Two drugs that are commonly used off-label in the treatment of male infertility are clomiphene citrate (CC) and anastrozole (AZ); however, data are lacking on the use of combination CC+AZ therapy. A new BJU International study found that combination CC+AZ therapy is safe and effective for patients with elevated estradiol or a low testosterone/estradiol ratio.
In the study of 51 men, AZ provided an effective means for lowering estradiol levels and increasing the testosterone/estradiol ratio following the initiation of CC therapy. CC is a selective estrogen receptor modulator that increases gonadotropin production and indirectly stimulates androgen synthesis, but it is associated with increased estradiol levels. AZ is an aromatase inhibitor that decreases conversion of testosterone to estradiol.