A 34-year-old man and his 33-year-old partner have been unable to conceive after 18 months of regular unprotected intercourse. His partner's fertility assessment is normal. He is a competitive powerlifter who used stanozolol and injectable testosterone for 6 years and stopped all anabolic-androgenic steroids 8 months ago; abstinence is confirmed. He has no other medical conditions and takes no medications. On examination, both testes are small at 12 mL each (15-25) and soft, with no varicocele. Semen analysis shows a sperm concentration of 1.2 million/mL (at least 16) on two occasions. Luteinizing hormone is 2.1 IU/L (1.7-8.6), follicle-stimulating hormone 1.9 IU/L (1.5-12.4), and total testosterone 8.0 nmol/L (9.9-27.8).
| Heart rate | 64/min |
| Respiratory rate | 14/min |
| Temperature | 36.8 °C |
| O2 saturation | 99%, room air |
| Blood pressure | 128/78 mm Hg |
Question 1 of 28
Given the patient's persistent steroid-induced suppression of spermatogenesis, which of the following are the most appropriate medication options to promote recovery of sperm production?
Select 2. (0 / 2 selected)
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