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Should empiric therapies be used for male factor infertility?

      Idiopathic male infertility is defined as abnormal semen parameters without an underlying cause. The primary treatment option used in this patient population is empiric medical therapy (EMT). Hormone treatment, particularly antiestrogens, is the most widely used method of EMT for idiopathic male infertility. Specifically, clomiphene citrate (CC), anastrozole, and human chorionic gonadotropin (hCG) are the most commonly prescribed (
      • Ko E.Y.
      • Siddiqi K.
      • Brannigan R.E.
      • Sabanegh E.S.
      Empirical medical therapy for idiopathic male infertility: a survey of the American urological association.
      ). For idiopathic male infertility EMT is a moderately effective treatment option with regards to improvement in semen parameters and pregnancy rate, but no clear predictors have been identified to determine which patients will respond optimally.
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      Linked Article

      • Empiric and lifestyle therapies for male infertility—should we recommend them?
        Fertility and SterilityVol. 113Issue 6
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          Despite significant advances in reproductive medicine, a substantial portion of men are diagnosed with idiopathic male infertility—abnormal semen parameters with no identifiable cause. We have a good understanding of many of the requirements needed for spermatogenesis, such as a functioning hypothalamic pituitary axis. We also have data indicating that an excess of certain compounds, such as reactive oxygen species, may be detrimental to fertility. For over 50 years, clinicians have used this knowledge as a basis for empiric therapy of the infertile male.
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