1. bookVolume 53 (2019): Issue 4 (October 2019)
Journal Details
License
Format
Journal
eISSN
1336-0329
First Published
30 Mar 2016
Publication timeframe
4 times per year
Languages
English
access type Open Access

Effect of letrozole on spermogram parameters and hormonal profile in infertile men: A clinical trial study

Published Online: 15 Nov 2019
Volume & Issue: Volume 53 (2019) - Issue 4 (October 2019)
Page range: 231 - 236
Journal Details
License
Format
Journal
eISSN
1336-0329
First Published
30 Mar 2016
Publication timeframe
4 times per year
Languages
English
Abstract

Objective. There is no reliable treatment for men with idiopathic infertility, but the relationship between severe sperm production and the ratio of estrogen to testosterone levels has been shown. Aromatase is an enzyme that plays an important role in converting testosterone to estradiol and androstenedione to estrogen. Aromatase inhibitors can increase testosterone and androgen production without increasing the amount of estrogen in circulation. The aim of this study was to evaluate the effect of aromatase inhibitor letrozole on the male infertility.

Method. This pre- and post-quasi-experimental clinical trial was carried out on 41 men with an infertility diagnosis. The basic hormonal profile included FSH, LH, testosterone, and estradiol. The ratio of testosterone to serum estradiol was also calculated and recorded. The sperm analysis was performed before the treatment and the seminal parameters were evaluated and recorded. Patients were then treated with letrozole 2.5 mg daily for 4 months. At the end of 4th months, the hormonal profile was studied and seminal analysis performed and recorded.

Results. The levels of FSH, LH, testosterone, and estradiol, and the ratio of testosterone to estradiol increased significantly after letrozole treatment. The sperm concentration, sperm motility, and sperm forward motion significantly increased after letrozole treatment. Sperm morphology only lightly altered.

Conclusion. The ratio of testosterone to estradiol levels in infertile men treated with aromatase inhibitor improved and caused changes in sperm parameters. Letrozole may be used to improve sperm parameters in infertile men with low serum testosterone to estradiol ratio.

Keywords

Bharti S, Misro M, Rai UJ. Clomiphene citrate potentiates the adverse effects of estrogen on rat testis and down-regulates the expression of steroidogenic enzyme genes. Fertil Steril 99, 140–148, 2013.10.1016/j.fertnstert.2012.08.05022999797Search in Google Scholar

Buzdar A, Howell A. Advances in aromatase inhibition: clinical efficacy and tolerability in the treatment of breast cancer. Clin Cancer Res 7, 2620–2635, 2001.11555572Search in Google Scholar

Carreau S, Bouraima-Lelong H, Delalande C. Estrogen, a female hormone involved in spermatogenesis. Adv Med Sci 57, 31–36, 2012.2244093710.2478/v10039-012-0005-y22440937Search in Google Scholar

Casper RF, Mitwally MF. Review: aromatase inhibitors for ovulation induction. J Clin Endocrinol Metab 91, 760–771, 2006.10.1210/jc.2005-192316384846Open DOISearch in Google Scholar

Clark RV, Sherins RJ. Treatment of men with idiopathic oligozoospermic infertility using the aromatase inhibitor, testolactone. Results of a double-blinded, randomized, placebo-controlled trial with crossover. J Androl 10, 240–247, 1989.266380010.1002/j.1939-4640.1989.tb00094.x2663800Search in Google Scholar

Fejes I, Koloszar S, Zavaczki Z, Daru J, Szollosi J, Pal A. Effect of body weight on testosterone/estradiol ratio in oligozoospermic patients. Arch Androl 52, 97–102, 2006.10.1080/0148501050031547916443585Search in Google Scholar

Gregoriou O, Bakas P, Grigoriadis C, Creatsa M, Hassiakos D, Creatsas G. Changes in hormonal profile and seminal parameters with use of aromatase inhibitors in management of infertile men with low testosterone to estradiol ratios. Fertil Steril 98, 48–51, 2012.10.1016/j.fertnstert.2012.04.0052257912922579129Open DOISearch in Google Scholar

Haider H, Solanki KS, Pal G, Singh MK, Kothari JS, Agarwal VK. Process for the preparation of letrozole. WO/2007/054964, PCT/IN2006/000337, 2007. https://patentscope.wipo.int › search › detail.Search in Google Scholar

Haynes BP, Jarman M, Dowsett M, Mehta A, Lonning PE, Griggs LJ, Jones A, Powles T, Stein R, Coombes RC. Pharmacokinetics and pharmacodynamics of the aromatase inhibitor 3-ethyl-3-(4-pyridyl)piperidine-2,6-dione in patients with postmenopausal breast cancer. Cancer Chemother Pharmacol 27, 367–372, 1991.10.1007/BF006888591847846Search in Google Scholar

Inkster S, Yue W, Brodie A. Human testicular aromatase: immunocytochemical and biochemical studies. J Clin Endocrinol Metab 80, 1941–1947, 1995.753981910.1210/jcem.80.6.75398197539819Search in Google Scholar

Ng KK, Donat R, Chan L, Lalak A, Di Pierro I, Handelsman DJ. Sperm output of older men. Hum Reprod 19, 1811–1815, 2004.10.1093/humrep/deh3151521800215218002Open DOISearch in Google Scholar

Patry G, Jarvi K, Grober ED, Lo KC. Use of the aromatase inhibitor letrozole to treat male infertility. Fertil Steril 92, 829.e1–829.e2, 2009.1952422510.1016/j.fertnstert.2009.05.01419524225Search in Google Scholar

Pavlovich CP, King P, Goldstein M, Schlegel PN. Evidence of a treatable endocrinopathy in infertile men. J Urol 165, 837–841, 2001.10.1016/S0022-5347(05)66540-8Search in Google Scholar

Raman JD, Schlegel PN. Aromatase inhibitors for male infertility. J Urol 167, 624–649, 2002.10.1097/00005392-200202000-0003811792932Search in Google Scholar

Saylam B, Efesoy O, Cayan S. The effect of aromatase inhibitor letrozole on body mass index, serum hormones, and sperm parameters in infertile men. Fertil Steril 95, 809–811, 2011.10.1016/j.fertnstert.2010.09.02120934689Search in Google Scholar

Smith IE, Norton A. Fadrozole and letrozole in advanced breast cancer: clinical and biochemical effects. Breast Cancer Res Treat 49, S67–S77, 1998.10.1023/A:1006005024377Search in Google Scholar

Wang JM, Gu CH, Tao L, Wu XL. Effect of surgery and efferent duct ligation on testicular blood flow and testicular steroidogenesis in the rat. J Reprod Fertil 73, 191–196, 1985.10.1530/jrf.0.07301913968652Search in Google Scholar

Recommended articles from Trend MD

Plan your remote conference with Sciendo