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Guidelines for Drug Treatment of Male Infertility

  • Practical Therapeutics
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Summary

The prerequisite for rational therapy of male fertility disorders is an exact diagnosis. While the possibilities of influencing disturbances of spermiogenesis are limited, male adnexal diseases can be successfully treated in many cases. Drugs for the treatment of fertility disorders must be applied with this in mind, and empiric therapy is often performed in addition to causal treatment which, however, may be quite rationally determined. The therapeutic spectrum in andrology includes antibiotic and antiphlogistic agents, mast cell blockers, zinc, vitamins, and immunosuppressive drugs (corticosteroids). These agents are used forj the treatment of inflammatory diseases of the testes and the accessory glands or for suppression of antispermatozoal antibodies. Hormonal disturbances are infrequently encountered by the andrologist, but they can be treated, with proven efficacy, with gonadotrophins, gonadotrophin-releasing hormone (GnRH) or androgens. In certain cases that are not hormonally related, the use of antiestrogens (clomifene, tamoxifen) as stimulating agents may be successful. Furthermore, tissue hormone releasing proteases (kallikrein) can be used both therapeytically (especially in motility disturbances that are not due to structural flagellar defects) and diagnostically (in order to distinguish between inflammatory and noninflammatory testicular damage). Anticholinergics and α-sympathomimetics are applied to ameliorate ejaculation or emission failure. In addition to a review of these treatment forms, the development of new concepts, e.g. angiotensin converting enzyme (ACE) inhibitors, is discussed

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Authors and Affiliations

  1. Center of Dermatology and Andrology, Justus Liebig University, Giessen, Federal Republic of Germany

    Gerhard Haidl & Wolf-Bernhard Schill

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  1. Gerhard Haidl
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  2. Wolf-Bernhard Schill
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Haidl, G., Schill, WB. Guidelines for Drug Treatment of Male Infertility. Drugs 41, 60–68 (1991). https://doi.org/10.2165/00003495-199141010-00006

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  • DOI: https://doi.org/10.2165/00003495-199141010-00006

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