Androgens and male fertility


Androgens play a crucial role in the development of male reproductive organs such as the epididymis, vas deferens, seminal vesicle, prostate and the penis. Furthermore, androgens are needed for puberty, male fertility and male sexual function. High levels of intratesticular testosterone, secreted by the leydig cells, are necessary for spermatogenesis. Intratesticular testosterone is mainly bound to androgen binding protein and secreted into the seminiferous tubules. Inside the sertoli cells, testosterone is selectively bound to the androgen receptor and activation of the receptor will result in initiation and maintenance of the spermatogenic process and inhibition of germ cell apoptosis. The androgen receptor is found in all male reproductive organs and can be stimulated by either testosterone or its more potential metabolite dihydrotestosterone. Severe defects of the androgen receptor may result in abnormal male sexual development. More subtle modulations can be a potential cause of male infertility. Treatment of an infertile man with testosterone does improve spermatogenesis, since exogenous administrated testosterone and its metabolite estrogen will suppress both GnRH production by the hypothalamus and Luteinising hormone production by the pituitary gland and subsequently suppress testicular testosterone production. Also, high levels of testosterone are needed inside the testis and this can never be accomplished by oral or parenteral administration of androgens. Suppression of testosterone production by the leydig cells will result in a deficient spermatogenesis, as can be seen in men taking anabolic-androgenic steroids. Suppression of spermatogenesis by testosterone administration is also the basis for the development of a male contraceptive. During cytotoxic treatment or irradiation suppression of intratesticular testosterone production cells may prevent irreversible damage to the spermotogonial stem cells.

This is a preview of subscription content, log in to check access.


  1. 1.

    Bentvelsen FM, McPhaul MJ, Wilson JD, George FW (1994) The androgen receptor of the urogenital tract of the fetal rat is regulated by androgen. Mol Cell Endocrinol 105(1):21–26

    Article  CAS  PubMed  Google Scholar 

  2. 2.

    Brinkmann AO, Jenster G, Ris-Stalpers C, van der Korput JA, Bruggenwirth HT, Boehmer AL, Trapman J (1995) Androgen receptor mutations. J Steroid Biochem Mol Biol 53(1–6):443–448

    Google Scholar 

  3. 3.

    Cooper TG (1996) Epididymis and sperm function. Andrologia 28[Suppl 1]: 57–59

  4. 4.

    De Kretser DM, Burger HG, Fortune D, Hudson B, Long AR, Paulsen CA, Taft HP (1972) Hormonal, histological and chromosomal studies in adult males with testicular disorders. J Clin Endocrinol Metab 35:392–401

    PubMed  Google Scholar 

  5. 5.

    Giwercman YL, Xu C, Arver S, Pousette A, Reneland R (1998) No association between the androgen receptor gene CAG repeat and impaired sperm production in Swedish men. Clin Genet 54:435–436

    CAS  PubMed  Google Scholar 

  6. 6.

    Handelsman DJ (1994) Testicular dysfunction in systemic disease. Endocrinol Metab Clin North Am 23:839–856

    CAS  PubMed  Google Scholar 

  7. 7.

    Johnsen SG (1978) Maintenance of spermatogenesis induced by HMG treatment by means of continuous HCG treatment in hypogonadotrophic men. Acta Endocrinol 89(4):763–769

    CAS  PubMed  Google Scholar 

  8. 8.

    Kreuser ED, Klingmuller D, Thiel E (1993) The role of LHRH-analogues in protecting gonadal functions during chemotherapy and irradiation. Eur Urol 23(1):157–163

    CAS  PubMed  Google Scholar 

  9. 9.

    La Spada AR, Wilson EM, Lubahn DB, Harding AE, Fischbeck KH (1991) Androgen receptor gene mutations in X-linked spinal and bulbar muscular atrophy. Nature 4;352:77–79

    Google Scholar 

  10. 10.

    Levalle O, Zylbersztein C, Aszpis S, Aquilano D, Terradas C, Colombani M, Aranda C, Scaglia H (1998) Recombinant human follicle-stimulating hormone administration increases testosterone production in men, possibly by a Sertoli cell-secreted nonsteroid factor. J Clin Endocrinol Metab 83(11):3973–3976

    CAS  PubMed  Google Scholar 

  11. 11.

    Lloyd FH, Powell P Murdoch AP (1996) Anabolic steroid abuse by bodybuilders and male subfertility. Br Med J 313:100–101

    CAS  Google Scholar 

  12. 12.

    McLachlan RI, O’Donnell L, Meachem SJ, Stanton PG, de K, Pratis K, Robertson DM (2002) Hormonal regulation of spermatogenesis in primates and man: insights for development of the male hormonal contraceptive. J Androl 23(2):149–162

    CAS  PubMed  Google Scholar 

  13. 13.

