Azoospermia and severe oligozoospermia in Indonesian men following injections with testosterone enanthate or 19-nortestosterone plus progestogen

The objective of this study is to ascertain the effects of Testosterone enanthate (TE) or 19-Nortestosterone hexyloxy phenyl-propionate (19-NT) plus Depot medroxyprogesterone acetate (DMPA) on the semen production in healthy Indonesian men. The prospective study consisted of 2 phases i.e. a control phase and treatment phase. Forty normal healthy male volunteers received seven weekly injections of TE or 19-NT, 200 mg IM, followed by injection every 3 weeks to week 24. In both groups 250 mg DMPA was injected IM at 0, 6,12, and 18 weeks. The results showed that there was no reduction in semen volume, but there was a reduction in sperm concentration, motility and the number of sperm with normal morphology in both groups. The three of 40 men discontinued injections for failure to attend at scheduled time (2) and for medical reasons (1), but had achieved azoospermia (2) and the third man achieved sperm concentration of 0.2 x 10⁶/mL Thirty three of 37 men (89.2%) achieved azoospermia within 21 weeks, of these 17 of 18 men (94.4%) from the TE group, and 16 of 19 (84.2%) from the 19-NT group. The achievement of severe oligozoospermia (sperm concentration < 5 million/mL) was 37 of 37 men (100%) within 15 weeks, of these 18 of 18 men (100%) within 12 weeks from the TE group and 19 of 19 men (100%) within 15 weeks from the 19-NT group. The two treatments were also effective in suppressing sperm motility, and normal morphology count. Conclusions: The rates of azoospermia and severe oligozoospermia in Indonesian men following injections of TE or 19-NT plus DMPA are higher compared to the Caucasian men (non Indonesian).