A systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertility.
Anastrozole
/ therapeutic use
Aromatase Inhibitors
/ therapeutic use
Clinical Trials as Topic
Estradiol
/ metabolism
Humans
Hypogonadism
/ drug therapy
Infertility, Male
/ drug therapy
Letrozole
/ therapeutic use
Male
Semen Analysis
Spermatogenesis
Testolactone
/ therapeutic use
Testosterone
/ metabolism
Treatment Outcome
aromatase inhibitor
hypogonadism
male infertility
meta-analysis
systematic review
Journal
Asian journal of andrology
ISSN: 1745-7262
Titre abrégé: Asian J Androl
Pays: China
ID NLM: 100942132
Informations de publication
Date de publication:
Historique:
pubmed:
18
10
2019
medline:
22
6
2021
entrez:
18
10
2019
Statut:
ppublish
Résumé
Aromatase activity has commonly been associated with male infertility characterized by testicular dysfunction with low serum testosterone and/or testosterone to estradiol ratio. In this subset of patients, and particularly in those with hypogonadism, elevated levels of circulating estradiol may establish a negative feedback on the hypothalamic-pituitary-testicular axis by suppressing follicle-stimulating hormone (FSH) and luteinizing hormone (LH) production and impaired spermatogenesis. Hormonal manipulation via different agents such as selective estrogen modulators or aromatase inhibitors to increase endogenous testosterone production and improve spermatogenesis in the setting of infertility is an off-label option for treatment. We carried out a systematic review and meta-analysis of the literature of the past 30 years in order to evaluate the benefits of the use of aromatase inhibitors in the medical management of infertile/hypoandrogenic males. Overall, eight original articles were included and critically evaluated. Either steroidal (Testolactone) or nonsteroidal (Anastrozole and Letrozole) aromatase inhibitors were found to statistically improve all the evaluated hormonal and seminal outcomes with a safe tolerability profile. While the evidence is promising, future prospective randomized placebo-controlled multicenter trials are necessary to better define the efficacy of these medications.
Identifiants
pubmed: 31621654
pii: 269237
doi: 10.4103/aja.aja_101_19
pmc: PMC7406101
doi:
Substances chimiques
Aromatase Inhibitors
0
Anastrozole
2Z07MYW1AZ
Testosterone
3XMK78S47O
Estradiol
4TI98Z838E
Testolactone
6J9BLA949Q
Letrozole
7LKK855W8I
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
360-367Déclaration de conflit d'intérêts
None
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