EMPIRIC TREATMENT OF MALE INFERTILITY
Most of the studies were performed in vitro. Available data do not confirm any positive effects on sperm parameters and pregnancy rates in vivo in controlled clinical trials. Empiric treatment of male infertility is generally not recommended.
| Class | Drugs | Effect | |||
| Antiestrogen | Clomiphene citrate Tamoxifen | Prevent negative feedback of estrogens to the pituitary and hypothalamus
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| Aromatase inhibitors | Testolactone | Block the conversion of testosterone to estrogen
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| Mast cell blockers | Tranilast | Blocking release of chemical mediators from mast cells | |||
| a-blockers | Terazosin | ? increase the rate of sperm transport from caput to cauda. Increase sperm concentration | |||
| Gonadotropins/GnRH | HCG/HMG, GnRH, Recombinant human FSH | Possible effect on spermatogenesis and sperm maturation
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| Pancreatic proteinase | Kallikrein | Cleaves kininogen to produce kinins( regulation of sperm motility)
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| ACE inhibitors | Captopril | Increase sperm count | |||
| Prostaglandin inhibitors | Indomethacin | Block negative regulatory effect of prostaglandin on testicular and spermatozoal function
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| Phosphodiesterase inhibitors | Pentoxyfilline | Increase sperm motility in vitro
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| Corticosteroids | Prednisone | Anti-inflammatory effect
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| Zinc | Zinc | Improve sperm production
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| Vitamins | C, E | Antioxidants, decrease level of Reactive Oxygen Species | |||
| Aminoacids | L-arginine | Improve sperm motility | |||
Selected Bibliography
- Wang C., Chan C-W., Wong K-K et al. Comparison of the effectiveness of placebo, clomiphene citrate,mesterolone, pentoxiphylline and testosterone rebound therapy for the treatment of idiopathic oligospermia. Fertil.Steril 1988;49:865
- Schill WB. Recent progress in pharmacological therapy of male infertility: a review. Abdrologia 1979;11:77
- Schill WB. Treatment of idiopathic oligospermia by kallikrein: result s of double-blind study.Arch Androl 1979;2:163
- Baker HWG. Medical treatment for idiopathic male infertility:Is it curative or palliative. Baillieres Clinical Obstetrics & Gynecology1997;11(4):673-689
- Schill WB. Survey of medical therapy in andrology. Int J Androl 1995;18 suppl 2: 56-62
- Scibona M. Meschini P. Capparelli S. Pecori C. Rossi P. Menchini Fabris GF. L-arginine and male infertility. Minerva Urologica e Nefrologica1994; 46(4):251-3
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