The combination of testosterone undecanoate with tamoxifen citrate enhances the effects of each agent given independently on seminal parameters in men with idiopathic oligozoospermia

Adamopoulos, D. A.; Nicopoulou, Stamatina; Kapolla, N.; Karamertzanis, Maria; Andreou, Evangelia

doi:10.1016/s0015-0282(97)81379-9

Cited by 57 publications

(43 citation statements)

References 15 publications

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“…Pooled effect estimates from nine studies with the result from Wang et al (1983) further sub-categorized, pregnancy outcome analysis showed an overall beneficial effect favouring oestrogen antagonists (pooled OR: 2.42; 95% CI 1.48, 3.94; p = 0.0004) ( (R€ onnberg, 1980;AinMelk et al, 1987;Sokol et al, 1988;WHO, 1992) 36.4 5 (Wang et al, 1983;Mi ci c & Dotli c, 1985;Krause et al, 1992;Kotoulas et al, 1994;Adamopoulos et al, 1997) 45.5 2 (T€ or€ ok, 1985;Cakan et al, 2009) 18.1 Blinding 6 (R€ onnberg, 1980;T€ or€ ok, 1985;AinMelk et al, 1987;Sokol et al, 1988;WHO, 1992;Cakan et al, 2009) 54.5 5 (Wang et al, 1983;Mi ci c & Dotli c, 1985;Krause et al, 1992;Kotoulas et al, 1994;Adamopoulos et al, 1997) 45.5 0 -Outcome assessor blinding 5 (R€ onnberg, 1980;T€ or€ ok, 1985;AinMelk et al, 1987;Sokol et al, 1988;WHO, 1992) 45.5 6 (Wang et al, 1983;Mi ci c & Dotli c, 1985;Krause et al, 1992;Kotoulas et al, 1994;Adamopoulos et al, 1997;Cakan et al, 2009) 54.5 0 -Incomplete outcome data addressed 8 (R€ onnberg, 1980;Wang et al, 1983;Mi ci c & Dotli c, 1985;T€ or€ ok, 1985;Sokol et al, 1988;Krause et al, 1992;WHO, 1992;…”

Section: Effects Of Interventionmentioning

confidence: 99%

“…Other source of bias 3 (Sokol et al, 1988;WHO, 1992;Adamopoulos et al, 1997) 27.3 1 ( Wang et al, 1983) 7 (R€ onnberg, 1980;Mi ci c & Dotli c, 1985;T€ or€ ok, 1985;AinMelk et al, 1987;Krause et al, 1992;Kotoulas et al, 1994;Cakan et al, 2009) 754 Andrology, 2013, 1, 749-757 p = 0.13; I 2 35%). Based on raw data pooled from the included trials, the calculated NNT is equivalent to 10.…”

Section: Effects Of Interventionmentioning

confidence: 99%

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Revisiting oestrogen antagonists (clomiphene or tamoxifen) as medical empiric therapy for idiopathic male infertility: a meta-analysis

et al. 2013

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SUMMARYThe aim of this study was to synthesize and present the latest available evidence regarding the use of oestrogen antagonists as empiric medical therapy for idiopathic male infertility with oligo and/or asthenoteratozoospermia through meta-analysis of randomized controlled trials (RCTs). Systematic literature acquisition was done for English and other foreign language biomedical databases up to March, 2013. RCTs relevant to the topic were identified and critically appraised independently by two physician reviewers. Dichotomous data of pregnancy rate and adverse events were extracted for calculation of odds ratio (OR) and 95% confidence interval (CI). Effect estimates were pooled using Peto method with fixed effect model. The continuous data of semen and endocrine parameters were calculated for the mean difference between pre-and post-treatment effects, the weighted mean difference (WMD) and SD between the control and intervention group were determined and pooled using the random effects model. Inter-study heterogeneity and publication bias were assessed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline for meta-analysis reporting was followed. Eleven RCTs of good methodological quality were included for meta-analysis. The pooled effect estimates showed that oestrogen antagonists use was associated with a statistically significant increased pregnancy rate compared with controls (pooled OR 2.42; 95% CI 1.47-3.94; p = 0.0004). Significant increase in sperm concentration (WMD 5.24; 95% CI 2.12, 88.37; p = 0.001) and per cent sperm motility (WMD 4.55; 95% CI 0.73, 8.37; p = 0.03) were also noted. While significant elevation of serum follicle stimulating hormone (WMD 4.19 95% CI 2.05, 6.34; p = 0.0001) and testosterone (WMD 54.59; 95% CI 15.92, 93.27; p = 0.006) was associated with its use. No significant difference in adverse event was noted between oestrogen antagonists-treated group and controls. The evidence suggests that oestrogen antagonists as empiric medical therapy for idiopathic male infertility with low non-serious adverse event associated, may increase spontaneous pregnancy rate, improve sperm concentration and per cent sperm motility.