    Meistrich ML, Shetty G (2003) Suppression of testosterone stimulates recovery of spermatogenesis after cancer treatment. Int J Androl 26(3):141–146

    Article  CAS  PubMed  Google Scholar 

  14. 14.

    Nieschlag E, Behre HM (eds) (1997) Andrology: male reproductive health and dysfunction. Springer, Berlin, Heidelberg, New York

  15. 15.

    Ochsenkuhn R, De Kretser DM (2003) The contributions of deficient androgen action in spermatogenic disorders. Int J Androl 26(4):195–201

    Article  PubMed  Google Scholar 

  16. 16.

    O’Donnell L, Robertson KM, Jones ME, Simpson ER (2001) Estrogen and spermatogenesis. Endocr Rev 22(3):289–318

    CAS  PubMed  Google Scholar 

  17. 17.

    Paniagua R, Nistal M, Saez FJ, Fraile B (1991) Ultrastructure of the aging human testis. J Electron Microsc Tech 19(2):241–260

    CAS  PubMed  Google Scholar 

  18. 18.

    Parker KL, Schimmer BP, Schedl A (1999) Genes essential for early events in gonadal development. Cell Mol Life Sci 55:831–838

    CAS  PubMed  Google Scholar 

  19. 19.

    Pierik FH, Van Ginneken AM, Dohle GR, Vreeburg JT, Weber RF (2002) The advantages of standardized evaluation of male infertility. Int J Androl 23(6):340–346

    Article  Google Scholar 

  20. 20.

    Sharpe RM, Kerr JB, McKinnell C, Millar M (1994) Temporal relationship between androgen-dependent changes in the volume of seminiferous tubule fluid, lumen size and seminiferous tubule protein secretion in rats. J Reprod Fertil 101(1):193–198

    CAS  PubMed  Google Scholar 

  21. 21.

    Singh J, O’Neill C, Handelsman DJ (1995) Induction of spermatogenesis by androgens in gonadotropin-deficient (hpg) mice. Endocrinology 136(12):5311–5321

    CAS  PubMed  Google Scholar 

  22. 22.

    Sun YT, Irby DC, Robertson DM, de Kretser DM (1989) The effects of exogenously administered testosterone on spermatogenesis in intact and hypophysectomized rats. Endocrinology 125(2):1000–1010

    CAS  PubMed  Google Scholar 

  23. 23.

    Turek PJ, Williamsl RH, Gilbaugh JH, Lipshultz LI (1995) The reversibility of anabolic steroid-induced azoospermia. J Urol 153(5):1628–1630

    CAS  PubMed  Google Scholar 

  24. 24.

    Vandekerckhove P, Lilford R, Vail A, Hughes E (2000) Androgens versus placebo or no treatment for idiopathic oligo/asthenospermia. Cochrane Database Syst Rev 2:CD000150

    PubMed  Google Scholar 

  25. 25.

    van Roijen JH, Ooms MP, Weber RF, Brinkmann AO, Grootegoed JA, Vreeburg JT (1997) Comparison of the response of rat testis and accessory sex organs to treatment with testosterone and the synthetic androgen methyltrienolone (R1881). J Androl 18(1):51–61

    PubMed  Google Scholar 

  26. 26.

    Vreeburg JT (1975) Distribution of testosterone and 5alpha-dihydrotestosterone in rat epididymis and their concentrations in efferent duct fluid. J Endocrinol 67(2):203–210

    CAS  PubMed  Google Scholar 

  27. 27.

    Walsh PC, Madden JD, Harrod MJ, Goldstein JL, MacDonald PC, Wilson JD (1974) Familial incomplete male pseudohermaphroditism, type 2. Decreased dihydrotestosterone formation in pseudovaginal perineoscrotal hypospadias. N Engl J Med 291(18):944–949

    CAS  PubMed  Google Scholar 

  28. 28.

    Weinbauer GF, Nieschlag E (1993) Gonadotrophin-releasing hormone analogue-induced manipulation of testicular function in the monkey. Hum Reprod 8[Suppl 2]: 45–50

  29. 29.

    Zitmann M, Nieschlag E (2003) The CAG repeat polymorphism within the androgen receptor gene and maleness. Int J Androl 26(2):76–83

    PubMed  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to G. R. Dohle.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Dohle, G.R., Smit, M. & Weber, R.F.A. Androgens and male fertility. World J Urol 21, 341–345 (2003).

Download citation


  • Androgens
  • Male infertility
  • Spermatogenesis
  • Testicular development
  • Anabolic steroids