A systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertility
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 esta...
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Wolters Kluwer Medknow Publications
2020-01-01
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doaj-fccee97f6bfa4d8ca19c5f6f1b943b822020-11-25T03:23:51ZengWolters Kluwer Medknow PublicationsAsian Journal of Andrology1008-682X1745-72622020-01-0122436036710.4103/aja.aja_101_19A systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertilityFrancesco Del GiudiceGian Maria BusettoEttore De BerardinisIsabella SperdutiMatteo FerroMartina MaggiMartin S GrossAlessandro SciarraMichael L EisenbergAromatase 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.http://www.ajandrology.com/article.asp?issn=1008-682X;year=2020;volume=22;issue=4;spage=360;epage=367;aulast=Delaromatase inhibitor; hypogonadism; male infertility; meta-analysis; systematic review |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Francesco Del Giudice Gian Maria Busetto Ettore De Berardinis Isabella Sperduti Matteo Ferro Martina Maggi Martin S Gross Alessandro Sciarra Michael L Eisenberg |
spellingShingle |
Francesco Del Giudice Gian Maria Busetto Ettore De Berardinis Isabella Sperduti Matteo Ferro Martina Maggi Martin S Gross Alessandro Sciarra Michael L Eisenberg A systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertility Asian Journal of Andrology aromatase inhibitor; hypogonadism; male infertility; meta-analysis; systematic review |
author_facet |
Francesco Del Giudice Gian Maria Busetto Ettore De Berardinis Isabella Sperduti Matteo Ferro Martina Maggi Martin S Gross Alessandro Sciarra Michael L Eisenberg |
author_sort |
Francesco Del Giudice |
title |
A systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertility |
title_short |
A systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertility |
title_full |
A systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertility |
title_fullStr |
A systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertility |
title_full_unstemmed |
A systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertility |
title_sort |
systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertility |
publisher |
Wolters Kluwer Medknow Publications |
series |
Asian Journal of Andrology |
issn |
1008-682X 1745-7262 |
publishDate |
2020-01-01 |
description |
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. |
topic |
aromatase inhibitor; hypogonadism; male infertility; meta-analysis; systematic review |
url |
http://www.ajandrology.com/article.asp?issn=1008-682X;year=2020;volume=22;issue=4;spage=360;epage=367;aulast=Del |
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