Abstract: PD68-08
Sources of Funding: None

Introduction

We aim to determine the effect of anastrazole on hormonal and seminal parameters in hypoandrogenic subfertile men. We also aim to assess whether seminal parameter changes are correlated to the magnitude of increase in testosterone to estrogen ratio in men responding to treatment.

Methods

A retrospective review was performed of all hypogonadal subfertile men attending a male infertility clinic and treated with anastrazole. Hormone analysis before treatment, 2 weeks after starting treatment and 4 months after were performed. Hormone analysis included measurements of total testosterone, estradiol, sex-hormone binding globulin, albumin, FSH and LH, and bioavailable testosterone was calculated. Semen analyses before treatment and 4 months after treatment were recorded. Total motile sperm count was calculated from the semen analysis. For statistical analysis, variables are presented as median interquartile range or mean ± standard error. A matched pairs analysis estimated significance of change in laboratory values and semen analyses with treatment. A sub-group analysis was performed of men with baseline oligozoospermia. In this group, we used linear regression to identify correlations between changes in hormone concentrations and increase in semen parameters.

Results

The study group consisted of 86 subfertile hypoandrogenic men with low testosterone to estradiol ratio (n=78) or a prior aversive reaction to clomiphene citrate (n=8). 95.3% of patients had an increased serum testosterone and decreased serum estradiol following treatment with anastrozole. Sperm concentration and total motile counts improved in 18 out of 21 subfertile hypoandrogenic oligozoospermic men treated with anastrozole. In these men, the magnitude of total motile count increase was significantly correlated with the change in the testosterone to estradiol ratio. None of the men with azoospermia or cryptozoospermia experienced an improvement in sperm in the ejaculate and microTESE recovery rates were 72.7% in these men.

Conclusions

Approximately 95% of men with hypoandrogenism responded with improved endocrine parameters, and a subset of oligozoospermic men (approximately 25% of all patients) displayed significantly improved sperm parameters. In that subset, increase in sperm parameters was correlated with the change in the testosterone to estradiol ratio, which argues for a physiological effect of treatment.

Funding

None