic-androgenic steroid cycles", "sample_size": "100", "testosterone_during_recovery": "Stopped after the planned cycle", "recovery_treatment": "Naturalistic follow-up; not a randomized treatment study", "record_type": "recovery summary", "endpoint_or_finding": "Blood testosterone recovery", "threshold_or_definition": "Return toward baseline", "time_point": "After cycle", "numerator": "", "denominator": "", "reported_value": "About 3 months for most participants", "interpretation": "Blood hormone recovery does not prove sperm recovery.", "main_limit": "AAS products, combinations, and doses differ from prescribed TRT; incomplete semen follow-up; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-042", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "smit-2021", "citation_short": "Smit et al. 2021 (HAARLEM)", "year": 2021, "title": "Disruption and recovery of testicular function during and after androgen abuse: the HAARLEM study", "journal": "Human Reproduction", "doi": "10.1093/humrep/deaa366", "pmid": "33550376", "source_url": "https://academic.oup.com/humrep/article/36/4/880/6129954", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Prospective observational cohort", "setting": "HAARLEM study of amateur athletes planning an AAS cycle", "population": "100 male amateur athletes", "exposure": "Self-selected anabolic-androgenic steroid cycles", "sample_size": "100", "testosterone_during_recovery": "Stopped after the planned cycle", "recovery_treatment": "Naturalistic follow-up; not a randomized treatment study", "record_type": "recovery summary", "endpoint_or_finding": "Sperm-production recovery", "threshold_or_definition": "Authors’ broad summary", "time_point": "After cycle", "numerator": "", "denominator": "", "reported_value": "About 1 year", "interpretation": "AAS cohort; individual recovery varied.", "main_limit": "AAS products, combinations, and doses differ from prescribed TRT; incomplete semen follow-up; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-043", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "smit-2021", "citation_short": "Smit et al. 2021 (HAARLEM)", "year": 2021, "title": "Disruption and recovery of testicular function during and after androgen abuse: the HAARLEM study", "journal": "Human Reproduction", "doi": "10.1093/humrep/deaa366", "pmid": "33550376", "source_url": "https://academic.oup.com/humrep/article/36/4/880/6129954", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Prospective observational cohort", "setting": "HAARLEM study of amateur athletes planning an AAS cycle", "population": "100 male amateur athletes", "exposure": "Self-selected anabolic-androgenic steroid cycles", "sample_size": "100", "testosterone_during_recovery": "Stopped after the planned cycle", "recovery_treatment": "Naturalistic follow-up; not a randomized treatment study", "record_type": "final semen result", "endpoint_or_finding": "Still below total sperm-count mark", "threshold_or_definition": "<40 million total sperm", "time_point": "Final follow-up", "numerator": "25", "denominator": "73", "reported_value": "25 of 73 (34.2%)", "interpretation": "Below 40 million is not the same as infertile; only 73 had a final result.", "main_limit": "AAS products, combinations, and doses differ from prescribed TRT; incomplete semen follow-up; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-044", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "smit-2021", "citation_short": "Smit et al. 2021 (HAARLEM)", "year": 2021, "title": "Disruption and recovery of testicular function during and after androgen abuse: the HAARLEM study", "journal": "Human Reproduction", "doi": "10.1093/humrep/deaa366", "pmid": "33550376", "source_url": "https://academic.oup.com/humrep/article/36/4/880/6129954", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Prospective observational cohort", "setting": "HAARLEM study of amateur athletes planning an AAS cycle", "population": "100 male amateur athletes", "exposure": "Self-selected anabolic-androgenic steroid cycles", "sample_size": "100", "testosterone_during_recovery": "Stopped after the planned cycle", "recovery_treatment": "Naturalistic follow-up; not a randomized treatment study", "record_type": "change from baseline", "endpoint_or_finding": "Mean total sperm-count difference", "threshold_or_definition": "Compared with participant baseline", "time_point": "3 months after cycle", "numerator": "", "denominator": "", "reported_value": "61.7 million lower (95% CI 33.7–90.0 million lower)", "interpretation": "Group mean difference, not every participant’s path.", "main_limit": "AAS products, combinations, and doses differ from prescribed TRT; incomplete semen follow-up; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-045", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "smit-2021", "citation_short": "Smit et al. 2021 (HAARLEM)", "year": 2021, "title": "Disruption and recovery of testicular function during and after androgen abuse: the HAARLEM study", "journal": "Human Reproduction", "doi": "10.1093/humrep/deaa366", "pmid": "33550376", "source_url": "https://academic.oup.com/humrep/article/36/4/880/6129954", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Prospective observational cohort", "setting": "HAARLEM study of amateur athletes planning an AAS cycle", "population": "100 male amateur athletes", "exposure": "Self-selected anabolic-androgenic steroid cycles", "sample_size": "100", "testosterone_during_recovery": "Stopped after the planned cycle", "recovery_treatment": "Naturalistic follow-up; not a randomized treatment study", "record_type": "change from baseline", "endpoint_or_finding": "Mean total sperm-count difference", "threshold_or_definition": "Compared with participant baseline", "time_point": "Final