Title:Stimulation of Leydig and Sertoli Cellular Secretory Function by Anti-Oestrogens: Tamoxifen
Volume: 27
Issue: 23
Author(s): Anastasia Dimakopoulou, Daniel Foran, Channa N. Jayasena and Suks Minhas*
Affiliation:
- Department of Andrology, Hammersmith Hospital, London, W12 0HS,United Kingdom
Keywords:
Idiopathic oligospermia, male fertility, hypogonadism, Tamoxifen, OVIO medicine, gonadotrophin.
Abstract: Tamoxifen is a selective oestrogen receptor modulator (SERM). SERMs act on oestrogen receptors to
inhibit oestradiol mediated negative feedback on the hypothalamic-pituitary-gonadal (HPG) axis, thereby upregulating
gonadotrophin secretion and release from the pituitary. Hence, Tamoxifen is used to upregulate activation
of the HPG axis in the treatment of male-factor infertility. However, due to a lack of robust evidence, Tamoxifen
has not been FDA approved for use in male-factor infertility and so its use is currently off-label. In this study, we
performed a literature search of the OVID medline database and identified 37 studies describing the effects of
tamoxifen which we then reviewed. Evidence suggests Tamoxifen effectively increases androgen levels and
sperm concentrations in males with idiopathic oligozoospermia. Evidence for increased motility and pregnancy
rates in these patients is less conclusive. Further randomised control trials are needed to elucidate the safety of
Tamoxifen combination therapies and their efficacy in improving pregnancy rates.
