Effect of aromatase inhibitor, letrozole on semen parameters in eugonadotropic hypoandrogenic men with oligozoospermia (original) (raw)
Related papers
Fertility and Sterility, 2012
Objective: To compare the effects of 2.5 mg letrozole with those of 1 mg anastrazole daily on the hormonal and semen profiles of a subset of infertile men with low T/E 2 ratios. Design: Prospective, nonrandomized study. Setting: Reproductive medicine clinic. Patient(s): The study group consisted of 29 infertile men with a low serum T/E 2 ratio (<10). Intervention(s): Patients were divided into two groups. Group A included 15 patients treated with 2.5 mg letrozole orally once daily for 6 months, and Group B consisted of 14 patients treated with 1 mg anastrazole orally every day for 6 months. Main Outcome Measure(s): Hormonal evaluation included measurement of serum FSH, LH, PRL, T, and E 2. In all sperm analyses pretreatment and posttreatment total motile sperm counts (ejaculate volume  concentration  motile fraction) were evaluated. Result(s): The use of aromatase inhibitors (either letrozole or anastrazole) in cases of infertile men with low T/E 2 ratios improved both hormonal and semen parameters. Conclusion(s): This study suggests that some men with severe oligospermia, low T levels, and normal gonadotropin concentration may have a treatable endocrinopathy. (Fertil Steril Ò 2012;98:48-51. Ó2012 by American Society for Reproductive Medicine.
Research in Health Science, 2020
This study was designed to evaluate the effect of letrozole 2.5 mg, an aromatase inhibitor, on the sperm retrieval rate (SRR) by the testicular sperm extraction (TESE) procedures that was done for the treatment of males with non-obstructive azoospermia (NOA). Materials and methods: Data was collected retrospectively from males diagnosed with non-obstructive azoospermia who underwent TESE procedure in the duration between May 2010 until June, 2018. The collected data includes the age of the patient, body mass index (BMI), testicular volume, hormonal profile (FSH LH, prolactin, testosterone), and the use of letrozole preoperatively. Logistic regression was done to address the association of these parameters to the sperm's retrieval rate. Results: The study screaned 145 patients. Eighty patients fit the inclusion criteria and thus they were statistically analyzed. The use of letrozole was associated with negative TESE outcome (p=0.006), odd (0.154) CI 0.04-0.579. The other factors had no significant correlation to the TESE results. Conclusion: The evidence in this study showed an adverse effect of letrozole use on TESE results of those with high FSH.
JBRA Assisted Reproduction, 2016
The aim of this study as to analyze published evidence regarding the effectiveness of aromatase inhibitor therapy on improving spermatogenesis in infertile men. We carried out a systematic review of randomized controlled trials. The date of the most recent search was October 4, 2015. Two authors independently selected relevant clinical trials, assessing their methodological quality and extracting data. Three studies were included in this review with a total of 100 participants; however, we were able to include data from only 54 participants in the analysis. In the representation of meta-analysis with a single study comparing testolactone versus placebo, related to the hormone concentrations, there was a statistically significance difference favoring the use of testolactone for Luteinizing Hormone (LH); Estrogen (E2); free Testosterone (free T); free Estrogen (free E2); 17-Hydroxyprogesterone (17OHP); prolactin (PRL). In another analysis from a single study comparing letrozole versus anastrozole, there was also a statistically significance difference favoring the use of letrozole for the increase in both the sperm count and LH. There is only low quality evidence regarding the effectiveness of aromatase inhibitor therapy in infertile men. Further trials are needed with standardized interventions and outcomes.
