PDF(Pubmed)
Abstract：
UNASSIGNED: Anabolic-androgenic steroids (AASs) are often used by men for bodybuilding and to improve sports performance. The use is not limited to professional competitive athletes, but many amateur men.
UNASSIGNED: The objective of this study was to assess and systematically review the effects of AAS on male fertility parameters, spermiogram, testosterone, follicle-stimulating hormone (FSH) and luteinising hormone (LH) and to review reversibility and other morbidity impacting fertility.
UNASSIGNED: Eligibility criteria - We included studies mentioning data about adult males using supraphysiologic doses of AAS for sports performance or appearance enhancement, with comparison data from general population or matched controls if available reporting fertility parameters and sexual performance. Information sources - A systematic literature search was performed using PubMed, MEDLINE, EMBASE, Google Scholar and World of Science. Controlled clinical trials randomised or nonrandomised (if available), case series with or without matched controls, case reports, cross-sectional surveys, reports on follow-up of subjects caught in doping test and their fertility parameters when reported. Risk of bias/quality assessment - The quality assessment of the included studies was performed using the Newcastle-Ottawa Scale.
UNASSIGNED: Included studies - Thirty-two studies were included. There were 12 cohort studies, 5 case-control studies, 9 cross-sectional surveys and 6 case reports. The study population comprised 9371 individuals, of which 2671 were AAS users. Synthesis of results - AAS users had reduced levels of FSH and LH than the naïve population. These levels remained low for 3-6 months after stopping AAS. One year after stopping AAS, the users and naïve population had insignificant differences in FSH and LH values. The total testosterone (TT) levels were comparable in users and naïve populations at baseline, 3 months and 6 months after stopping, but at 1 year, TT values were lower in AAS users. Sperm concentration in AAS users and naïve population was similar, but sperm motility was lower in AAS users. The testicular size was lower in AAS users. The erectile function improved with AAS use, but on withdrawal, there was decreased libido and erectile dysfunction. Most AAS users need additional medications to mitigate detrimental effects on fertility. Description of the effect - AAS use negatively impacted the gonadotrophin levels and had lower sperm motility and testicular size. Strength - Comprehensive review of 32 publications, study population of 9371 individuals, of which 2671 were AAS users, meta-analysis of reproductive hormones, semen parameters and testis size.
UNASSIGNED: The limitations are small sample size of most of the studies, polypharmacy, lack of information on dosing and high heterogeneity.
UNASSIGNED: AAS use is detrimental for sperm motility and has a partially reversible negative impact on male fertility. Users must be cautioned about its negative impact on libido and erectile function.Registration: PROSPERO Registration No. CRD42023411294.
UNASSIGNED: The objective of this study was to assess and systematically review the effects of AAS on male fertility parameters, spermiogram, testosterone, follicle-stimulating hormone (FSH) and luteinising hormone (LH) and to review reversibility and other morbidity impacting fertility.
UNASSIGNED: Eligibility criteria - We included studies mentioning data about adult males using supraphysiologic doses of AAS for sports performance or appearance enhancement, with comparison data from general population or matched controls if available reporting fertility parameters and sexual performance. Information sources - A systematic literature search was performed using PubMed, MEDLINE, EMBASE, Google Scholar and World of Science. Controlled clinical trials randomised or nonrandomised (if available), case series with or without matched controls, case reports, cross-sectional surveys, reports on follow-up of subjects caught in doping test and their fertility parameters when reported. Risk of bias/quality assessment - The quality assessment of the included studies was performed using the Newcastle-Ottawa Scale.
UNASSIGNED: Included studies - Thirty-two studies were included. There were 12 cohort studies, 5 case-control studies, 9 cross-sectional surveys and 6 case reports. The study population comprised 9371 individuals, of which 2671 were AAS users. Synthesis of results - AAS users had reduced levels of FSH and LH than the naïve population. These levels remained low for 3-6 months after stopping AAS. One year after stopping AAS, the users and naïve population had insignificant differences in FSH and LH values. The total testosterone (TT) levels were comparable in users and naïve populations at baseline, 3 months and 6 months after stopping, but at 1 year, TT values were lower in AAS users. Sperm concentration in AAS users and naïve population was similar, but sperm motility was lower in AAS users. The testicular size was lower in AAS users. The erectile function improved with AAS use, but on withdrawal, there was decreased libido and erectile dysfunction. Most AAS users need additional medications to mitigate detrimental effects on fertility. Description of the effect - AAS use negatively impacted the gonadotrophin levels and had lower sperm motility and testicular size. Strength - Comprehensive review of 32 publications, study population of 9371 individuals, of which 2671 were AAS users, meta-analysis of reproductive hormones, semen parameters and testis size.
UNASSIGNED: The limitations are small sample size of most of the studies, polypharmacy, lack of information on dosing and high heterogeneity.
