EMPIRIC TREATMENT OF MALE INFERTILITY

EMPIRIC TREATMENT OF MALE INFERTILITY

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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

 

Aromatase inhibitors

Testolactone

Block the conversion of testosterone to estrogen

 

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

 

Pancreatic proteinase

Kallikrein

Cleaves kininogen to produce kinins( regulation of sperm motility)

 

ACE inhibitors

Captopril

Increase sperm count

Prostaglandin inhibitors

Indomethacin

Block negative regulatory effect of prostaglandin on testicular and spermatozoal function

 

Phosphodiesterase inhibitors

Pentoxyfilline

Increase sperm motility in vitro

 

Corticosteroids

Prednisone

Anti-inflammatory effect

 

Zinc

Zinc

Improve sperm production

 

Vitamins

C, E

Antioxidants, decrease level of Reactive Oxygen Species

Aminoacids

L-arginine

Improve sperm motility