Changes in the hormonal profile and seminal parameters with the use of aromatase inhibitors in the management of infertile men with low testosterone to estradiol ratios

Capsule:
Therapy with 2.5 mg letrozole or 1 mg anastrazole daily, in cases of infertile men with low T/E2 ratios, leads to a significant increase of T/E2 ratio, ejaculate volume, sperm motility, and total motile sperm count.

Authors:
Odysseas Gregoriou, M.D., Panagiotis Bakas, M.D., Charalampos Grigoriadis, M.D., Maria Creatsa, M.D., Dimitrios Hassiakos, M.D., Georgios Creatsas, M.D.
Volume 98, Issue 1 , Pages 48-51, July 2012

Objective:
To compare the effects of 2.5 mg letrozole with those of 1 mg anastrazole daily on the hormonal and semen profiles of a subset of infertile men with low T/E2 ratios.

Design:
Prospective, nonrandomized study.

Setting:
Reproductive medicine clinic.

Patient(s):
The study group consisted of 29 infertile men with a low serum T/E2 ratio (<10).

Intervention(s):
Patients were divided into two groups. Group A included 15 patients treated with 2.5 mg letrozole orally once daily for 6 months, and Group B consisted of 14 patients treated with 1 mg anastrazole orally every day for 6 months.

Main Outcome Measure(s):
Hormonal evaluation included measurement of serum FSH, LH, PRL, T, and E2. In all sperm analyses pretreatment and posttreatment total motile sperm counts (ejaculate volume × concentration × motile fraction) were evaluated.

Result(s):
The use of aromatase inhibitors (either letrozole or anastrazole) in cases of infertile men with low T/E2 ratios improved both hormonal and semen parameters.

Conclusion(s):
This study suggests that some men with severe oligospermia, low T levels, and normal gonadotropin concentration may have a treatable endocrinopathy.

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