scholarly journals The Efficacy and Safety of Letrozole or Anastrozole in The Treatment of Specific Male Infertility Patients: Meta-Analysis and Systematic Review

2021 ◽  
Author(s):  
Bin Guo ◽  
Jiao-jiao Li ◽  
Ya-ling Ma ◽  
Yu-tao Zhao ◽  
Jian-guo Liu
Keyword(s):  
Systematic Review ◽  
Male Infertility ◽  
Pregnancy Rate ◽  
Sperm Count ◽  
Meta Analysis ◽  
Sperm Concentration ◽  
Efficacy And Safety ◽  
Testosterone Undecanoate ◽  
Testosterone Levels ◽  
Infertility Patients

Abstract Background: Letrozole (LE) or anastrozole (AZ) is clinically beneficial in male infertility patients with a low testosterone-estradiol ratio (T/E2). Many scholars believe it has the potential to become one of the effective drugs to treat male infertility. But some relevant research results are different or even the opposite. Study Question: The purpose of this report is to evaluate the efficacy and safety of letrozole or anastrozole in the treatment of specific male infertility patients. Data Sources: We performed a comprehensive literature search using PubMed, Embase, Cochrane, CNKI, VIP, CBM, and Wanfang Date through August 2021 for all studies.Study Design: We conducted a systematic review with meta- analysis of the all available literature reporting sperm conventional parameters, gonadotropin and testosterone levels, and/or the pregnancy rate. Results: The total of 10 studies involving 280 patients were included. LE or AZ administration increased significantly sperm concentration, total sperm count, and serum luteinizing hormone, follicle-stimulating hormone, testosterone levels and T / E2 compared with baseline values, but E2 levels were significantly reduced. In contrast, LE or AZ did not have any significant effect on sperm concentration and motility and pregnancy rate, but improved total sperm count, sperm morphology, compared to the control group, which included studies done with Selective estrogen receptor modulators (SEMR) or testosterone undecanoate (TU). Conclusion: LE or AZ may be effective in the treatment of low T / E2 male infertility, perhaps better than other anti-estrogen or exogenous testosterone supplementation. In addition, we should pay special attention to the changes of E2 during treatment.

scholarly journals Effectiveness of Pharmacological Intervention Among Men with Infertility: A Systematic Review and Network Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Muhammad Nabeel Shahid ◽  
Tahir Mehmood Khan ◽  
Chin Fen Neoh ◽  
Qi Ying Lean ◽  
Allah Bukhsh ◽  
...  
Keyword(s):  
Male Infertility ◽  
Meta Analysis ◽  
Clomiphene Citrate ◽  
Random Effect ◽  
Random Effect Model ◽  
Sperm Concentration ◽  
Pharmacological Intervention ◽  
Total Testosterone ◽  
Pharmacological Interventions ◽  
Testosterone Undecanoate

