Aromatase inhibitors in the treatment of male infertility

Elkhiat, Yasser; Fahmy, Ibrahim

doi:10.1097/01.xha.0000397087.63955.45

Cited by 4 publications

(4 citation statements)

References 34 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pharmacological interventions via medication can be used to treat obesity by addressing weight loss via appetite suppressants, or to treat the effects of obesity upon the male reproductive tract. Aromatase inhibitors can be prescribed for males presenting with infertility problems, and who exhibit elevated oestrogen and reduced testosterone levels, in order to prevent the excessive conversion of testosterone to oestrogen (Elkhiat & Fahmy, 2011;Schlegel, 2012). Studies have shown that the administration of aromatase inhibitors is not only effective at restoring normal hormone levels, but can also normalise spermatogenesis and semen parameters (Raman & Schlegel, 2002;Zumoff et al, 2003;Roth et al, 2008).…”

Section: Solutions To Obesity-related Sub-fertilitymentioning

confidence: 98%

Deleterious effects of obesity upon the hormonal and molecular mechanisms controlling spermatogenesis and male fertility

et al. 2015

View full text Add to dashboard Cite

Worldwide obesity rates have nearly doubled since 1980 and currently over 10% of the population is obese. In 2008, over 1.4 billion adults aged 20 years and older had a body mass index or BMI above a healthy weight and of these, over 200 million men and nearly 300 million women were obese. While obesity can have many ramifications upon adult life, one growing area of concern is that of reproductive capacity. Obesity affects male infertility by influencing the hypothalamic-pituitary-gonadal axis, thus causing detrimental effects upon spermatogenesis and subsequent fertility. In particular, evidence indicates that excess adipose tissue can alter the relative ratio of testosterone and oestrogen. Additional effects involve the homeostatic disruption of insulin, sex-hormone-binding-globulin, leptin and inhibin B, leading to diminished testosterone production and impairment to spermatogenesis. Aberrant spermatogenesis arising from obesity is associated with downstream changes in key semen parameters, defective sperm capacitation and binding, and deleterious effects on sperm chromatin structure. More recent investigations into trans-generational epigenetic inheritance further suggest that molecular changes in sperm that arise from obesity-related impaired spermatogenesis, such as modified sperm RNA levels, DNA methylation, protamination and histone acetylation, can impact upon the development of offspring. Here, we summarise our current understanding of how obesity exerts influence over spermatogenesis and subsequent fertility status, and make recommendations for future investigative research.

show abstract

Section: Solutions To Obesity-related Sub-fertilitymentioning

confidence: 98%

Deleterious effects of obesity upon the hormonal and molecular mechanisms controlling spermatogenesis and male fertility

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Anastrozole and letrozole are the most widely used non-steroidal aromatase inhibitors in the clinical management of male infertility. They act by inhibiting aromatase enzyme thus limiting the conversion of testosterone to E2, thus increasing the production of gonadotrophins [43] , [50] .…”

Section: Resultsmentioning

confidence: 99%

Systematic review of hormone replacement therapy in the infertile man

Meliegy

Motawi

Salam

2018

Arab Journal of Urology

View full text Add to dashboard Cite

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.

show abstract

“…Aromatase is a cytochrome P450 enzyme that is present in men in the testes, prostate, brain, bone, and adipose tissue. 34,35 Aromatase converts T and androstenedione to E 2 and estrone, respectively. E 2 has an important role in gaining and maintaining bone mass and closure of the epiphyses.…”

Section: Use Of Aromatase Inhibitors To Enhance Male Fertilitymentioning

confidence: 99%

“…Nonsteroidal aromatase inhibitors include anastrozole and letrozole and compete with endogenous substrates causing reversible enzyme inhibition. 34 Aromatase inhibitors can also be classified as first, second, or third generation according to the level of selectivity and potency. Third-generation aromatase inhibitors include anastrozole and letrozole and are highly selective and potent.…”

Section: Use Of Aromatase Inhibitors To Enhance Male Fertilitymentioning

confidence: 99%

Big Enough for an Aromatase Inhibitor? How Adiposity Affects Male Fertility

Stephens

Polotsky

2013

Semin Reprod Med

View full text Add to dashboard Cite

Obesity is a pandemic and is associated with multiple medical problems including subfertility. Male obesity has been associated with altered semen parameters and reproductive hormonal levels, including a reduced testosterone:estradiol (T:E₂) ratio. Treatment methods employed for obesity-related male subfertility include gonadotropin administration, weight loss, and aromatase inhibitors. Letrozole is a highly effective nonsteroidal aromatase inhibitor that has been used to treat male subfertility in several case series with promising results. Adequately designed randomized controlled studies are needed to produce evidence-based data on the role of aromatase inhibitors in male subfertility management and evaluate the side-effect profile.

show abstract

Aromatase inhibitors in the treatment of male infertility

Cited by 4 publications

References 34 publications

Deleterious effects of obesity upon the hormonal and molecular mechanisms controlling spermatogenesis and male fertility

Deleterious effects of obesity upon the hormonal and molecular mechanisms controlling spermatogenesis and male fertility

Systematic review of hormone replacement therapy in the infertile man

Big Enough for an Aromatase Inhibitor? How Adiposity Affects Male Fertility

Contact Info

Product

Resources

About