Role of Aromatase Inhibitor to Improve Semen Quality in Case of Eugonadotropic Hypogonadism

Abstract

Background: Excess aromatase activity is common in males with severely impaired sperm production, as shown by low Semen testosterone and somewhat increased estradiol levels. Elevated estrogen levels cause inhibitory effects of the hypothalamic-pituitary-gonadal axis, resulting in a reduction in LH required for testosterone production and FSH to maximize sperm motility. The main objective of this study was to see how an aromatase inhibitor to Improve Semen Quality in Case of Eugonadotropic Hypogonadism. Methods: This Prospective study was conducted in the Department of obstetrics and gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh during the period from June 2020 to May 2021. The sample size was 40 subfertile men with oligospermia. (≤ 10 million/ml), low semen testosterone level (<300 ng/dl) and low testosterone to estradiol ratio (<10). All patients were treated with Aromatase Inhibitor 2.5 mg daily for 4 months. At the end of the 4 months the semen analysis was performed. Statistical analysis was carried out by using IBM Statistical Package for Social Sciences version 25 for windows (SPSS version 25.0). Results: The sperm concentration, sperm motility and total motile sperm count significantly increased after Aromatase Inhibitor treatment. The side effects were mild and well tolerated. Conclusions: According to the findings of this study, some men with oligospermia, low Semen testosterone levels, and normal gonadotropin levels may have curable endocrinopathy. In infertile males with a low Semen testosterone to estradiol ratio, Aromatase Inhibitor may be administered to enhance sperm parameters.