Unidad de Andrología y Cirugía Reconstructiva Urogenital, Servicio de Urología, Hospital Universitario Puerta del Mar, Cádiz, España.
Unidad de Andrología y Cirugía Reconstructiva Urogenital, Servicio de Urología, Hospital Universitario Puerta del Mar, Cádiz, España.
Actas Urol Esp (Engl Ed). 2020 Jun;44(5):281-288. doi: 10.1016/j.acuro.2019.10.007. Epub 2020 Apr 10.
Male infertility accounts for 50% of the causes of infertile couples, being more than 30% of unknown etiology. In these cases, empiric treatment can be an option prior to the application of assisted reproduction techniques. Empiric treatment can be categorized as hormonal, such as gonadotropins, antiestrogens and aromatase inhibitors, and antioxidant, with vitamins, trace elements and carnitine, among others. Although scientifically acceptable evidence is limited due to the absence of large randomized and controlled clinical trials, recent systematic reviews and meta-analyses show that treatment with gonadotropins, antiestrogens and antioxidants increases pregnancy and live birth rates and improves seminal parameters. Empiric medical treatment for idiopathic infertility can be considered in specific cases in order to improve semen quality and spontaneous fertility.
男性不育占不孕夫妇病因的 50%，其中超过 30%的病因不明。在这些情况下，在应用辅助生殖技术之前，经验性治疗可能是一种选择。经验性治疗可分为激素治疗，如促性腺激素、抗雌激素和芳香化酶抑制剂，以及抗氧化剂治疗，包括维生素、微量元素和肉碱等。尽管由于缺乏大型随机对照临床试验，科学上可接受的证据有限，但最近的系统评价和荟萃分析表明，使用促性腺激素、抗雌激素和抗氧化剂治疗可以提高妊娠率和活产率，并改善精液参数。在某些特定情况下，对于特发性不育，可以考虑采用经验性医学治疗来改善精液质量和自然生育能力。
