Outcomes of anastrozole in oligozoospermic hypoandrogenic subfertile men

Shoshany, Ohad; Abhyankar, Nikita; Mufarreh, Naem; Daniel, Garvey; Niederberger, Craig S.

doi:10.1016/j.fertnstert.2016.11.021

Cited by 60 publications

(64 citation statements)

References 30 publications

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“…A recent study showed that 20% of infertile men are hypogonadal (Ventimiglia et al, ). Others have shown 40%–45% of men with abnormal semen parameters are hypogonadal (Shoshany, Abhyankar, Mufarreh, Daniel, & Niederberger, ; Sussman, Chudnovsky, & Niederberger, ).…”

Section: Introductionmentioning

confidence: 99%

Improvements in semen parameters in men treated with clomiphene citrate—A retrospective analysis

et al. 2019

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Clomiphene citrate (CC) is commonly used off‐label for the treatment of male infertility, yet there is limited data to guide patient selection. To identify a subset of patients more likely to benefit from CC, we aimed to define predictors of improvement in semen parameters among men receiving CC. We retrospectively analysed 151 men treated with at least 25 mg CC daily for male infertility and/or hypogonadism at two institutions between 2004 and 2014. Men previously on testosterone were excluded. The primary outcome was change in semen parameters. Variables included baseline patient characteristics, pre‐treatment hormone profiles and pre‐treatment semen analyses. A total of 77 men met inclusion criteria. Median length of therapy was 2.8 months. There was significant improvement in sperm concentration (14–21 million/ml; p = 0.002) and total motile count (TMC; 13–28 million; p = 0.04). One third of patients who began with fewer than 5 million motile spermatozoon improved to a TMC > 5 million, increasing reproductive options to include intrauterine insemination. Patient characteristics, pre‐treatment hormone profile and degree of oligozoospermia did not predict treatment response. While no predictors of improvement were identified, clinically useful response rates are described for use in shared decision‐making.

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Section: Introductionmentioning

confidence: 99%

Improvements in semen parameters in men treated with clomiphene citrate—A retrospective analysis

et al. 2019

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“…<10) might benefit from aromatase inhibitors as a treatment of infertility. Anastrozole (1 mg once daily) and letrozole (2.5 mg once daily) are used for treatment of impaired spermatogenesis, although this represents an off-label use [51] , [52] . They can increase endogenous testosterone production and serum testosterone levels.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of hormone replacement therapy in the infertile man

Meliegy

Motawi

Salam

2018

Arab Journal of Urology

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ObjectivesTo highlight alternative treatment options other than exogenous testosterone administration for hypogonadal men with concomitant infertility or who wish to preserve their fertility potential, as testosterone replacement therapy (TRT) inhibits spermatogenesis, representing a problem for hypogonadal men of reproductive age.Materials and methodsWe performed a comprehensive literature review for the years 1978–2017 via PubMed. Also abstracts from major urological/surgical conferences were reviewed. Review was consistent with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) criteria. We used Medical Subject Heading terms for the search including ‘testosterone replacement therapy’ or ‘TRT’ and ‘male infertility’.ResultsIn all, 91 manuscripts were screened and the final number used for the review was 56. All studies included were performed in adults, were written in English and had an abstract available.ConclusionsExogenous testosterone inhibits spermatogenesis. Hypogonadal men wanting to preserve their fertility and at the same time benefiting from TRT effects can be prescribed selective oestrogen receptor modulators or testosterone plus low-dose human chorionic gonadotrophin (hCG). Patients treated for infertility with hypogonadotrophic hypogonadism can be prescribed hCG alone at first followed by or in combination from the start with follicle-stimulating hormone preparations.

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“…Studies of human chorionic gonadotropin, clomiphene citrate, and aromatase inhibitors have been limited by their small sizes and short durations, and randomized controlled trials are lacking to establish their efficacy and safety (43,44). In one trial of 85 men treated with clomiphene citrate, adverse events among four participants included depression, erythrocytosis, ischemic stroke, and psoriatic arthropathy (43).…”

Section: Risks Of Testosterone and Supplementsmentioning

confidence: 99%

“…In case reports, use of clomiphene citrate has been associated with acute mania, central retinal vein occlusion, pulmonary embolism, and suicidal behavior (45)(46)(47)(48). Aromatase inhibitors decrease bone density and have been associated with breast tenderness, depression, joint pain, limb swelling, and tendon pain (44).…”

Section: Risks Of Testosterone and Supplementsmentioning

confidence: 99%