Anastrazole is an Effective Treatment for Infertile Men with Hyperestrogenemia
Male infertility has multiple etiologies, many of which are treatable. Recent reports have demonstrated the deleterious impact of obesity on male fertility. Obese men often experience hypogonadism, typically secondary to hyperestrogenemia. This is presumably due to increased aromatase activity in body fat, resulting in impaired hormone and sperm production. The aim of this study is to investigate the effect of anastrazole on semen profiles in infertile men with hyperestrogenemia.
Following IRB approval, we retrospectively evaluated all patients seen at a single academic Reproductive Medicine Center from January 2011 to June 2016 for infertility related to hyperestrogenemia. Patients included in this study demonstrated either true (Estradiol >42pg/mL) or relative (defined as Testosterone: Estradiol ratios <10) hyperestrogenemia, with at least 1 abnormal semen analysis, and subsequently underwent treatment with anastrazole 1 mg 3 times/week. Any patients with palpable varicoceles, hypergonadotrophic hypogonadism, or those receiving any additional hormonally active pharmaceuticals were excluded. Patient characteristics included testicular volume, BMI, as well as their hormonal evaluation, which included serum Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), total Testosterone (T) and Estradiol (E2) levels. Semen parameters were compared pre-and post-treatment.</p>
Seventy-two patients fit inclusion criteria and received anastrazole for either true or relative hyperestrogenemia. 23 patients had adequate post treatment follow up for evaluation. Following initiation of anastrazole therapy, average T, T:E2 ratios, total sperm count, and total progressively motile sperm count all significantly increased. Thirteen patients (56%) experienced a >50% increase in total progressively motile sperm counts (p=0.02).
Anastrazole therapy can significantly improve semen quality in infertile men with hyperestrogenemia.