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Updated: Jul 4, 2026

Treatment Model for Young Patients with Psychogenic Erectile Dysfunction and Resultant Infertility
Published on: May 30, 2025
Treatment of male infertility secondary to morbid obesity
Mara Y Roth1, John K Amory, Stephanie T Page
1Division of Metabolism, Endocrinology and Nutrition, University of Washington School of Medicine, Seattle, WA 98195-6246, USA.
Background:
A 29-year-old man presented to a clinic with infertility and hypogonadism in the setting of morbid obesity. On presentation, he had notable gynecomastia and a low testicular volume. The patient's weight was 154 kg and his height was 168 cm (BMI 54.5 kg/m(2)). Before referral to the clinic, the patient had been treated with testosterone therapy for 4 months for hypogonadism. This treatment had caused his initially low sperm concentration to fall to undetectable levels.
Investigations:
Measurement of reproductive hormone levels, pituitary MRI, and semen analysis.
Diagnosis:
Infertility secondary to hypogonadotropic hypogonadism and an elevated estrogen:testosterone ratio.
Management:
Treatment with an aromatase inhibitor, anastrozole, led to normalization of the patient's testosterone, luteinizing hormone and follicle-stimulating hormone levels, suppression of serum estradiol levels, and to normalization of spermatogenesis and fertility.
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