An Updated Role of Anastrozole in Male Factor Infertility for Avoidance of Need for Assisted Reproductive Technology (ART): A Short Communication, 2023
Male factor infertility causes infertility in about 50% couples. Aromatase hampering agents, like anastrozole restricts the transformation of testosterone (T) to estradiol (E2), minimize negative hampering on pituitary accessibility, and escalate endogenous Gn generation. Aromatase hampering agents have been offered historically to patients with a T: E2 ratio <10. Anastrozole, a more selective hampering agent in contrast to prior agents, has been illustrated to decrease serum E2 quantities and improvement of semen parameters in men with a low T: E2 ratio. Despite, escalated utilization of anastrozole for the treatment of infertile men with escalated peripheral estrogen, it is uncertain if a broader cohort may benefit also from therapy. For corroborating that Naelitz BD, et al. revealed in a multi institutional retrospective cohort study with regards to infertile men with the objective to evaluate the anticipative factors for World Health Organization-sperm concentration category (WHO-SCC)upgrade in case of male patients receiving anastrozole treatment. Their observations were that anastrozole Initiation was correlated with decreased serum estradiol (E2), escalated serum gonadotropin (Gn) quantities, and clinical improvement of semen paradigms in approximately 50% of infertile men. Baseline generation of sperms and greater T: LH ratios anticipated an upgrade of WHO-SCC. E2 quantities, E2: T ratio, and BMI revealed poor anticipative power in this cohort. Men with pretreatment azoospermia displayed poor response to anastrozole needing other treatment modalities. Non-azoospermic infertile men with a T-LH ratio ≥100 (in addition to a lesser degree those with a ratio <100) might gain advantage from treatment with anastrozole and get counseled regarding the anticipated probability of a clinically significant enhancement in semen paradigm. This might expand the availability of different therapies to couples who present with male factor infertility also aid in a trial of lesser invasive / costly fertility treatments.
JBRA Assisted Reproduction, 2015
Objective: The aim of this study was to report our preliminary experience regarding the use of letrozole in men with obstructive azoospermia (OA) undergoing percutaneous epididymal sperm aspiration (PESA) for in vitro fertilization treatment using intracytoplasmic sperm injection (ICSI), who had a very low sperm recovery upon PESA and unsuccessful ICSI. Our hypothesis was that letrozole therapy could improve testicular function by increasing serum gonadotropins and T levels, stimulate testicle germ cells and, most importantly, that it enhanced the motile sperm count at a second attempt. Methods: We report on our preliminary experience with letrozole therapy in 11 men with OA, who failed to achieve pregnancy in the first PESA-ICSI and did not have spermatozoa cryopreserved for a second attempt. The patients received 3 months of letrozole at 2.5mg/day and underwent PESA-ICSI after 6.1±3.8 months. The patients were 48.6 ± 9.6 years old, and underwent at least two PESA procedures. We evaluated the total motile sperm count per PESA samples, as the increases in serum FSH, LH, and T levels after treatment. Results: All parameters increased significantly at 3 months following letrozole therapy for most patients. The total motile sperm count increased from 100 to 500% compared to the first PESA. Conclusion: Letrozole can be considered a reliable treatment to improve sperm recovery for men with OA undergoing PESA-ICSI cycles by increasing serum gonadotropins and testosterone (T) levels, and-most importantly-the motile sperm count.
Journal of Advances in Medicine and Medical Research
Background: Infertility is a major cause of socio-emotional and psychological burden world-wide and nearly half of all cases of infertility were as a result of male partner’s related factors of which oligoasthenozoospermia is a major contributor. Currently, different treatments have been developed to manage this deficiency and improve semen parameters but no substantial results have been documented. Aims: This study therefore aims at evaluating the effects of clomiphene citrate versus letrozole on semen count and motility in men with oligoasthenozoospermia in Osogbo, south-western Nigeria Study Design: A randomized control study carried out at the gynaecology clinic of LAUTECH teaching hospital, State specialist hospital and Ayomide Women’s Health Specialist Hospital and IVF Centre Osogbo, Osun State. Methodology: One hundred and forty (140) participants were randomized into the letrozole group and the clomiphene citrate group, with 70 participants in each arm of the study. The outc...