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Section: Effects Of Interventionmentioning

confidence: 99%

Section: Effects Of Interventionmentioning

confidence: 99%

Revisiting oestrogen antagonists (clomiphene or tamoxifen) as medical empiric therapy for idiopathic male infertility: a meta-analysis

et al. 2013

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“…Previous studies demonstrated that tamoxifen significantly increased sperm concentration in infertile men with oligozoospermia, but does not affect other semen values, such as volume, pH, motility, morphology, or viability, because of tamoxifen's effectiveness on the seminiferous tubules during the early stages of spermatogenesis (Vermeulen and Comhaire, 1978;Kotoulas et al, 1994). Other studies have shown that given tamoxifen citrate alone exerts a limited effect on sperm morphology and motility; it appears that the superior functional sperm fraction response was probably related to administration of testosterone undecanoate (Adamopoulos et al, 1997;. In this study, the sperm concentration, motility, and percentage of normal morphology were improved in infertile men with oligozoospermia after treatment with tamoxifen citrate and testosterone undecanoate.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have shown that giving tamoxifen citrate alone exerts a limited effect on sperm morphology and motility; it appears that the superior functional sperm fraction response was probably related to administration of testosterone undecanoate (Adamopoulos et al, 1997;. In this study, we assess the effectiveness of treatment with tamoxifen citrate and testosterone undecanoate in infertile men with idiopathic oligozoospermia, and whether they are affected by polymorphisms of CYP2D6*10.…”

Section: Introductionmentioning

confidence: 95%

Genetic polymorphisms of CYP2D6*10 and the effectiveness of combined tamoxifen citrate and testosterone undecanoate treatment in infertile men with idiopathic oligozoospermia

Tang

Zhao

Ding

et al. 2015

J. Zhejiang Univ. Sci. B

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Abstract:Tamoxifen citrate, as the first line of treatment for infertile men with idiopathic oligozoospermia, was proposed by the World Health Organization (WHO), and testosterone undecanoate has shown benefits in semen values. Our objective was to assess the effectiveness of treatment with tamoxifen citrate and testosterone undecanoate in infertile men with idiopathic oligozoospermia, and whether the results would be affected by polymorphisms of CYP2D6*10. A total of 230 infertile men and 147 controls were included in the study. Patients were treated with tamoxifen citrate and testosterone undecanoate. Sex hormone, sperm parameters, and incidence of spontaneous pregnancy were detected. There were no significant differences between the control and patient groups with respect to CYP2D6*10 genotype frequencies (P>0.05). The follicle-stimulation hormone (FSH), luteinizing hormone (LH), and testosterone (T) levels were raised, and sperm concentration and motility were increased at 3 months and became significant at 6 months, and they were higher in the wild-type allele (C/C) than in the heterozygous variant allele (C/T) or homozygous variant allele (T/T) subgroups (P<0.05). In addition, the percentage of normal morphology was raised at 6 months, and represented the highest percentage in the C/C subgroup (P<0.05). The incidence of spontaneous pregnancy in the C/C subgroup was higher than that in the C/T or T/T subgroups (P<0.01). This study showed that the CYP2D6*10 variant genotype demonstrated worse clinical effects in infertile men with idiopathic oligozoospermia.

