SynthesisAsian journal of andrology
A systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertility.
Synthesis in Asian journal of andrology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 5 syntheses or guidelines pooled it, 92 citations in OpenAlex.
- The effectiveness of hormonal treatment to improve reproductive outcomes in normogonadotropic men with abnormal semen parameters: results of 2 linked systematic reviews.The Journal of clinical endocrinology and metabolism · 2026Pooled it
- The first Australian evidence-based guidelines on male infertility.The Medical journal of Australia · 2025Guideline
- Clomiphene or enclomiphene citrate for the treatment of male hypogonadism: a systematic review and meta-analysis of randomized controlled trials.Archives of endocrinology and metabolism · 2025Pooled it
- The association of impaired semen quality and pregnancy rates in assisted reproduction technology cycles: Systematic review and meta-analysis.Andrologia · 2022Pooled it
- Clinical correlation among male infertility and overall male health: A systematic review of the literature.Investigative and clinical urology · 2020Pooled it
- Impact of coenzyme Q10 as an adjuvant therapy to letrozole on spermiogram results and sex hormone levels in Iraqi men with infertility; randomized open label comparative study.F1000Research · 2023Trial
- Health consequences of anabolic steroids: a sexual-medicine perspective.International journal of impotence research · 2026Review
- Testosterone replacement therapy and spermatogenesis in reproductive age men.Nature reviews. Urology · 2025Review
- A Review on Testosterone: Estradiol Ratio-Does It Matter, How Do You Measure It, and Can You Optimize It?The world journal of men's health · 2025Review
- Clinician's guide to the management of azoospermia induced by exogenous testosterone or anabolic-androgenic steroids.Asian journal of andrology · 2025Review
- Health risks associated with infertility and non-obstructive azoospermia.Asian journal of andrology · 2025Review
- Is There a Role for Hormonal Therapy in Men with Oligoasthenoteratozoospermia (OAT)?Journal of clinical medicine · 2024Review
- Empirical Treatments for Male Infertility: A Focus on Lifestyle Modifications and Medicines.Diseases (Basel, Switzerland) · 2024Review
- Management of Male Fertility in Hypogonadal Patients on Testosterone Replacement Therapy.Medicina (Kaunas, Lithuania) · 2024Review
- Frequency, morbidity and equity - the case for increased research on male fertility.Nature reviews. Urology · 2024Review
- From Diagnosis to Treatment: Comprehensive Care by Reproductive Urologists in Assisted Reproductive Technology.Medicina (Kaunas, Lithuania) · 2023Review
- Review
- Dose-response association between 24-hour total movement activity and testosterone deficiency in adult males.Frontiers in endocrinology · 2023Article
- The impact of male factors and their correct and early diagnosis in the infertile couple's pathway: 2021 perspectives.Journal of endocrinological investigation · 2022Review
- The efficacy of anastrozole in subfertile men with and without abnormal testosterone to estradiol ratios.Translational andrology and urology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Aromatase activity has commonly been associated with male infertility characterized by testicular dysfunction with low serum testosterone and/or testosterone to estradiol ratio. In this subset of patients, and particularly in those with hypogonadism, elevated levels of circulating estradiol may establish a negative feedback on the hypothalamic-pituitary-testicular axis by suppressing follicle-stimulating hormone (FSH) and luteinizing hormone (LH) production and impaired spermatogenesis. Hormonal manipulation via different agents such as selective estrogen modulators or aromatase inhibitors to increase endogenous testosterone production and improve spermatogenesis in the setting of infertility is an off-label option for treatment. We carried out a systematic review and meta-analysis of the literature of the past 30 years in order to evaluate the benefits of the use of aromatase inhibitors in the medical management of infertile/hypoandrogenic males. Overall, eight original articles were included and critically evaluated. Either steroidal (Testolactone) or nonsteroidal (Anastrozole and Letrozole) aromatase inhibitors were found to statistically improve all the evaluated hormonal and seminal outcomes with a safe tolerability profile. While the evidence is promising, future prospective randomized placebo-controlled multicenter trials are necessary to better define the efficacy of these medications.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.