Efficacy of the Oestrogen Antagonist Tamoxifen on Sperm Parameters in Patients with Idiopathic Oligoathenoteratozoospermia

Abstract

Background: The oestrogen antagonist tamoxifen has been suggested as an empiric treatment option for treating idiopathic oligoathenoteratozoospermia (iOAT). Objectives: To analyse the use of tamoxifen in iOAT. Method: Fifty-seven men receiving tamoxifen for iOAT were recruited from 2016 to 2017 in a retrospective, single-centre setting. Hormone and semen analysis was performed before and after 3 months of treatment. Results: After a 3-month treatment, serum levels of testosterone (3.4 ng/mL [2.7–4.8] vs. 5.3 [3.1–7.1]; p = 0.026), follicle stimulating hormone (FSH; 7.6 [5.9–11.5] vs. 15.9 mIU/mL [8.4–19.9]; p = 0.003) and luteinizing hormone (4.5 [3.3–6.6] vs. 7.6 mIU/mL [4.8–10.7]; p = 0.007) significantly increased. At a cut-off of >8.8 mIU/mL, serum levels of FSH were predictive for an improved sperm motility (OR 0.229 [95% CI 0.068–0.773]; p = 0.018) and serum levels of inhibin B were predictive for an improved total sperm count at a cut-off of <82 ng/L (OR 18.0 [95% CI 1.267–255.744]; p = 0.033). During an 11 month-follow-up, patients receiving tamoxifen showed a clinical pregnancy rate of 42%, leading to a live birth rate of 56% of all pregnant women. Twenty-three per cent of all patients reported non-serious adverse events. Conclusions: Tamoxifen is effective in improving the total sperm count as well as motility and can thus be safely used as empiric medical therapy in iOAT.

The influence of a combination of lifestyle modification and a new formula supplement with antioxidative and antioestrogenic activity on mild idiopathic abnormalities of semen parameters—A pilot study

“…In addition, antioestrogens such as oestrogen receptor blockers and selective oestrogen receptors modulators are used to increase intratesticular and serum testosterone concentration and to stimulate spermatogenesis. Although antioestrogens may be beneficial in treating idiopathic semen abnormalities (Chua et al., 2013; Del Giudice et al., 2020; Paffenholz et al., 2019), insufficient scientific evidence exists to recommend their use for idiopathic oligo‐astheno‐teratozoospermia (OAT) treatment (Colpi et al., 2018). Moreover, several herbs used in traditional folk medicine demonstrate also antioxidant and antioestrogenic actions (Tempest et al., 2008; Wang et al., 2018).…”