Effects of the selective estrogen receptor modulators for the treatment of male infertility: a systematic review and meta-analysis

ABSTRACT

Background: Selective estrogen receptor modulators (SERMs) represent a poorly investigated class of drugs for the treatment of male infertility. The aim of this study was to assess the effects of SERMs on conventional sperm parameters, serum gonadotropin and testosterone levels, and pregnancy rate in patients with idiopathic infertility.

Methods: The authors performed a comprehensive systematic review with meta-analysis of all available controlled and not-controlled studies of the literature reporting sperm conventional parameters, gonadotropin and testosterone levels, and/or the pregnancy rate following SERM administration in normogonadotropic patients with idiopathic oligozoospermia.

Results: From the 418 papers retrieved, 16 controlled and not-controlled trials were lastly included. SERM administration increased significantly sperm concentration, total sperm count, and serum luteinizing hormone, follicle-stimulating hormone, and total testosterone levels compared with baseline values. In contrast, SERMs did not have any significant effect on sperm concentration and progressive and total motility, but improved total sperm count, sperm morphology, and increased the pregnancy rate compared to the control group, which included studies done with placebo or other treatments.

Conclusions: The results of this meta-analysis suggest that SERMs may be effective in the treatment of infertile patients with idiopathic infertility. However, the paucity of data does not allow to draw a definitive conclusion.

KEYWORDS:

• Selective estrogen receptor modulators
• SERM
• male infertility
• tamoxifen
• clomiphene
• oligozoospermia
• pregnancy rate

Author contributions

Conception and design: Prof. AE Calogero, Prof. S La Vignera and Dr. R Cannarella. Analysis and interpretation of the data: Dr. RA Condorelli, Dr. L Mongioi and Dr. F Barbagallo; the drafting of the paper: Prof. S La Vignera and Dr. R Cannarella. Revising the paper critically for intellectual content: Prof. AE Calogero and Prof. S La Vignera. Final approval of the version to be published: Prof. AE Calogero, Prof. S La Vignera, Dr. R Cannarella, Dr. RA Condorelli, Dr. L Mongioi and Dr. F Barbagallo. All authors agree to be accountable for all aspects of the work.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This manuscript has not been funded.