Potentialities and limitations of endocrine treatment in idiopathic oligozoospermia

The effectiveness of various forms of endocrine treatment for idiopathic oligozoospermia and the action of kallikrein on sperm parameters were evaluated in a retrospective study including 321 individuals with normogonadotropic idiopathic oligozoospermia (sperm count less than 20 Mio/ml). Within a follow up of 3 years 67 conceptions were noted. 51 of them appeared to be treatment-related. The highest conception rate was recorded under tamoxifen. Systemic treatment of idiopathic normogonadotropic oligozoospermia seems to be very limited, since the pathogenetic mechanisms of tubular dysfunction in idiopathic oligozoospermia are still unknown and treatment remains empirical. Spontaneous variations of semen parameters and spontaneous conceptions of the partners of oligospermic males are often responsible for a misinterpretation of the interference of a pharmacological agent with the fertilizing ability of the ejaculate. Development of new treatment regimens and controlled clinical trials are necessary to improve the efficacy of endocrine treatment in idiopathic oligozoospermia.