{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:12:30Z","timestamp":1791389550914,"version":"4.3.3"},"reference-count":51,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T00:00:00Z","timestamp":1650931200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Aromatase inhibitors (AIs) have been used to treat male infertility for decades. However, due to the lack of large\u2010scale randomized controlled studies and basic research, the efficacy and safety of AIs in the treatment of male infertility remain controversial. Therefore, it is necessary to conduct an evidence\u2010based preliminary evaluation of the existing clinical trials of AIs in the treatment of male infertility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A comprehensive literature search was performed in the PubMed, Embase, Cochrane, CNKI, VIP, CBM, and Wanfang databases through August 2021 for all studies. We conducted a systematic review with a meta\u2010analysis of all available studies reporting sperm conventional parameters, gonadotropin and testosterone levels, and\/or the pregnancy rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 10 studies involving 666 patients were included. Letrozole (LE) or anastrozole (AZ) administration significantly increased sperm concentration, total sperm count, serum luteinizing hormone (LH), follicle\u2010stimulating hormone (FSH), testosterone (T) levels, and the testosterone\u2010to\u2010estradiol ratio (T\/E2), but E2 levels were significantly reduced compared with baseline values. Compared with the control group, which included selective estrogen receptor modulators (SEMRs) or human chorionic gonadotropin (HCG), LE, or AZ did not have any significant effect on sperm concentration, motility, and morphology, except that AIs had less effect on sperm motility than the control group (weighted mean difference [WMD]: \u22122.55; 95% CI: \u22124.11 to \u22121.00; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>AIs may be effective in the treatment of male infertility. For infertile male patients planning assisted reproduction, discontinuation of AIs for 2\u20137 days prior to sperm retrieval may increase the success rate of fertilization. Further studies with larger sample sizes are needed to validate these findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/andr.13185","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T16:41:31Z","timestamp":1650386491000},"page":"894-909","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Efficacy and safety of letrozole or anastrozole in the treatment of male infertility with low testosterone\u2010estradiol ratio: A meta\u2010analysis and systematic review"],"prefix":"10.1111","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8041-602X","authenticated-orcid":false,"given":"Bin","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Andrology Shaanxi University of Chinese Medicine  Xianyang Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao\u2010jiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Andrology Shaanxi University of Chinese Medicine  Xianyang Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya\u2010ling","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Andrology Shaanxi University of Chinese Medicine  Xianyang Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010tao","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Andrology Shaanxi University of Chinese Medicine  Xianyang Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian\u2010guo","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Andrology Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi'an  Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12575-019-0108-y"},{"key":"e_1_2_9_3_1","unstructured":"JungwirthA DiemerT KopaZ KrauszC PalR.European Association of Urology Guidelines on Male Infertility.2017."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ17-0001"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.5653\/cerm.2014.41.3.108"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)47069-X"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)56705-3"},{"issue":"2","key":"e_1_2_9_8_1","first-page":"1","article-title":"Effects of the selective estrogen receptor modulators for the treatment of male infertility: a systematic review and meta\u2010analysis","volume":"20","author":"Cannarella R","year":"2019","journal-title":"Expert Opin Pharmacother"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.03.036"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-52-5-897"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)66540-8"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2018.09.016"},{"key":"e_1_2_9_13_1","unstructured":"Fertil Steril 2012 Schlegel PN. Aromatase inhibitors for male infertility"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1939-4640.1989.tb00094.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2012.04.048"},{"key":"e_1_2_9_16_1","first-page":"29S","article-title":"Total functional sperm fraction measurements in males of known fertility and infertility","volume":"41","author":"Zavos P","year":"1984","journal-title":"Fertil Steril"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)57860-1"},{"issue":"2","key":"e_1_2_9_18_1","first-page":"S38","article-title":"cochrane handbook for systematic reviews of interventions version 5.1.0. the cochrane collaboration","volume":"5","author":"Higgins J","year":"2008","journal-title":"Naunyn\u2010Schmiedebergs Archiv f\u00fcr experimentelle Pathologie und Pharmakologie"},{"key":"e_1_2_9_19_1","unstructured":"WellsG.The Newcastle\u2010Ottawa Scale (NOS) for assessing the quality of non randomised studies in metaanalyses.2012. Available from:http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp"},{"key":"e_1_2_9_20_1","unstructured":"HigginsJPT GreenS.Cochrane handbook for system\u2010 atic reviews of interventions V ersion 5.1.0 [updated September 2011]. The Cochrane Collaboration. Available fromwww.cochrane\u2010handbook.org"},{"key":"e_1_2_9_21_1","unstructured":"ShiJ LuoD WanX et\u00a0al.Detecting the skewness of data from the sample size and the five\u2010number summary.2020."},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1429"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280216669183"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-135"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_9_26_1","article-title":"Clinical treatment on the low testosterone estradiol ratio of patients with oligoasthenospermia","author":"Tian F","year":"2016","journal-title":"Chinese Journal of Coal Industry Medicine"},{"key":"e_1_2_9_27_1","article-title":"Clinical study of aromatase inhibitor letrozole to treat oligoasthenospermia of male patients","author":"Tian F","year":"2016","journal-title":"Chinese Journal of Family Planning"},{"key":"e_1_2_9_28_1","article-title":"Clinical efficacy of letrozole and tamoxifen in the treatment of patients with idiopathic oli\u2010gozoospermia","author":"Xiaoxia LI","year":"2019","journal-title":"Medical Journal of the Chinese People's Armed Police Force"},{"issue":"4","key":"e_1_2_9_29_1","first-page":"519","article-title":"Aromatase inhibitors in infertile patients: effects on seminal parameters, serum and seminal plasma testosterone levels, and estradiol levels during short\u2010term follow\u2010up","volume":"39","author":"Murad M","year":"2009","journal-title":"Turkish Journal of Medical Sciences"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.04.005"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12944"},{"key":"e_1_2_9_32_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12958-020-00591-2","article-title":"Effect of letrozole on sperm parameters, chromatin status and ros level in idiopathic oligo\/astheno\/teratozoospermia","volume":"18","author":"Kooshesh L","year":"2020","journal-title":"Reprod Biol Endocrinol"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.2478\/enr-2019-0023"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2010.09.021"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2016.11.021"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1336.023"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.08.050"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2010.08.094"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.125.3.310"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1210\/endo-84-6-1365"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1210\/endocr\/bqaa137"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2009.05.014"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1038\/aja.2011.44"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1038\/aja.2013.99"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/and.12122"},{"issue":"10","key":"e_1_2_9_46_1","first-page":"989","article-title":"Application of letrozole in patients with non\u2010obstructive azoospermia","volume":"26","year":"2017","journal-title":"J Reprod Med"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13048-015-0131-9"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0960-0760(02)00041-9"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.96.14.7986"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1093\/molehr\/gag020"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deg340"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1590\/1984-3143-ar2020-0029"}],"container-title":["Andrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/andr.13185","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/andr.13185","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/andr.13185","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T13:20:19Z","timestamp":1692883219000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/andr.13185"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,26]]},"references-count":51,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1111\/andr.13185"],"URL":"https:\/\/doi.org\/10.1111\/andr.13185","archive":["Portico"],"relation":{},"ISSN":["2047-2919","2047-2927"],"issn-type":[{"value":"2047-2919","type":"print"},{"value":"2047-2927","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,26]]},"assertion":[{"value":"2022-01-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}