follow-up", "numerator": "", "denominator": "", "reported_value": "29.7 million lower (95% CI 0.39–59.1 million lower; p=0.05)", "interpretation": "Borderline group result with incomplete semen follow-up.", "main_limit": "AAS products, combinations, and doses differ from prescribed TRT; incomplete semen follow-up; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-046", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "al-hashimi-2022", "citation_short": "Al Hashimi 2022", "year": 2022, "title": "The deleterious effects of anabolic androgenic steroid abuse on sexual and reproductive health and comparison of recovery between treated and untreated patients: Single-center prospective randomized study", "journal": "Andrologia", "doi": "10.1111/and.14576", "pmid": "36065528", "source_url": "https://pubmed.ncbi.nlm.nih.gov/36065528/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Single-center prospective study; paper describes post-observation allocation in the wider cohort as randomized", "setting": "Urology-andrology clinic with 12-month follow-up", "population": "520 men with confirmed AAS use within the prior year; 94 presented with infertility", "exposure": "Non-prescribed anabolic-androgenic steroids", "sample_size": "520", "testosterone_during_recovery": "AAS stopped before observation and follow-up", "recovery_treatment": "Observation first; treatment for men without recovery; all 94 infertility patients received treatment", "record_type": "sample", "endpoint_or_finding": "Men analyzed", "threshold_or_definition": "Confirmed AAS use within prior year", "time_point": "", "numerator": "", "denominator": "", "reported_value": "520 men", "interpretation": "Large clinic cohort with broad outcomes.", "main_limit": "The infertility subgroup had no untreated comparison because all 94 received treatment; treatment mix and allocation details limit causal inference; pregnancy was not live birth." }, { "record_id": "SRAT-047", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "al-hashimi-2022", "citation_short": "Al Hashimi 2022", "year": 2022, "title": "The deleterious effects of anabolic androgenic steroid abuse on sexual and reproductive health and comparison of recovery between treated and untreated patients: Single-center prospective randomized study", "journal": "Andrologia", "doi": "10.1111/and.14576", "pmid": "36065528", "source_url": "https://pubmed.ncbi.nlm.nih.gov/36065528/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Single-center prospective study; paper describes post-observation allocation in the wider cohort as randomized", "setting": "Urology-andrology clinic with 12-month follow-up", "population": "520 men with confirmed AAS use within the prior year; 94 presented with infertility", "exposure": "Non-prescribed anabolic-androgenic steroids", "sample_size": "520", "testosterone_during_recovery": "AAS stopped before observation and follow-up", "recovery_treatment": "Observation first; treatment for men without recovery; all 94 infertility patients received treatment", "record_type": "infertility subgroup", "endpoint_or_finding": "Men who presented with infertility", "threshold_or_definition": "Infertility subgroup", "time_point": "Baseline", "numerator": "94", "denominator": "520", "reported_value": "94 of 520 (18.1%; reported as 18%)", "interpretation": "Only this subgroup informs the pregnancy result.", "main_limit": "The infertility subgroup had no untreated comparison because all 94 received treatment; treatment mix and allocation details limit causal inference; pregnancy was not live birth." }, { "record_id": "SRAT-048", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "al-hashimi-2022", "citation_short": "Al Hashimi 2022", "year": 2022, "title": "The deleterious effects of anabolic androgenic steroid abuse on sexual and reproductive health and comparison of recovery between treated and untreated patients: Single-center prospective randomized study", "journal": "Andrologia", "doi": "10.1111/and.14576", "pmid": "36065528", "source_url": "https://pubmed.ncbi.nlm.nih.gov/36065528/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Single-center prospective study; paper describes post-observation allocation in the wider cohort as randomized", "setting": "Urology-andrology clinic with 12-month follow-up", "population": "520 men with confirmed AAS use within the prior year; 94 presented with infertility", "exposure": "Non-prescribed anabolic-androgenic steroids", "sample_size": "520", "testosterone_during_recovery": "AAS stopped before observation and follow-up", "recovery_treatment": "Observation first; treatment for men without recovery; all 94 infertility patients received treatment", "record_type": "baseline semen status", "endpoint_or_finding": "Infertility patients with oligospermia", "threshold_or_definition": "Low sperm count", "time_point": "Baseline", "numerator": "61", "denominator": "94", "reported_value": "61 of 94", "interpretation": "Starting semen category, not recovery.", "main_limit": "The infertility subgroup had no untreated comparison because all 94 received treatment; treatment mix and allocation details limit causal inference; pregnancy was not live birth." }, { "record_id": "SRAT-049", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "al-hashimi-2022", "citation_short": "Al Hashimi 2022", "year": 2022, "title": "The deleterious effects of anabolic androgenic steroid abuse on sexual and reproductive health and comparison of recovery between treated and untreated patients: Single-center prospective randomized study", "journal": "Andrologia", "doi": "10.1111/and.14576", "pmid": "36065528", "source_url": "https://pubmed.ncbi.nlm.nih.gov/36065528/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Single-center