[Systemic therapy of male subfertility]

Almost 90% of subfertile patients show no specific aetiological condition to account for their pathological spermiogram and therefore have to be subjected to non-causal systemic therapy. The retrospective analysis of 212 patients who were treated with 30 mg tamoxifen daily because of oligozoospermia showed a significant (p less than 0.001) increase in sperm density without influencing other ejaculate parameters. The gravidity rate amounted to 32% after 6 months of therapy, on average. 147 patients with isolated asthenozoospermia treated by means of 600 IU kallikrein daily showed a resultant significant elevation (p less than 0.002) in sperm motility only. Endocrine profiles showed no statistical changes. The gravidity rate was 37%. Combination therapy with tamoxifen and kallikrein resulted in a significant increase in both sperm density and motility in males with oligoasthenoteratozoospermia (OAT-syndrome) provided pretherapeutic levels were above 10 million sperms/ml. The problems encountered in the systemic therapy of male subfertility are discussed.