Effectiveness of Antiestrogens in Infertile Men

Abstract

Eighty-nine oligozoospermic men, treated by clomiphene or tamoxifen or with no treatment at all, were evaluated during a 4-year follow-up period. Ejaculate volume, sperm concentration, and sperm motility were determined and concentrations of prolactin (PRL), estradiol, beta hCG, prostaglandin E2, zinc, and fructose were ascertained. Isoenzyme LDH-C4 activity and serum PRL and follicle stimulating hormone were also determined. During treatment there was only a minimum increase in sperm concentration. No improvement in sperm motility and no alteration in ejaculate volume were observed. The pregnancy rate was lower in the partners of patients receiving treatment (23.8%) than in the partners of those receiving none (29.6%). Statistically the difference is insignificant. After antiestrogen therapy, prolactin concentrations in serum decreased and zinc concentrations in seminal plasma increased. For the treatment of idiopathic oligozoospermia in infertile men, clomiphene and tamoxifen were ineffective medication.

Effect of tamoxifen treatment on the semen quality and fertility of the male rat

“…On the other hand, several works demonstrated no significant efficacy of tamoxifen for the treatment of male infertility/idiopathic oligospermia (27,(41)(42)(43). Moreover, Rolf et al reviewed the treatment of male infertility in 29 clinical trials with a total of 1,586 patients and concluded that the benefits may not justify the risks (thrombocytopenia, carcinogenicity) of using tamoxifen in otherwise healthy males (44).…”

Steps in the investigation and management of low semen volume in the infertile man

“…In hypogonadal men with low-volume ejaculate, treatment with clomiphene citrate may increase testosterone levels, but its effects on ejaculate volume are unknown, although one report found no difference in ejaculate volume before and after treatment. 49 …”

Hormonal Treatment of Male Infertility: Promises and Pitfalls

“…Dosages of 10-25 mg/kg were administered ranging over periods of 10 days to 9 months. Sperm motility, concentration, and morphology improved significantly in oligozoospermic patients (Micic and Dotlic, 1985;Hayashi et al, 1988;Homonnai et al, 1988;Breznik and Borko, 1993) (Table 9). More than 50% pregnancy rates were obtained in oligozoospermic patients and patients recovered from varicocelectomy not responding to hCG (Epstein, 1977).…”

“…Sperm motility was analyzed in 5 studies, of which none reported improvement (Maier and Hienert, 1990; Sterzik et al, 1991, 1993; Krause et al, 1992; Breznik and Borko, 1993). Among all 6 studies following up for pregnancy rates (Bartsch and Scheiber, 1981; Traub and Thompson, 1981; Buvat et al, 1983; Török, 1985; AinMelk et al, 1987; Breznik and Borko, 1993), values ranging from 12% to 40% pregnancy rates were reported. However, another study involving 89 subjects has reported higher pregnancy rates in the control group, along with an interesting observation of increase in seminal zinc and decrease in serum prolactin (PRL) levels (Breznik and Borko, 1993).…”

“…Among all 6 studies following up for pregnancy rates (Bartsch and Scheiber, 1981; Traub and Thompson, 1981; Buvat et al, 1983; Török, 1985; AinMelk et al, 1987; Breznik and Borko, 1993), values ranging from 12% to 40% pregnancy rates were reported. However, another study involving 89 subjects has reported higher pregnancy rates in the control group, along with an interesting observation of increase in seminal zinc and decrease in serum prolactin (PRL) levels (Breznik and Borko, 1993). The increase in seminal zinc concentrations should rather improve pregnancy rates, because seminal zinc concentration is linearly correlated with sperm motility (Skandhan et al, 1978).…”