Background. Infertility is an emerging health issue for men. Comparative efficacy of different pharmacological interventions on male infertility is not clear. The aim of this review is to investigate the efficacy of various pharmacological interventions among men with idiopathic male infertility. All randomized control trials evaluating the effectuality of interventions on male infertility were included for network meta-analysis (NMA) from inception to 31 April 2020, systematically performed using STATA through the random effect model. The protocol was registered at PROSPERO (CRD42020152891).Results. The outcomes of interest were semen and hormonal parameters. Treatment effects (p < 0.05) were estimated through WMD at the confidence interval of 95%. Upon applying exclusion criteria, n=28 RCTs were found eligible for NMA. Results from NMA indicated that consumption of supplements increases sperm concentration levels [6.26, 95% CI 3.32, 9.21] in comparison to SERMs [4.97, 95% CI 1.61, 8.32], hormones [4.14, 95% CI 1.83, 6.46], and vitamins [0.15, 95% CI −20.86, 21.15)] with placebo, whereas the use of SERMs increased percentage sperm motility [6.69, 95% CI 2.38, 10.99] in comparison to supplements [6.46, 95% CI 2.57, 10.06], hormones [3.47, 95% CI 0.40, 6.54], and vitamins [−1.24, 95% CI −11.84, 9.43] with placebo. Consumption of hormones increased the sperm morphology [3.71, 95% CI, 1.34, 6.07] in contrast to supplements [2.22, 95% CI 0.12, 4.55], SERMs [2.21, 95% CI −0.78, 5.20], and vitamins [0.51, 95% CI −3.60, 4.62] with placebo. Supplements boosted the total testosterone levels [2.70, 95% CI 1.34, 4.07] in comparison to SERMs [1.83, 95% CI 1.16, 2.50], hormones [0.40, 95% CI −0.49, 1.29], and vitamins [−0.70, 95% CI −6.71, 5.31] with placebo. SERMs increase the serum FSH levels [3.63, 95% CI 1.48, 5.79] better than hormones [1.29, 95% CI −0.79, 3.36], vitamins [0.03, 95% CI −2.69, 2.76], and supplements [−4.45, 95% CI −7.15, −1.76] in comparison with placebo.Conclusion. This review establishes that all interventions had a significantly positive effect on male infertility. Statistically significant increased sperm parameters were noted in combinations of zinc sulfate (220 mg BID), clomiphene citrate (50 mg BID), and testosterone undecanoate and CoQ10; tamoxifen citrate and FSH were shown to improve the hormonal profile in infertile males.

scholarly journals The Impact of Radiofrequency Waves on Male Infertility: A Systematic Review

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Leili Darvish ◽  
Azadeh Amraee ◽  
Marjan Akhavan Amjadi ◽  
Zahra Atarodi Kashani ◽  
Masoumeh Ghazanfarpour ◽  
...  
Keyword(s):  
Systematic Review ◽  
Male Infertility ◽  
Sperm Quality ◽  
Sperm Count ◽  
Sperm Concentration ◽  
Membrane Integrity ◽  
Semen Parameters ◽  
Cochrane Library ◽  
Negative Effects ◽  
The Impact

Context: As the use of cellphones and other electronic devices increases, concerns about the possible effect of radiofrequency waves on health are growing. Long-term use of the cellphone may have negative effects on sperm quality. Objectives: The purpose of this research was to examine men's infertility due to the effect of radiofrequency waves. Methods: In this systematic review, language restrictions were not considered in searching the databases. Cochrane Library, Google Scholar, PubMed, EMBASE, ProQuest, CINAHL, Science Direct, MEDLINE, and Scopus were used to obtain the data from them. All data were scanned from the year 2000 until 2019. Papers selected for retrieval were evaluated by the Newcastle-Ottawa and CONSORT scales. Results: A total of 14 articles that met the inclusion criteria were ultimately assessed. Motile sperm, sperm vitality and membrane integrity, morphology, volume, total sperm count, sperm concentration, and sperm fertility were found to be influenced by radiofrequency waves. Conclusions: The results showed that RF has detrimental effects on semen parameters and due to an increase in RF wave use currently and its role in male infertility, giving information to men about adverse complications of RF is necessary. Further studies are needed to design the less harmful devices.

scholarly journals The role of obesity in male fertility

2018 ◽  
Vol 7 (9) ◽  
pp. 3435 ◽  
Author(s):  
Meltem Mermer ◽  
Yasemin Akdevelioğlu
Keyword(s):  
Body Weight ◽  
Male Infertility ◽  
Male Fertility ◽  
Sperm Morphology ◽  
Sperm Count ◽  
Sperm Concentration ◽  
High Body Mass Index ◽  
Serum Testosterone ◽  
Serum Testosterone Level ◽  
Testosterone Levels

