MEDICAL THERAPY OF THE INFERTILE MEN

Background and Aim : Infertility affects around 15% of couples trying to conceive. A male factor is involved in about 50% of cases. Unfortunately in the vast majority of the cases it is not possible to identify a specific etiological factor; in the later cases only empirical therapy is possible.Methods : A comprehensive review of available data will be performed providing the best evidence based information published so far.Results : lifestyle modification including weight loss and smoking cessation should be the first step in all obese or overweight infertile subjects. Hypogonadotropic, hypogonadism is one of the few causes of male infertility that can benefit from medical therapy. In this case the combined use of gonadotropins can allow sperm production in about 50% of cases. Antibiotic therapy can be useful in patients with symptomatic male genitalia tract infections. Whereas its role in asymptomatic leukocytospermia is conflicting. The use of follicular stimulating hormone (FSH) alone has been demonstrated to improve sperm parameters and pregnancy outcomes even in idiopathic oligo-astheno-teratozoospermia. In the latter case FSH receptor(FSHR) genotype can modulate the final response. A beneficial effect of nutraceuticals in the treatment of idiopathic male infertility has also been described. However despite their large use in clinical setting evidence supporting the use of antioxidants for the treatment of male infertility is of low quality. Similar considerations can be drawn for the use of steroids in autoimmune infertility.Conclusion : : medical therapy plays an important role in the management of male of infertile couple. A correct diagnosis and specific therapy can improve fertility outcome independent of the use of assisted reproductive techniques.

کلیدواژه ها:

Male infertility ، Medical therapy ، lifestyle ، antioxidant ، follicular stimulating hormone