Abstract: PD13-09
Sources of Funding: none

Introduction

Anabolic steroid (AS) use is increasing, with a 6.4% lifetime abuse rate for males. Use of high doses of AS can manifest with a variety of adverse effects on multiple different organ systems. Specifically, AS impact the male reproductive system via central suppression of gonadotropins leading to decreased endogenous testosterone production, testicular atrophy, and impaired spermatogenesis. Despite the known contraceptive effect of androgens, spontaneous pregnancies while using AS are often reported within online communities of users. Therefore, our objective is to describe self-reported medication patterns and fertility rates in a population of anabolic steroid users.

Methods

Nine bodybuilding forums were identified using Google search terms. After receiving permission from the websites, a link to an anonymous 49 item questionnaire was posted. Data was collected using Survey Monkey. Information collected included demographics, anabolic steroid use, ancillary medications, and fertility outcomes. Only men attempting to achieve a pregnancy while using testosterone and other AS constituted the cohort of the current study.

Results

A total of 323 participants initiated the survey, of whom 97 (30%) met inclusion criteria. The majority of men were 25-44 years old (63.9%), married (75.5%) and Caucasian (88.7%). Ancillary drug use was common with only 5.2% denying drug use other than anabolic steroids. The most commonly reported ancillary drugs were antiestrogens (selective estrogen receptor modulators and/or aromatase inhibitors - 89.7%) and sexual enhancement medications (68%). The overall fertility rate was 92.8% with 82.5% achieving pregnancy within one year. Only 13.5% sought fertility evaluation with treatment required in 8.3%. Age at initiation of anabolic steroid use, maximum dosage utilized, yearly duration of supplementation, and number of years using steroids were not associated with a prolonged duration to pregnancy or decreased rate of pregnancy

Conclusions

Fertility rates are maintained in a population of AS users and are relatively equivalent to age-matched historical controls. This surprising finding may be related to the common use of washout periods, adjunctive medications (SERMs, AIs), and incomplete suppression of the hypothalamic pituitary testicular axis despite large doses of AS.

Funding

none