Page 25 - Aspire April -2023 Vol 8 / Issue 2

MALE INFERTILITY SIG
Gwo-Jang Wu (Taiwan)
Is aromatase inhibitor
a therapeutic option for
men with non-obstructive
azoospermia
By Professors Gwo-Jang Wu and Atsushi Tanaka
The final treatment for men with non-obstructive azoospermia (NOA) is Micro-TESE.
If no testicular sperm are found during this test, the patient has no chance to become father.
FSH, HCC, and Clomiphene therapies have been used for a long time for men with this condition, but their effectiveness is low. Recently, attention has been paid to the function of aromatase, which affects the levels of testosterone and estradiol in the testicles.
The dynamics of Aromatase in blood and the testicle are still not well known. Recently, Shiraishi et al. reported good results with long-term administration of an Aromatase inhibitor.
Spermatogenesis is strictly regulated by the intratesticular hormonal milieu, in which testosterone (T) and estradiol (E2) play pivotal roles.
Atsushi Tanaka (Japan)
However, the optimal expression of aromatase and intratesticular T (ITT) and E2 (ITE2) levels are unknown.
Shiraishi et al. reported that aromatase was mainly located in Leydig cells, and the levels of its transcript and protein expression levels were increased in men with NOA, while significant associations were observed between decreased ITT and increased ITE2, aromatase expression, and sperm retrieval.
Leydig cell aromatase is a factor that is independently correlated with spermatogenesis, and aromatase inhibitors may open a therapeutic window by increasing ITT/ITE2 in selected patients.
Reference: K. Shiraishi et al. Testicular Testosterone and Estradiol Concentrations and Aromatase Expression in Men with Nonobstructive Azoospermia. J Clin Endocrinol Metab. 2021; 106 (4): e1803–e1815.
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