Dr. Bastuba, a male infertility specialist, recalls how anabolic steroids can affect a man's sperm count.
Anabolic steroids are increasingly used in our current culture and present difficulties from many angles. Interestingly, they are getting more and more common in college females, but let’s just talk about males.
There is a fairly recent report that suggested that up to five percent of high school males may have used or be using anabolic steroids. That is a scary figure when one considers that even one cycle of anabolic steroids in certain people that we cannot predict may leave them sterile for the rest of their lives.
Now that is by far the minority of people, but it still is out there and I certainly see that in a male fertility practice. Now the typical patient is possibly a bodybuilder or someone who has used fairly high doses of steroids for a long period of time. So I don’t want to be alarmed as to say that even after one cycle it will have an impact on your fertility, but it is true that it could have an impact on certain people that we can’t predict.
What’s much more of an issue is the person who is doing what we know as cycling steroids. This would be where you take high doses – ten or twelve times the normal dose of testosterone or a similar product to testosterone typically for a 6 to 12 week period of time - then you come off, let your body readjust and then start that cycle again. That is known as cycling.
Another way that steroids are used is something called stacking. In stacking you use various types of these substances that are similar to testosterone known as anabolic steroids to try to achieve a similar effect and you might stack on a cycle. These type of high-dose products have the impact of increasing testosterone in the blood, which can lead to a muscle growth and some useful things, but at the same time, they send a message to the testicle, “Stop producing testosterone. We’ve got plenty in our bloodstream so shut down.” As part of that same process, those stem cells, the spermatogonia that are making sperms, are also told, “Slow down or stop”. And sometimes if you do a high enough dose for long enough, those cells never get the message that they are supposed to restart.
Now when I see people who have used anabolic steroids, one important message is that they are very addictive and in my practice, it’s similar to talking to someone who has been addicted to any substance that you have to have a sense of how powerful that is in their lives and that many times they are reluctant to tell you the complete truth as to what’s going on.
There are substances we can use to try to stimulate the body to regain its own production of testosterone, which then can also help to promote sperm production. Substances such as Clomid or clomiphene, often times used in females to try to stimulate egg health; also substances such as an aromatase inhibitor can also help promote sperm production.
And so, this can be treated in the great majority of males, at least 80% of males even who have used significant anabolic steroids, we can get sperm from their body. It may not come back in their ejaculate, but oftentimes we can get it directly from their testicle in a process known as testicular sperm extraction; low numbers of sperm, but enough that we can use it for in vitro fertilization.
By saying this I am absolutely not condoning the use of anabolic steroids and saying it’s okay, we can figure it out later, but I am saying that if you have used, there is still hope for the great majority of patients that we can usually, about four out of five times, get sperm directly from the testicles and do something useful with it.
About Dr. Martin D. Bastuba:
As San Diego's leading subspecialist in male fertility and male and female sexual dysfunction issues, Dr. Martin Bastuba gives hope to couples who have been unable to conceive, and to men and women who are experiencing the anxieties and frustration of sexual dysfunction. He offers complete diagnosis, treatment, prevention techniques and education for his patients.