Reversible testosterone-induced azoospermia in a 45-year-old man attending an infertility outpatient clinic

A 45-year-old male with azoospermia was presented to us with primary infertility. We found that he had been taking testosterone due to erectile dysfunction. Upon its discontinuation, the normozoospermia was restored. This led to a pregnancy. In men aged 40-50, the diagnostic work up of testosterone deficiency should be in accordance with the current guidelines. Moreover, no testosterone prescription should be made without having inquired about parenthood desires. In men of the reproductive age with recent-onset azoospermia, consider the possibility of an iatrogenic cause, primarily due to the testosterone replacement therapy. The treatment is simple: to discontinue the therapy.