prospective study; paper describes post-observation allocation in the wider cohort as randomized", "setting": "Urology-andrology clinic with 12-month follow-up", "population": "520 men with confirmed AAS use within the prior year; 94 presented with infertility", "exposure": "Non-prescribed anabolic-androgenic steroids", "sample_size": "520", "testosterone_during_recovery": "AAS stopped before observation and follow-up", "recovery_treatment": "Observation first; treatment for men without recovery; all 94 infertility patients received treatment", "record_type": "baseline semen status", "endpoint_or_finding": "Infertility patients with azoospermia", "threshold_or_definition": "No sperm detected", "time_point": "Baseline", "numerator": "33", "denominator": "94", "reported_value": "33 of 94", "interpretation": "Starting semen category, not recovery.", "main_limit": "The infertility subgroup had no untreated comparison because all 94 received treatment; treatment mix and allocation details limit causal inference; pregnancy was not live birth." }, { "record_id": "SRAT-050", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "al-hashimi-2022", "citation_short": "Al Hashimi 2022", "year": 2022, "title": "The deleterious effects of anabolic androgenic steroid abuse on sexual and reproductive health and comparison of recovery between treated and untreated patients: Single-center prospective randomized study", "journal": "Andrologia", "doi": "10.1111/and.14576", "pmid": "36065528", "source_url": "https://pubmed.ncbi.nlm.nih.gov/36065528/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Single-center prospective study; paper describes post-observation allocation in the wider cohort as randomized", "setting": "Urology-andrology clinic with 12-month follow-up", "population": "520 men with confirmed AAS use within the prior year; 94 presented with infertility", "exposure": "Non-prescribed anabolic-androgenic steroids", "sample_size": "520", "testosterone_during_recovery": "AAS stopped before observation and follow-up", "recovery_treatment": "Observation first; treatment for men without recovery; all 94 infertility patients received treatment", "record_type": "pregnancy outcome", "endpoint_or_finding": "Infertility subgroup reporting pregnancy", "threshold_or_definition": "Pregnancy; not live birth", "time_point": "12 months", "numerator": "14", "denominator": "94", "reported_value": "14 of 94 (14.9%; reported as 15%)", "interpretation": "Couple-level outcome during treatment; no untreated infertility comparison.", "main_limit": "The infertility subgroup had no untreated comparison because all 94 received treatment; treatment mix and allocation details limit causal inference; pregnancy was not live birth." }, { "record_id": "SRAT-051", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "al-hashimi-2022", "citation_short": "Al Hashimi 2022", "year": 2022, "title": "The deleterious effects of anabolic androgenic steroid abuse on sexual and reproductive health and comparison of recovery between treated and untreated patients: Single-center prospective randomized study", "journal": "Andrologia", "doi": "10.1111/and.14576", "pmid": "36065528", "source_url": "https://pubmed.ncbi.nlm.nih.gov/36065528/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Single-center prospective study; paper describes post-observation allocation in the wider cohort as randomized", "setting": "Urology-andrology clinic with 12-month follow-up", "population": "520 men with confirmed AAS use within the prior year; 94 presented with infertility", "exposure": "Non-prescribed anabolic-androgenic steroids", "sample_size": "520", "testosterone_during_recovery": "AAS stopped before observation and follow-up", "recovery_treatment": "Observation first; treatment for men without recovery; all 94 infertility patients received treatment", "record_type": "subgroup status", "endpoint_or_finding": "Men who began with azoospermia and remained classified as infertile", "threshold_or_definition": "Infertility status, not necessarily persistent azoospermia", "time_point": "End of follow-up", "numerator": "33", "denominator": "33", "reported_value": "All 33", "interpretation": "Do not rewrite this as all remaining azoospermic.", "main_limit": "The infertility subgroup had no untreated comparison because all 94 received treatment; treatment mix and allocation details limit causal inference; pregnancy was not live birth." }, { "record_id": "SRAT-052", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ledesma-2023", "citation_short": "Ledesma et al. 2023", "year": 2023, "title": "Fertility outcomes in men with prior history of anabolic steroid use", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2023.09.016", "pmid": "37769866", "source_url": "https://pubmed.ncbi.nlm.nih.gov/37769866/", "evidence_group": "Prior testosterone/AAS use reported by infertility patients", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "45 men with azoospermia or severe oligospermia and prior testosterone/AAS use", "exposure": "Prior testosterone or anabolic-steroid use", "sample_size": "45", "testosterone_during_recovery": "Stopped", "recovery_treatment": "Clomiphene plus hCG for at least 3–6 months", "record_type": "sample", "endpoint_or_finding": "Men meeting inclusion criteria", "threshold_or_definition": "Prior testosterone/AAS use with azoospermia or severe oligospermia", "time_point": "Baseline", "numerator": "", "denominator": "", "reported_value": "45 men", "interpretation": "Nine were lost before follow-up semen results.", "main_limit": "Nine men were lost to semen follow-up; retrospective treated cohort; pregnancy follow-up reached only 24 couples; no untreated control; no live-birth