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“…The effects of testosterone undecanoate (TU) on pituitary and testicular basal or stimulated hormone secretion have been studied in detail and no compromising actions of its administration have been demonstrated at a dose of 120 mg/day [1][2][3]. Moreover, TU administration as an auxiliary of tamoxifen citrate therapy in patients with idiopathic oligozoospermia (I.O.)…”

Section: Introductionmentioning

confidence: 99%

Testosterone undecanoate in the functional compartments of the male reproductive tract

Koukkou

Mitios

Kapolla

et al. 2009

Basic Clin. Androl.

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Background: Assessment of testosterone undecanoate's (TU) presence in the functional compartments of the male reproductive tract has never been performed despite the evidence that its documented beneficial effect in male infertility might be mediated through an epididymal action and this study was set to examine this possibility. Materials and methods: In 18 normozoospermic volunteers TU has been administered (40 mg t.i.d.) for 6 days with serum measurements of TU, total testosterone (T), DHT, E2, SHBG, FSH, LH, and PRL before and at the end of medication. Steroid hormones (T, E2, and TU) were also assayed in seminal plasma. In a selected group of 7 men with previously diagnosed non-obstructive azoospermia TU, T, and E2 were assayed in the extracts of testicular biopsy material taken before ICSI and at the end of the same medication. Results: A marked rise of serum DHT (average 148%, P < 0.001) has been found after treatment, whereas T, E2, FSH, LH, SHBG, and PRL did not significantly change. Measurable amounts of TU were found in the serum of all men but only in 6 cases in seminal plasma (11.1 ± 8.0 ng/mL) and all of them in semen delivered 7-8 h after the last TU capsule was taken. In dilution fluid from testicular tissue extracts, no detectable amounts of TU were found whereas mean values of 92.5 ± 54.3 pg/mL and 43.8 ± 16.3 ng/mL for E2 and T were observed. Positive correlations among TU and E2, T or DHT concentrations were found in serum samples (P < 0.01, 0.02, and 0.002) as well as between E2 and T (P < 0.01), E2 and DHT (P < 0.001), or T and DHT (P < 0.001). Conclusion: It is concluded that TU was identified and measured for the first time in seminal plasma of a fair percentage (33%) of men on this medication and was associated in all men with a marked rise of DHT concentration, a known epididymal function promoter, in the absence of an effect on pituitary and gonadal activity. On this evidence, it appears that a beneficial effect of TU on epididymal function may be a distinct possibility.Keywords Testosterone undecanoate · Dihydrotestosterone · Seminal plasma · Peripheral blood Résumé L'évaluation de la présence d'undécanoate de testostérone (TU) dans les compartiments fonctionnels de l'appareil reproducteur masculin n'a jamais été réalisée malgré le fait que son effet bénéfique documenté dans l'infertilité masculine pourrait être médié par une action épididymaire; cette étude avait comme but d'examiner cette possibilité. Chez 18 volontaires normozoospermiques, du TU a été administré (40 mg 3x/j) pendant 6 jours avec des dosages sériques de TU, testostérone totale (T), DHT, E 2 , SHBG, FSH, LH et PRL avant et à la fin du traitement. Les hormones stéroïdes (T, E 2 , TU) ont également été mesurées dans le plasma séminal. Dans un groupe de 7 hommes ayant une azoospermie non obstructive préalablement diagnostiquée, les concentrations de TU, T et E2 ont été mesurées dans des fragments de tissu de la biopsie testiculaire effectuée avant ICSI et à la fin du même traitement. Une augmentation marquée des taux sér...

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The combination of testosterone undecanoate with tamoxifen citrate enhances the effects of each agent given independently on seminal parameters in men with idiopathic oligozoospermia

Cited by 57 publications

References 15 publications

Revisiting oestrogen antagonists (clomiphene or tamoxifen) as medical empiric therapy for idiopathic male infertility: a meta-analysis

Revisiting oestrogen antagonists (clomiphene or tamoxifen) as medical empiric therapy for idiopathic male infertility: a meta-analysis

Genetic polymorphisms of CYP2D6*10 and the effectiveness of combined tamoxifen citrate and testosterone undecanoate treatment in infertile men with idiopathic oligozoospermia

Testosterone undecanoate in the functional compartments of the male reproductive tract

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