P450-aromatase activity and expression in human testicular tissues with severe spermatogenic failure
International Journal of Andrology, 2009
There is evidence that impaired spermatogenesis is associated with an imbalance in the oestradiol ⁄ testosterone ratio and with Leydig cell (LC) dysfunction. In testis, P450-aromatase, encoded by CYP19, is responsible for the conversion of testosterone to oestradiol. The aims of this study were to quantify CYP19 mRNA expression, aromatase activity and protein localization, and to measure the oestradiol to testosterone ratio in testicular tissues of men with spermatogenic impairment. Twenty-four men with complete Sertoli cell-only syndrome (SCOS), 14 with focal SCOS, 14 with maturation arrest (MA), 8 with mixed atrophy and 30 controls with normal spermatogenesis were subjected to testicular biopsy. All subjects underwent a physical examination, cytogenetic and serum hormonal studies. Testicular CYP19 mRNA was quantified using real time RT-PCR. Testicular aromatase activity was measured using the 3 H 2 0 assay and protein expression was evaluated using immunohistochemistry. In cases, serum testosterone and oestradiol were normal, but the testosterone ⁄ LH ratio was lower compared with controls (p < 0.05). Aromatase was localized in the Leydig, Sertoli and germ cells of all tissues, although stronger intensity was observed in LC. Aromatase mRNA and activity were not altered in cases and correlated positively with LC number (r = 0.516 and r = 0.369; p < 0.008). The intratesticular oestradiol ⁄ testosterone ratio was elevated (p = 0.005) in complete SCOS patients compared with controls. In conclusion, testicular aromatase seems to be normal in most subjects with impaired spermatogenesis. However, an altered intratesticular oestradiol ⁄ testosterone ratio in some patients with complete SCOS suggests that aromatase is increased, which might contribute to Leydig cell dysfunction.
A Review on the Use of Letrozole in Female and Male Infertility
Cureus
Infertility in developing countries is a distinct and complex problem that disproportionately affects women. Though not a physically restraining disease, it causes a huge social burden on the emotional, financial, and psychosocial quotients of those who suffer from it. Assisted reproductive procedures are frequently used to treat infertility. Years ago, the emergence of ovulation induction represented a significant advancement in treating female infertility. Letrozole, an aromatase inhibitor, is a potential therapy for ovulation induction. Numerous clinical conditions, including anovulatory infertility, polycystic ovarian syndrome, unexplained infertility, and early stages of endometriosis-related infertility, as well as many with improved live birth rates, have been proven to benefit from letrozole treatment. Letrozole is a superior alternative to the widely utilized ovulation induction with clomiphene citrate. While clomiphene citrate has certain limitations, letrozole successfully overcomes these limitations because of its lack of prolonged anti-estrogenic activity, short half-life, and lack of estrogen receptor activation. In most cases, this results in mono-follicular development and excellent live birth rates. According to the most recent research, letrozole can be used as the first-line therapy to treat infertility caused by polycystic ovarian syndrome and other causes. Letrozole is also emerging as a possible treatment for male infertility of unknown cause, proving to be an effective way of influencing hormonal profiles and increasing various seminal parameters such as sperm motility and concentration, as it inhibits aromatization affecting the feedback mechanism to the hypothalamus. This review focuses on our current knowledge of the uses of letrozole for female and male infertility, its mechanisms, and its benefits.
Archives of Andrology, 1996
S. CARRANZA-LIRA c. MORAN Fourteen asthenoteratozoosperic (ATZS) patients were treated with 75-IU follicle-stimulating hormone (FSH) injections 3 times a week for 3 months. In the group as a whole, sperm motility, viability, and morphology were improved, but not significantly. Only 3 patients impregnated their wives following treatment. Semen characteristics of the 3 patients whose wives were pregnant showed significant improvement in sperm morphology (p = ,001). Only FSH levels were statistically higher (p = ,022) than controls. The administration of FSH in weekly doses can improve the fertilization potential of sperm. asthenozoospermia, follicle-stimulating hormone (FSH), hormone treatment, male factor, s e m e n analysis Keywords Men with impaired semen characteristics often exhibit a reduced fertility potential [3, 7, 91. Approximately 25% of infertile men have normal levels of gonadotropins and sexual steroids and no detectable cause of their abnormal sperm analysis as judged by standard evaluation [2, 3, 71. Normogonadotropic patients with this idiopathic abnormal sperm analysis have been treated empirically with gonadotropin releasing hormone (GnRH) [9], gonadotropins [2, 3, 101, estrogen (E) antagonists, androgens, and several nonhormonal drugs. Some success has been claimed, but the benefit of these treatments was often poor, and none of them has proved to be effective. This suggests a heterogeneity in the physiopathology of normogonadotropic oligoasthenozoospermia (OAZS).