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  • Print publication year: 2011
  • Online publication date: May 2011

4 - Non-surgical therapy

Summary

This chapter discusses a number of specific therapeutic modalities aimed at the management of defined causes of male infertility. Androgen replacement therapy is gaining significant attention as a possible treatment for ailments ranging from lack of libido to increased body fat to depression and decreased mental acuity. Hyperprolactinemia is a cause of male infertility that is often amenable to non-surgical therapy. Elevated levels of prolactin may impair male fertility based on multiple pathways. A particularly interesting application of pharmacotherapy in the management of male infertility is the use of clomiphene citrate before testis biopsy in the management of azoospermic men suffering from primary testicular failure. Substances, including antiestrogen agents, aromatase inhibitors, gonadotropins, L-carnitine, antioxidants, and a variety of other compounds have been employed for years with little conclusive evidence that they consistently improve either semen quality or pregnancy rates.

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References

[1] LipshultzL, HowardsS, NiederbergerC, eds. Infertility in the Male, 4th edn (Cambridge, Cambridge University Press, 2009).
[2] RamanJD, SchlegelPN. Aromatase inhibitors for male infertility. J Urol 2002; 167: 624–9.
[3] NishimuraK, MatsumiyaK, TsuboniwaN, et al. Bromocriptine for infertile males with mild hyperprolactinemia: hormonal and spermatogenic effects. Arch Androl 1999; 43: 207–13.
[4] SchlechteJA. Long-term management of prolactinomas. J Clin Endocrinol Metab 2007; 92(8): 2861–5.
[5] GillamMP, MolichME, LombardiG, et al. Advances in the treatment of prolactinomas. Endocr Rev 2006; 27(5): 485–534.
[6] HusseinA, OzgokY, RossL, NiederbergerC. Clomiphene administration for cases of nonobstructive azoospermia: a multicenter study. J Androl 2005; 26: 787–91.
[7] MunkelwitzR, GilbertBR. Are boxer shorts really better? A critical analysis of the role of underwear type in male subfertility. J Urol 1998; 160(4): 1329–33.
[8] SmithJF, EisenbergML, MillsteinSG, et al. The use of complementary and alternative fertility treatment in couples seeking fertility care: data from a prospective cohort in the United States. Fertil Steril 2010; 93(7): 2169.