endpoint." }, { "record_id": "SRAT-053", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ledesma-2023", "citation_short": "Ledesma et al. 2023", "year": 2023, "title": "Fertility outcomes in men with prior history of anabolic steroid use", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2023.09.016", "pmid": "37769866", "source_url": "https://pubmed.ncbi.nlm.nih.gov/37769866/", "evidence_group": "Prior testosterone/AAS use reported by infertility patients", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "45 men with azoospermia or severe oligospermia and prior testosterone/AAS use", "exposure": "Prior testosterone or anabolic-steroid use", "sample_size": "45", "testosterone_during_recovery": "Stopped", "recovery_treatment": "Clomiphene plus hCG for at least 3–6 months", "record_type": "population", "endpoint_or_finding": "Median age", "threshold_or_definition": "Interquartile range", "time_point": "Baseline", "numerator": "", "denominator": "", "reported_value": "37 years (IQR 32–45)", "interpretation": "Selected clinic cohort.", "main_limit": "Nine men were lost to semen follow-up; retrospective treated cohort; pregnancy follow-up reached only 24 couples; no untreated control; no live-birth endpoint." }, { "record_id": "SRAT-054", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ledesma-2023", "citation_short": "Ledesma et al. 2023", "year": 2023, "title": "Fertility outcomes in men with prior history of anabolic steroid use", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2023.09.016", "pmid": "37769866", "source_url": "https://pubmed.ncbi.nlm.nih.gov/37769866/", "evidence_group": "Prior testosterone/AAS use reported by infertility patients", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "45 men with azoospermia or severe oligospermia and prior testosterone/AAS use", "exposure": "Prior testosterone or anabolic-steroid use", "sample_size": "45", "testosterone_during_recovery": "Stopped", "recovery_treatment": "Clomiphene plus hCG for at least 3–6 months", "record_type": "exposure duration", "endpoint_or_finding": "Median duration of prior testosterone use", "threshold_or_definition": "Interquartile range", "time_point": "Baseline", "numerator": "", "denominator": "", "reported_value": "4 years (IQR 1.3–10)", "interpretation": "Prior exposure history in a clinic cohort.", "main_limit": "Nine men were lost to semen follow-up; retrospective treated cohort; pregnancy follow-up reached only 24 couples; no untreated control; no live-birth endpoint." }, { "record_id": "SRAT-055", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ledesma-2023", "citation_short": "Ledesma et al. 2023", "year": 2023, "title": "Fertility outcomes in men with prior history of anabolic steroid use", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2023.09.016", "pmid": "37769866", "source_url": "https://pubmed.ncbi.nlm.nih.gov/37769866/", "evidence_group": "Prior testosterone/AAS use reported by infertility patients", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "45 men with azoospermia or severe oligospermia and prior testosterone/AAS use", "exposure": "Prior testosterone or anabolic-steroid use", "sample_size": "45", "testosterone_during_recovery": "Stopped", "recovery_treatment": "Clomiphene plus hCG for at least 3–6 months", "record_type": "follow-up", "endpoint_or_finding": "Men with follow-up semen results", "threshold_or_definition": "After treatment", "time_point": "About 6 months", "numerator": "36", "denominator": "45", "reported_value": "36 of 45; 9 lost to follow-up", "interpretation": "Loss to follow-up may bias results.", "main_limit": "Nine men were lost to semen follow-up; retrospective treated cohort; pregnancy follow-up reached only 24 couples; no untreated control; no live-birth endpoint." }, { "record_id": "SRAT-056", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ledesma-2023", "citation_short": "Ledesma et al. 2023", "year": 2023, "title": "Fertility outcomes in men with prior history of anabolic steroid use", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2023.09.016", "pmid": "37769866", "source_url": "https://pubmed.ncbi.nlm.nih.gov/37769866/", "evidence_group": "Prior testosterone/AAS use reported by infertility patients", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "45 men with azoospermia or severe oligospermia and prior testosterone/AAS use", "exposure": "Prior testosterone or anabolic-steroid use", "sample_size": "45", "testosterone_during_recovery": "Stopped", "recovery_treatment": "Clomiphene plus hCG for at least 3–6 months", "record_type": "category change", "endpoint_or_finding": "Progressed to oligospermia", "threshold_or_definition": "From azoospermia or severe oligospermia", "time_point": "After 6 months", "numerator": "11", "denominator": "36", "reported_value": "11 of 36; calculated 30.6% (paper text prints 30.1%)", "interpretation": "Counts are internally consistent; printed percentage does not equal 11/36.", "main_limit": "Nine men were lost to semen follow-up; retrospective treated cohort; pregnancy follow-up reached only 24 couples; no untreated control; no live-birth endpoint." }, { "record_id": "SRAT-057", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ledesma-2023", "citation_short": "Ledesma et al. 2023", "year": 2023, "title": "Fertility outcomes in men with prior history of anabolic steroid use", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2023.09.016", "pmid": "37769866", "source_url": "https://pubmed.ncbi.nlm.nih.gov/37769866/", "evidence_group": "Prior testosterone/AAS use reported by infertility patients", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "45 men with azoospermia or severe oligospermia and prior testosterone/AAS use", "exposure": "Prior