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Aromatase Inhibitors in the Treatment of Male Infertility
This study is currently recruiting participants.
Verified by University of Utah, October 2008
Sponsors and Collaborators: University of Utah
AstraZeneca
Information provided by: University of Utah
ClinicalTrials.gov Identifier: NCT00440180
  Purpose

Obesity is associated with an increase in blood levels of estrogen. Estrogen or "female hormone" is believed to have a negative effect on sperm production. Aromatase inhibitors such as anastrozole work to decrease the production of estrogen and increase testosterone in the body. By decreasing the level of estrogen, sperm production should improve. In this study, we will try to determine the benefit of anastrozole in obese men with low sperm counts.

Patients participating in this study will be randomly assigned (by chance) to treatment in one of two study arms: Group A: Anastrozole 1mg per day for 4 months and Group B: Placebo for 4 months. Neither patients nor doctors will know in which treatment group they are.

Screening assessments will take place prior to the start of treatment. During this time, demographic data and medical history will be reviewed and recorded. Also, testicular exam, sperm count and laboratory blood analysis will be performed. Over the course of study, semen and blood analysis including hormonal profile (testosterone, estrogen, follicle stimulating hormone and luteinizing hormone) will be recollected.

At the conclusion of the trial, we expect the group that received anastrozole to have an improved sperm count, increased testosterone and decreased estrogen levels.


Condition Intervention Phase
Obesity
Low Sperm Count
Drug: Anastrozole
Drug: Placebo
Phase III

MedlinePlus related topics: Infertility Obesity Obesity in Children
Drug Information available for: Anastrozole
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Placebo Control, Parallel Assignment, Safety/Efficacy Study
Official Title: The Role of Aromatase Inhibitors in the Treatment of Infertility in Obese Male

Further study details as provided by University of Utah:

Primary Outcome Measures:
  • Sperm concentration [ Time Frame: 4 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Other sperm parameters, hormonal measures and pregnancy rates [ Time Frame: 4 months ] [ Designated as safety issue: No ]

Estimated Enrollment: 50
Study Start Date: March 2007
Estimated Study Completion Date: April 2009
Estimated Primary Completion Date: March 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Group B: Placebo Comparator
Placebo
Drug: Placebo
Placebo Comparator
Group A: Experimental
Anastrozole
Drug: Anastrozole
1 mg qd for 4 months

Detailed Description:

The role of aromatase inhibitors in the treatment of infertility (due to hypogonadism) in obese Male

Background:

The incidence of male infertility is increasing in the western world in parallel with an increase in obesity. It is estimated that in the United States sperm counts may be decreasing by as much as 1.5% each year (Swan et al, 2000). It is proposed that increased estrogen levels associated with obesity cause hypogonadism and male infertility via inappropriate suppression of gonadotropins and direct adverse effects on spermatogenesis. The link between obesity and its likely effects on the endocrine function of the male reproductive axis underlie the mechanistic justification for this novel trial of a medical therapy for hypogonadism and male infertility associated with obesity.

Study design:

We designed a double blind, randomized, placebo control trial of the aromatase inhibitor Anastrozole to treat men that are overweight (BMI ≥ 30 kg/m2) and oligospermic (sperm count ≤ 20 × 106/mL and ≥ than 3 × 106/mL). After enrollment, patients will be randomized to receive Anastrozole 1mg/d or placebo for 4 months. Semen analysis and hormonal profile (FSH, LH, Estradiol, total and free Testosterone will be measured at the start and the conclusion of the study. The primary outcome will be sperm density. Secondary outcomes will be other sperm parameters including: total count per ejaculate, total motile sperm per ejaculate, and sperm morphology. We will also follow the change in FSH and LH, testosterone and estrogen levels, and will seek correlation between endocrine change and semen parameters. Based on a power analysis, a total of 50 patients will be included in the study. Study design and reporting will comply with the CONSORT (Consolidated Standards of Reporting Trials) guidelines.

Anticipated results:

The study will evaluate the research hypothesis that inhibition of aromatase will result in improvements in sperm density, as well as secondary semen analysis parameters (e.g. morphology and motility). Supporting endocrine data will be obtained as part of this clinical protocol that we expect will show an increase in testosterone, LH and FSH levels and a decrease in estrogen levels associated with active treatment.

  Eligibility

Ages Eligible for Study:   16 Years to 80 Years
Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Male partner of a couple presenting for infertility work up after one year of unprotected intercourse.
  2. Moderate oligozoospermia (defined as mean sperm count ≤ 20 × 106/mL and ≥ than 3 × 106/mL) of at least two separate occasions spanning a minimum of two weeks.
  3. Obese men BMI ≥ 30
  4. FSH and LH levels < 10 mIU/mL

Exclusion Criteria:

  1. Severe Oligozoospermia: Sperm count < than 3 × 106/mL, including azoospermia.
  2. Age less than 18 or greater than 65 years
  3. Pyospermia or leukospermia: defined by white blood cells ≥1 million leukocytes per milliliter of semen.
  4. Cryptorchidism
  5. Vasectomy reversal
  6. Regular use of tobacco products
  7. BMI < 30
  8. Use of anabolic steroids or testosterone replacement
  9. All patients with abnormal initial liver function tests "AST or ALT" will be excluded form the study.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00440180

Contacts
Contact: Ahmad O Hammoud, MD 801-587-3795 ahmad.hammoud@hsc.utah.edu

Locations
United States, Utah
University of Utah Recruiting
salt lake city, Utah, United States, 84132
Contact: Ahmad O hammoud, MD     801-587-3795     ahmad.hammoud@hsc.utah.edu    
Sponsors and Collaborators
University of Utah
AstraZeneca
Investigators
Principal Investigator: Ahmad O Hammoud, MD University of Utah
  More Information

Responsible Party: University of Utah ( Ahmad Hammoud )
Study ID Numbers: IRB_00016246
Study First Received: February 22, 2007
Last Updated: October 20, 2008
ClinicalTrials.gov Identifier: NCT00440180  
Health Authority: United States: Food and Drug Administration

Keywords provided by University of Utah:
Obesity
Low sperm count
Male infertility

Study placed in the following topic categories:
Infertility
Oligospermia
Obesity
Anastrozole
Infertility, Male
Overweight
Genital Diseases, Male
Genital Diseases, Female
Body Weight
Signs and Symptoms
Nutrition Disorders
Overnutrition
Spastic paraplegia epilepsy mental retardation

Additional relevant MeSH terms:
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents, Hormonal
Antineoplastic Agents
Therapeutic Uses
Enzyme Inhibitors
Aromatase Inhibitors
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 14, 2009