Aromatase Inhibitors in the Treatment of Oligozoospermic Or Azoospermic Men: a Systematic Review of Randomized Controlled Trials
JBRA Assisted Reproduction 2016;20(2):82-88 doi: 10.5935/1518-0557.20160019 Review Article Aromatase inhibitors in the treatment of oligozoospermic or azoospermic men: a systematic review of randomized controlled trials Mariana A. Ribeiro1, Luís F. O. Gameiro2, Wellerson R. Scarano1, Christine Briton-Jones3, Anil Kapoor4,5, Mauro B. Rosa6, Regina El Dib5,7 1Department of Morphology, Institute of Biosciences, Sao Paulo State University, UNESP, Botucatu, SP, Brazil 2Physiotherapy Service School of Medicine, Sao Paulo State University, UNESP, Botucatu, SP, Brazil 3Reproductive Medicine Partners of New York, New York, NY, USA 4Genito-Urinary Oncology Program, Juravinski Cancer Centre, Hamilton, ON, Canada 5McMaster Institute of Urology, at St. Joseph’s Healthcare, Hamilton, ON, Canada 6Hospital do Coração (HCOR), Sao Paulo,SP, Brazil 7Department of Anesthesiology, Faculdade de Medicina de Botucatu (FMB), Sao Paulo State University, UNESP, Botucatu, SP, Brazil ABSTRACT endogenous testosterone production without the asso- The aim of this study as to analyze published evidence ciated increase in circulating estrogens seen with es- regarding the effectiveness of aromatase inhibitor therapy trogen receptor modulators (Pavlovich et al., 2001). on improving spermatogenesis in infertile men. We carried AIs are classified as either steroidal or nonsteroidal. Ste- out a systematic review of randomized controlled trials. roidal inhibitors (such as testolactone, formestane, and The date of the most recent search was October 4, 2015. exemestane) competitively inhibit aromatase by mimick- Two authors independently selected relevant clinical trials, ing androstenedione, causing irreversible enzyme inhibi- assessing their methodological quality and extracting data. tion. Letrozole and anastrozole are nonsteroidal inhibitors Three studies were included in this review with a total of that cause reversible enzyme inhibition.
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