testosterone or anabolic-steroid use", "sample_size": "45", "testosterone_during_recovery": "Stopped", "recovery_treatment": "Clomiphene plus hCG for at least 3–6 months", "record_type": "category change", "endpoint_or_finding": "Progressed to normozoospermia", "threshold_or_definition": ">15 million/mL in the paper", "time_point": "After 6 months", "numerator": "6", "denominator": "36", "reported_value": "6 of 36 (16.7%)", "interpretation": "Study-specific category, not pregnancy.", "main_limit": "Nine men were lost to semen follow-up; retrospective treated cohort; pregnancy follow-up reached only 24 couples; no untreated control; no live-birth endpoint." }, { "record_id": "SRAT-058", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ledesma-2023", "citation_short": "Ledesma et al. 2023", "year": 2023, "title": "Fertility outcomes in men with prior history of anabolic steroid use", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2023.09.016", "pmid": "37769866", "source_url": "https://pubmed.ncbi.nlm.nih.gov/37769866/", "evidence_group": "Prior testosterone/AAS use reported by infertility patients", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "45 men with azoospermia or severe oligospermia and prior testosterone/AAS use", "exposure": "Prior testosterone or anabolic-steroid use", "sample_size": "45", "testosterone_during_recovery": "Stopped", "recovery_treatment": "Clomiphene plus hCG for at least 3–6 months", "record_type": "category status", "endpoint_or_finding": "Remained azoospermic or severely oligospermic", "threshold_or_definition": "Same broad low-count categories", "time_point": "After 6 months", "numerator": "19", "denominator": "36", "reported_value": "19 of 36; calculated 52.8% (paper text prints 52.3%)", "interpretation": "Counts are internally consistent; printed percentage does not equal 19/36.", "main_limit": "Nine men were lost to semen follow-up; retrospective treated cohort; pregnancy follow-up reached only 24 couples; no untreated control; no live-birth endpoint." }, { "record_id": "SRAT-059", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ledesma-2023", "citation_short": "Ledesma et al. 2023", "year": 2023, "title": "Fertility outcomes in men with prior history of anabolic steroid use", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2023.09.016", "pmid": "37769866", "source_url": "https://pubmed.ncbi.nlm.nih.gov/37769866/", "evidence_group": "Prior testosterone/AAS use reported by infertility patients", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "45 men with azoospermia or severe oligospermia and prior testosterone/AAS use", "exposure": "Prior testosterone or anabolic-steroid use", "sample_size": "45", "testosterone_during_recovery": "Stopped", "recovery_treatment": "Clomiphene plus hCG for at least 3–6 months", "record_type": "azoospermia subgroup", "endpoint_or_finding": "Azoospermic men with sperm return into any nonzero category", "threshold_or_definition": "Severe oligospermia, oligospermia, or normozoospermia", "time_point": "After 6 months", "numerator": "13", "denominator": "18", "reported_value": "13 of 18 (72.2%)", "interpretation": "Calculated from 6 + 6 + 1; not a return-to-normal rate.", "main_limit": "Nine men were lost to semen follow-up; retrospective treated cohort; pregnancy follow-up reached only 24 couples; no untreated control; no live-birth endpoint." }, { "record_id": "SRAT-060", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ledesma-2023", "citation_short": "Ledesma et al. 2023", "year": 2023, "title": "Fertility outcomes in men with prior history of anabolic steroid use", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2023.09.016", "pmid": "37769866", "source_url": "https://pubmed.ncbi.nlm.nih.gov/37769866/", "evidence_group": "Prior testosterone/AAS use reported by infertility patients", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "45 men with azoospermia or severe oligospermia and prior testosterone/AAS use", "exposure": "Prior testosterone or anabolic-steroid use", "sample_size": "45", "testosterone_during_recovery": "Stopped", "recovery_treatment": "Clomiphene plus hCG for at least 3–6 months", "record_type": "azoospermia subgroup", "endpoint_or_finding": "Azoospermic men who remained azoospermic", "threshold_or_definition": "No sperm detected", "time_point": "After 6 months", "numerator": "5", "denominator": "18", "reported_value": "5 of 18 (27.8%)", "interpretation": "Selected treated cohort with no control.", "main_limit": "Nine men were lost to semen follow-up; retrospective treated cohort; pregnancy follow-up reached only 24 couples; no untreated control; no live-birth endpoint." }, { "record_id": "SRAT-061", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ledesma-2023", "citation_short": "Ledesma et al. 2023", "year": 2023, "title": "Fertility outcomes in men with prior history of anabolic steroid use", "journal": "Fertility and Sterility", "doi": "10.1016/j.fertnstert.2023.09.016", "pmid": "37769866", "source_url": "https://pubmed.ncbi.nlm.nih.gov/37769866/", "evidence_group": "Prior testosterone/AAS use reported by infertility patients", "study_design": "Retrospective cohort", "setting": "Male infertility clinic", "population": "45 men with azoospermia or severe oligospermia and prior testosterone/AAS use", "exposure": "Prior testosterone or anabolic-steroid use", "sample_size": "45", "testosterone_during_recovery": "Stopped", "recovery_treatment": "Clomiphene plus hCG for at least 3–6 months", "record_type": "pregnancy outcome", "endpoint_or_finding": "Responding couples reporting pregnancy", "threshold_or_definition": "Pregnancy, natural or assisted", "time_point": "Follow-up call", "numerator": "9", "denominator": "24", "reported_value": "9 