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Title: Aromatase Inhibition Corrects Endocrinopathy In Infertile Men

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Journal of Urology 2001;165:837-841. "Evidence Of A Treatable Endocrinopathy In Infertile Men"
04/09/2001 09:41:20 AM
By David Loshak

Aromatase inhibition can significantly improve serum parameters in men who are infertile due to the absence or deficiency of sperm. Investigators at the Center for Biomedical Research and other institutions in New York, US, have found that this technique can correct a decreased serum testosterone-to-oestradiol ratio which is characteristic of an endocrinopathy in men with severe male factor infertility. The serum testosterone-to-oestradiol ratios of 63 such men or men with hypergonadotropic hypogonadism (mean follicle-stimulating hormone 21.2 ą 1.8) were compared with those of age-matched, fertile male controls. Of the 63 affected men, 43 were azoospermic with biopsy-proved severe male infertility. The other 20 were oligospermic. The men with the lowest ratios, those below the 20th percentile, were given twice daily 50-100 mg. oral doses of the aromatase inhibitor testolactone. Testosterone-to-oestradiol ratios and semen analyses were evaluated during therapy. The investigators found that men with severe infertility had significantly lower testosterone (328 versus 543 ng/dl) and significantly higher oestradiol (58.4 versus 43.5 ng/l) than the fertile controls. As a result, the infertile men had much lower testosterone-to-oestradiol ratios. These abnormalities were corrected in the 45 men who received testolactone and their testosterone-to-oestradiol ratios rose into the normal range. Semen analyses were considered evaluable only in men with sperm in the ejaculate before aromatase inhibitor treatment. Semen analyses before and during testolactone treatment in 12 oligospermic men showed significant increases in sperm concentration, which rose from 16.1 to 28.9 million sperm per ml, and in motility, which rose correspondingly, from 27.1 percent to 45.3 percent.

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