芳香化酶抑制剂在男性不育治疗中的应用

Application of aromatase inhibitors in treatment of male infertility

男性不育的病因复杂多样,且多被归为特发性因素。许多特发性男性不育症患者均表现为体内睾酮(T)水平下降、雌二醇(E2)水平上升、T/E2失调和生精功能障碍等。芳香化酶在男性体内雄激素转化为雌激素的过程中发挥关键作用。以来曲唑为代表的芳香化酶抑制剂可有效抑制芳香化酶活性,从而降低E2水平、提升T与促性腺激素水平,提高T/E2,改善生精功能,对提高不育症自然妊娠率与人工辅助生殖的成功率具有重要意义。大样本的随机对照临床试验将进一步明确其在男性不育症治疗中的地位,并有望成为男性不育症的常规治疗药物。

The causes of male infertility are diversified, and the unknown etiology of infertility is called idiopathic infertility. The patients with idiopathic infertility often present with low testosterone level and high estradiol level in serum and impaired spermatogenesis. The aromatase plays a key role in converting testosterone to estradiol. Aromatase inhibitors,such as letrozole,have the effects to inhibit the activity of aromatase. They decrease estradiol level and increase testosterone and gonadotropin levels and the ratio of T/E2. Therefore the spermatogenesis and semen parameters could be improved after aromatase inhibitors treatment,which is important for increasing pregnancy rate and assisted reproductive technique success rate in infertile couples. The large-size, randomly controlled clinical trials are required to further evaluate the role of aromatase inhibitors, and make them as promising Conventional and standard therapeutic regimes for male infertility.