of 24 (37.5%): 6 natural, 3 with ART", "interpretation": "Only 24 couples answered; no live-birth endpoint and no causal treatment estimate.", "main_limit": "Nine men were lost to semen follow-up; retrospective treated cohort; pregnancy follow-up reached only 24 couples; no untreated control; no live-birth endpoint." }, { "record_id": "SRAT-062", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "smit-2025", "citation_short": "Smit et al. 2025", "year": 2025, "title": "Efficacy of human chorionic gonadotropin hormone in restoring spermatogenesis in men using non-prescribed androgens: a retrospective analysis of real-world data", "journal": "F&S Reports", "doi": "10.1016/j.xfre.2025.03.001", "pmid": "40620361", "source_url": "https://pubmed.ncbi.nlm.nih.gov/40620361/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Retrospective real-world cohort", "setting": "Dutch harm-reduction clinic, April 2023–July 2024", "population": "19 men using non-prescribed androgens who did not want to stop", "exposure": "Continued non-prescribed androgen use", "sample_size": "19", "testosterone_during_recovery": "Non-prescribed androgens continued", "recovery_treatment": "hCG for 3–6 months", "record_type": "sample", "endpoint_or_finding": "Men in harm-reduction cohort", "threshold_or_definition": "Continued non-prescribed androgens", "time_point": "Baseline to 3–6 months", "numerator": "", "denominator": "", "reported_value": "19 men", "interpretation": "Very small selected cohort.", "main_limit": "Only 19 selected men; retrospective; no untreated or stop-androgen comparison; non-prescribed exposure; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-063", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "smit-2025", "citation_short": "Smit et al. 2025", "year": 2025, "title": "Efficacy of human chorionic gonadotropin hormone in restoring spermatogenesis in men using non-prescribed androgens: a retrospective analysis of real-world data", "journal": "F&S Reports", "doi": "10.1016/j.xfre.2025.03.001", "pmid": "40620361", "source_url": "https://pubmed.ncbi.nlm.nih.gov/40620361/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Retrospective real-world cohort", "setting": "Dutch harm-reduction clinic, April 2023–July 2024", "population": "19 men using non-prescribed androgens who did not want to stop", "exposure": "Continued non-prescribed androgen use", "sample_size": "19", "testosterone_during_recovery": "Non-prescribed androgens continued", "recovery_treatment": "hCG for 3–6 months", "record_type": "mean change", "endpoint_or_finding": "Mean total sperm count", "threshold_or_definition": "Total sperm in ejaculate", "time_point": "Baseline to after 3–6 months", "numerator": "", "denominator": "", "reported_value": "18.0 million to 146.9 million", "interpretation": "Within-group change; no matched control.", "main_limit": "Only 19 selected men; retrospective; no untreated or stop-androgen comparison; non-prescribed exposure; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-064", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "smit-2025", "citation_short": "Smit et al. 2025", "year": 2025, "title": "Efficacy of human chorionic gonadotropin hormone in restoring spermatogenesis in men using non-prescribed androgens: a retrospective analysis of real-world data", "journal": "F&S Reports", "doi": "10.1016/j.xfre.2025.03.001", "pmid": "40620361", "source_url": "https://pubmed.ncbi.nlm.nih.gov/40620361/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Retrospective real-world cohort", "setting": "Dutch harm-reduction clinic, April 2023–July 2024", "population": "19 men using non-prescribed androgens who did not want to stop", "exposure": "Continued non-prescribed androgen use", "sample_size": "19", "testosterone_during_recovery": "Non-prescribed androgens continued", "recovery_treatment": "hCG for 3–6 months", "record_type": "mean change", "endpoint_or_finding": "Mean total motile sperm count", "threshold_or_definition": "Moving sperm in whole ejaculate", "time_point": "Baseline to after 3–6 months", "numerator": "", "denominator": "", "reported_value": "1.1 million to 66.9 million", "interpretation": "Within-group change; not a stopping-androgen comparison.", "main_limit": "Only 19 selected men; retrospective; no untreated or stop-androgen comparison; non-prescribed exposure; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-065", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "smit-2025", "citation_short": "Smit et al. 2025", "year": 2025, "title": "Efficacy of human chorionic gonadotropin hormone in restoring spermatogenesis in men using non-prescribed androgens: a retrospective analysis of real-world data", "journal": "F&S Reports", "doi": "10.1016/j.xfre.2025.03.001", "pmid": "40620361", "source_url": "https://pubmed.ncbi.nlm.nih.gov/40620361/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Retrospective real-world cohort", "setting": "Dutch harm-reduction clinic, April 2023–July 2024", "population": "19 men using non-prescribed androgens who did not want to stop", "exposure": "Continued non-prescribed androgen use", "sample_size": "19", "testosterone_during_recovery": "Non-prescribed androgens continued", "recovery_treatment": "hCG for 3–6 months", "record_type": "threshold result", "endpoint_or_finding": "Men with study-defined normal TMSC", "threshold_or_definition": "Study-defined normal total motile sperm count", "time_point": "Baseline to after 3–6 months", "numerator": "", "denominator": "", "reported_value": "5% to 58%", "interpretation": "Small uncontrolled cohort; not proof that continuing androgens is safe.", "main_limit": "Only 19 selected men; retrospective; no untreated or stop-androgen comparison; non-prescribed