UNASSIGNED: AAS use is detrimental for sperm motility and has a partially reversible negative impact on male fertility. Users must be cautioned about its negative impact on libido and erectile function.Registration: PROSPERO Registration No. CRD42023411294.
摘要：
■合成代谢-雄激素类固醇（AASs）通常被男性用于健美和改善运动表现。使用不仅限于专业竞技运动员，但是很多业余的男人。
■本研究的目的是评估和系统地回顾AAS对男性生育力参数的影响，精子图,睾丸激素，卵泡刺激素（FSH）和黄体生成素（LH），并回顾可逆性和其他影响生育能力的发病率。
■合格标准-我们纳入了提及成年男性使用超生理剂量AAS进行运动表现或外观增强的数据的研究，与来自普通人群或匹配对照的比较数据（如果有的话）报告生育参数和性表现。信息源-使用PubMed进行了系统的文献检索，MEDLINE,EMBASE,谷歌学者和科学世界。随机或非随机的对照临床试验（如果有），带或不带匹配控件的案例系列，病例报告,横断面调查，关于在兴奋剂测试中发现的受试者的随访报告及其报告时的生育参数。偏倚风险/质量评估—纳入研究的质量评估采用纽卡斯尔-渥太华量表进行。
■纳入研究——纳入32项研究。有12项队列研究，5个病例对照研究，9次横断面调查和6例病例报告。研究人群包括9371个人，其中2671人为AAS用户。结果合成-AAS使用者的FSH和LH水平低于未接种人群。这些水平在停止AAS后3-6个月保持在低水平。停止AAS一年后，使用者和初治人群的FSH和LH值差异不显著.基线时，使用者和幼稚人群的总睾酮（TT）水平相当，停止后3个月和6个月，但是在一年的时候，AAS用户的TT值较低。AAS使用者和幼稚人群的精子浓度相似，但AAS使用者的精子活力较低。AAS使用者的睾丸大小较小。使用AAS可以改善勃起功能，但是在撤军时，性欲下降和勃起功能障碍。大多数AAS使用者需要额外的药物来减轻对生育能力的不利影响。效果描述-使用AAS对促性腺激素水平产生负面影响，精子活力和睾丸大小较低。实力-全面审查32种出版物，9371人的研究人群，其中2671是AAS用户，生殖激素的荟萃分析，精液参数和睾丸大小。
■限制是大多数研究的样本量小，多药，缺乏剂量信息和高度异质性。
■使用AAS对精子运动有害，并且对男性生育力具有部分可逆的负面影响。用户必须注意其对性欲和勃起功能的负面影响。注册：PROSPERO注册号.CRD42023411294。
■本研究的目的是评估和系统地回顾AAS对男性生育力参数的影响，精子图,睾丸激素，卵泡刺激素（FSH）和黄体生成素（LH），并回顾可逆性和其他影响生育能力的发病率。
■合格标准-我们纳入了提及成年男性使用超生理剂量AAS进行运动表现或外观增强的数据的研究，与来自普通人群或匹配对照的比较数据（如果有的话）报告生育参数和性表现。信息源-使用PubMed进行了系统的文献检索，MEDLINE,EMBASE,谷歌学者和科学世界。随机或非随机的对照临床试验（如果有），带或不带匹配控件的案例系列，病例报告,横断面调查，关于在兴奋剂测试中发现的受试者的随访报告及其报告时的生育参数。偏倚风险/质量评估—纳入研究的质量评估采用纽卡斯尔-渥太华量表进行。
■纳入研究——纳入32项研究。有12项队列研究，5个病例对照研究，9次横断面调查和6例病例报告。研究人群包括9371个人，其中2671人为AAS用户。结果合成-AAS使用者的FSH和LH水平低于未接种人群。这些水平在停止AAS后3-6个月保持在低水平。停止AAS一年后，使用者和初治人群的FSH和LH值差异不显著.基线时，使用者和幼稚人群的总睾酮（TT）水平相当，停止后3个月和6个月，但是在一年的时候，AAS用户的TT值较低。AAS使用者和幼稚人群的精子浓度相似，但AAS使用者的精子活力较低。AAS使用者的睾丸大小较小。使用AAS可以改善勃起功能，但是在撤军时，性欲下降和勃起功能障碍。大多数AAS使用者需要额外的药物来减轻对生育能力的不利影响。效果描述-使用AAS对促性腺激素水平产生负面影响，精子活力和睾丸大小较低。实力-全面审查32种出版物，9371人的研究人群，其中2671是AAS用户，生殖激素的荟萃分析，精液参数和睾丸大小。
■限制是大多数研究的样本量小，多药，缺乏剂量信息和高度异质性。
■使用AAS对精子运动有害，并且对男性生育力具有部分可逆的负面影响。用户必须注意其对性欲和勃起功能的负面影响。注册：PROSPERO注册号.CRD42023411294。