Obesity causes many health problems as well as having negative effects on fertility. There is a multifaceted relationship between obesity and male infertility. Male fertility is associated with sperm concentration, motility and morphology. Testosterone (total and free) and gonadotropin levels were low and estrogen levels were found to be high in obese men. The decrease in androgen levels varies based on the degree of obesity. High body mass index is inversely related to total sperm count, sperm concentration, sperm morphology and number of motile sperm. Leptin and ghrelin are hormones that influence body weight regulation and eating behaviors. Serum leptin level, which is high in obese infertile men, showed a significant positive correlation with abnormal sperm morphology, serum FSH, LH, prolactin level and showed a significant negative correlation with sperm concentration, sperm motility and serum testosterone level. Further research is needed on the effects of ghrelin levels on male infertility. The relationship between obesity and erectile dysfunction can be explained by decreased testosterone levels and elevation of some proinflammatory cytokine levels. Decreased physical activity due to obesity, long-term sitting increases testicular temperature and affects sperm production negatively. There is a multifaceted relationship between obesity, metabolic syndrome and type 2 diabetes and serum testosterone and SHBG. Diet and exercise showed improvement in testosterone levels and sperm concentration due to decreased body weight. However, studies on this subject are extremely limited. The possible effects of weight loss on successful infertility treatment of obese men should not be ignored.

scholarly journals Association of diabetes and obesity with sperm parameters and testosterone levels: a meta-analysis

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Ou Zhong ◽  
Lin Ji ◽  
Jinyuan Wang ◽  
Xiaocan Lei ◽  
Hua Huang
Keyword(s):  
Sperm Count ◽  
Meta Analysis ◽  
Sperm Concentration ◽  
Sperm Parameters ◽  
Current Evidence ◽  
Cochrane Library ◽  
Testosterone Levels ◽  
Obesity And Diabetes ◽  
Meta Analyses

Abstract Background The present study performed two distinct meta-analyses with common outcomes (sperm parameters); one was performed in obese individuals (and non-obese controls) and the other in diabetic individuals (and non-diabetic controls). Methods PubMed, Embase, The Cochrane library, Web of Science, Scopus databases were searched to collect clinical studies related to the effects of obesity and diabetes on male sperm from inception to on 1st February 2021. Statistical meta-analyses were performed using the RevMan 5.4 software. Stata16 software was used to detect publication bias. The methodological quality of the included studies was assessed with the Ottawa–Newcastle scale using a star-based system. Results A total of 44 studies were finally included in the present study, which enrolled 20,367 obese patients and 1386 patients with diabetes. The meta-analysis results showed that both obesity and diabetes were associated with reduced semen volume (obese versus non-obese controls: mean difference (MD) = − 0.25, 95% CI = (− 0.33, − 0.16), p < 0.001; diabetes versus non-diabetic controls: MD = − 0.45, 95% CI = (− 0.63, − 0.27), p < 0.001), reduced sperm count (obese versus non-obese controls: MD = − 23.84, 95% CI = (− 30.36, − 17.33), p < 0.001; diabetes versus non-diabetic controls: MD = − 13.12, 95% CI = (− 18.43, − 7.82), p < 0.001), reduced sperm concentration (obese versus non-obese controls: MD = − 7.26, 95% CI = (− 10.07, − 4.46), p < 0.001; diabetes versus non-diabetic controls: MD = − 11.73, 95% CI = (− 21.44, − 2.01), p = 0.02), reduced progressive motility (obese versus non-obese controls: MD = − 5.68, 95% CI = (− 8.79, − 2.56), p < 0.001; diabetes versus non-diabetic controls: MD = − 14.37, 95% CI = (− 21.79, − 6.96), p = 0.001), and decreased testosterone levels (obese versus non-obese controls: MD = − 1.11, 95% CI = (− 1.92, − 0.30), p = 0.007; diabetes versus non-diabetic controls: MD = − 0.37, 95% CI = (− 0.63, − 0.12), p = 0.004). Conclusions Current evidence suggests that obesity and diabetes negatively affect sperm parameters in men and are associated with low testosterone levels. Due to the limitation of the number and quality of included studies, the above conclusions need to be verified by more high-quality studies.

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