exposure; no pregnancy or live-birth endpoint." }, { "record_id": "SRAT-066", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ibis-2026", "citation_short": "İbis et al. 2026", "year": 2026, "title": "Post-cycle therapy after short-term anabolic-androgenic steroid use: comparative outcomes in recreational bodybuilders", "journal": "BJU International", "doi": "10.1111/bju.70059", "pmid": "41147237", "source_url": "https://pubmed.ncbi.nlm.nih.gov/41147237/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Retrospective dual-center cohort", "setting": "Two centers; recreational bodybuilders", "population": "79 men with no more than 6 months of AAS use and documented normal pre-cycle reproductive tests", "exposure": "Short-term anabolic-androgenic steroid use", "sample_size": "79", "testosterone_during_recovery": "AAS stopped", "recovery_treatment": "No treatment, clomiphene, or clomiphene plus hCG; recombinant FSH for a small subgroup", "record_type": "sample", "endpoint_or_finding": "Men in cohort", "threshold_or_definition": "≤6 months AAS use; normal pre-cycle tests", "time_point": "Baseline through 12 months", "numerator": "", "denominator": "", "reported_value": "79 men", "interpretation": "Short-term AAS cohort with known baseline.", "main_limit": "Nonrandomized treatment groups; short-term AAS users with known normal baselines; small subgroups and wide confidence intervals; not prescribed TRT; no live-birth endpoint." }, { "record_id": "SRAT-067", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ibis-2026", "citation_short": "İbis et al. 2026", "year": 2026, "title": "Post-cycle therapy after short-term anabolic-androgenic steroid use: comparative outcomes in recreational bodybuilders", "journal": "BJU International", "doi": "10.1111/bju.70059", "pmid": "41147237", "source_url": "https://pubmed.ncbi.nlm.nih.gov/41147237/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Retrospective dual-center cohort", "setting": "Two centers; recreational bodybuilders", "population": "79 men with no more than 6 months of AAS use and documented normal pre-cycle reproductive tests", "exposure": "Short-term anabolic-androgenic steroid use", "sample_size": "79", "testosterone_during_recovery": "AAS stopped", "recovery_treatment": "No treatment, clomiphene, or clomiphene plus hCG; recombinant FSH for a small subgroup", "record_type": "baseline semen status", "endpoint_or_finding": "Azoospermia or severe oligozoospermia", "threshold_or_definition": "Combined low-count category", "time_point": "Post-cycle baseline visit", "numerator": "", "denominator": "", "reported_value": "69.7%", "interpretation": "Starting post-cycle status, not recovery rate.", "main_limit": "Nonrandomized treatment groups; short-term AAS users with known normal baselines; small subgroups and wide confidence intervals; not prescribed TRT; no live-birth endpoint." }, { "record_id": "SRAT-068", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ibis-2026", "citation_short": "İbis et al. 2026", "year": 2026, "title": "Post-cycle therapy after short-term anabolic-androgenic steroid use: comparative outcomes in recreational bodybuilders", "journal": "BJU International", "doi": "10.1111/bju.70059", "pmid": "41147237", "source_url": "https://pubmed.ncbi.nlm.nih.gov/41147237/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Retrospective dual-center cohort", "setting": "Two centers; recreational bodybuilders", "population": "79 men with no more than 6 months of AAS use and documented normal pre-cycle reproductive tests", "exposure": "Short-term anabolic-androgenic steroid use", "sample_size": "79", "testosterone_during_recovery": "AAS stopped", "recovery_treatment": "No treatment, clomiphene, or clomiphene plus hCG; recombinant FSH for a small subgroup", "record_type": "normozoospermia", "endpoint_or_finding": "No-treatment group with normal sperm concentration", "threshold_or_definition": "Study-defined normozoospermia", "time_point": "12 months", "numerator": "", "denominator": "", "reported_value": "58.6%", "interpretation": "Nonrandomized group; not a long-term TRT estimate.", "main_limit": "Nonrandomized treatment groups; short-term AAS users with known normal baselines; small subgroups and wide confidence intervals; not prescribed TRT; no live-birth endpoint." }, { "record_id": "SRAT-069", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ibis-2026", "citation_short": "İbis et al. 2026", "year": 2026, "title": "Post-cycle therapy after short-term anabolic-androgenic steroid use: comparative outcomes in recreational bodybuilders", "journal": "BJU International", "doi": "10.1111/bju.70059", "pmid": "41147237", "source_url": "https://pubmed.ncbi.nlm.nih.gov/41147237/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Retrospective dual-center cohort", "setting": "Two centers; recreational bodybuilders", "population": "79 men with no more than 6 months of AAS use and documented normal pre-cycle reproductive tests", "exposure": "Short-term anabolic-androgenic steroid use", "sample_size": "79", "testosterone_during_recovery": "AAS stopped", "recovery_treatment": "No treatment, clomiphene, or clomiphene plus hCG; recombinant FSH for a small subgroup", "record_type": "normozoospermia", "endpoint_or_finding": "Clomiphene group with normal sperm concentration", "threshold_or_definition": "Study-defined normozoospermia", "time_point": "12 months", "numerator": "", "denominator": "", "reported_value": "69.2%", "interpretation": "Nonrandomized treatment selection.", "main_limit": "Nonrandomized treatment groups; short-term AAS users with known normal baselines; small subgroups and wide confidence intervals; not prescribed TRT; no live-birth endpoint." }, { "record_id": "SRAT-070", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ibis-2026", "citation_short": "İbis et al. 2026", "year": 2026, "title": "Post-cycle therapy after short-term anabolic-androgenic steroid use: comparative outcomes in recreational bodybuilders", "journal": "BJU International", "doi": "10.1111/bju.70059", "pmid": "41147237", "source_url": "https://pubmed.ncbi.nlm.nih.gov/41147237/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Retrospective dual-center cohort", "setting": "Two centers; recreational bodybuilders", "population": "79 men with no more than 6 months of AAS use and documented normal pre-cycle reproductive tests", "exposure": "Short-term anabolic-androgenic steroid use", "sample_size": "79", "testosterone_during_recovery": "AAS stopped", "recovery_treatment": "No treatment, clomiphene, or clomiphene plus hCG; recombinant FSH for a small subgroup", "record_type": "normozoospermia", "endpoint_or_finding": "Clomiphene plus hCG group with normal sperm concentration", "threshold_or_definition": "Study-defined normozoospermia", "time_point": "12 months", "numerator": "", "denominator": "", "reported_value": "87.5%", "interpretation": "Nonrandomized; no live-birth endpoint.", "main_limit": "Nonrandomized treatment groups; short-term AAS users with known normal baselines; small subgroups and wide confidence intervals; not prescribed TRT; no live-birth endpoint." }, { "record_id": "SRAT-071", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ibis-2026", "citation_short": "İbis et al. 2026", "year": 2026, "title": "Post-cycle therapy after short-term anabolic-androgenic steroid use: comparative outcomes in recreational bodybuilders", "journal": "BJU International", "doi": "10.1111/bju.70059", "pmid": "41147237", "source_url": "https://pubmed.ncbi.nlm.nih.gov/41147237/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Retrospective dual-center cohort", "setting": "Two centers; recreational bodybuilders", "population": "79 men with no more than 6 months of AAS use and documented normal pre-cycle reproductive tests", "exposure": "Short-term anabolic-androgenic steroid use", "sample_size": "79", "testosterone_during_recovery": "AAS stopped", "recovery_treatment": "No treatment, clomiphene, or clomiphene plus hCG; recombinant FSH for a small subgroup", "record_type": "model association", "endpoint_or_finding": "Combined therapy association with normozoospermia", "threshold_or_definition": "Adjusted odds ratio", "time_point": "12 months", "numerator": "", "denominator": "", "reported_value": "OR 6.23 (95% CI 1.32–29.4)", "interpretation": "Wide CI and nonrandomized selection; association is not proof of cause.", "main_limit": "Nonrandomized treatment groups; short-term AAS users with known normal baselines; small subgroups and wide confidence intervals; not prescribed TRT; no live-birth endpoint." }, { "record_id": "SRAT-072", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ibis-2026", "citation_short": "İbis et al. 2026", "year": 2026, "title": "Post-cycle therapy after short-term anabolic-androgenic steroid use: comparative outcomes in recreational bodybuilders", "journal": "BJU International", "doi": "10.1111/bju.70059", "pmid": "41147237", "source_url": "https://pubmed.ncbi.nlm.nih.gov/41147237/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Retrospective dual-center cohort", "setting": "Two centers; recreational bodybuilders", "population": "79 men with no more than 6 months of AAS use and documented normal pre-cycle reproductive tests", "exposure": "Short-term anabolic-androgenic steroid use", "sample_size": "79", "testosterone_during_recovery": "AAS stopped", "recovery_treatment": "No treatment, clomiphene, or clomiphene plus hCG; recombinant FSH for a small subgroup", "record_type": "model association", "endpoint_or_finding": "Combined therapy association with motility recovery", "threshold_or_definition": "Adjusted odds ratio", "time_point": "12 months", "numerator": "", "denominator": "", "reported_value": "OR 4.85 (95% CI 1.27–18.4)", "interpretation": "Wide CI and nonrandomized selection.", "main_limit": "Nonrandomized treatment groups; short-term AAS users with known normal baselines; small subgroups and wide confidence intervals; not prescribed TRT; no live-birth endpoint." }, { "record_id": "SRAT-073", "dataset_version": "2.0", "verified_date": "2026-09-03", "study_key": "ibis-2026", "citation_short": "İbis et al. 2026", "year": 2026, "title": "Post-cycle therapy after short-term anabolic-androgenic steroid use: comparative outcomes in recreational bodybuilders", "journal": "BJU International", "doi": "10.1111/bju.70059", "pmid": "41147237", "source_url": "https://pubmed.ncbi.nlm.nih.gov/41147237/", "evidence_group": "Non-prescribed androgen/AAS use", "study_design": "Retrospective dual-center cohort", "setting": "Two centers; recreational bodybuilders", "population": "79 men with no more than 6 months of AAS use and documented normal pre-cycle reproductive tests", "exposure": "Short-term anabolic-androgenic steroid use", "sample_size": "79", "testosterone_during_recovery": "AAS stopped", "recovery_treatment": "No treatment, clomiphene, or clomiphene plus hCG; recombinant FSH for a small subgroup", "record_type": "small subgroup", "endpoint_or_finding": "Men receiving recombinant FSH who reached normozoospermia", "threshold_or_definition": "Study-defined normozoospermia", "time_point": "12 months", "numerator": "5", "denominator": "5", "reported_value": "5 of 5", "interpretation": "Only five selected men; not a general treatment claim.", "main_limit": "Nonrandomized treatment groups; short-term AAS users with known normal baselines; small subgroups and wide confidence intervals; not prescribed TRT; no live-birth endpoint." } ] }