Correlation between post-tamoxifen hormonal changes and seminal fluid analysis parameters improvement


  • Ali Abdulkhaleq The High Institute for Infertility Diagnosis and Assisted Reproductive Technologies
  • Ula AL-kawaz The High Institute for Infertility Diagnosis and Assisted Reproductive Technologies



tamoxifen, oligoasthenoteratospermia, FSH, testosterone


Oligoasthenoteratozoospermia is a prevalent cause of male infertility.
(iOAT). It is generally acknowledged that, due to the fact that
spermatogenesis is a sex-hormone-dependent process, specific endocrine
treatments might enhance or recover male fertility. The typical negative
feedback of sex steroids is disrupted by anti-estrogen medication, leading to
a rise in endogenous gonadotropin-releasing hormone secretion (FSH and
LH) straight from the pituitary. The stimulation of Leydig cells in the testes
by FSH and LH is thought to promote local testosterone synthesis, which in
turn may improve spermatogenesis. The study sample consisted of 42 iOAT
patients. Baseline seminal fluid analysis (SFA) and hormonal assessment
(FSH, LH, prolactin, and testosterone) were taken. Each patient was given
medical treatment with tamoxifen (20 mg/day) for three months. SFA, FSH,
and testosterone were taken after three months. There was a significant
increase in FSH, testosterone, sperm concentration, and progressive motility
after treatment (p value <0.001), furthermore, there was no significant
correlation between hormonal changes and changes in SFA study markers
(p value > 0,05). Improvements in hormone levels following tamoxifen
treatment for patients with idiopathic oligoasthenoteratospermia do not
correlate with alterations in SFA markers.


Guo L, Jing J, Ming Y, Bing F, Tamoxifen TAM. Tamoxifen is a potent antioxidant modulator for sperm quality in patients with idiopathic oligoasthenospermia. Int Urol Nephrol. 2015;

Al-yasiry RZ, Jwad MA, Hasan MF, Alsayigh HA. How Obesity Affects Female Fertility. 2022;111–4.

Albarzanji RK, Zakar SS, Abdulkader N, Ali M. Impact of Ciprofloxacin and Coenzyme Q10 on Spermatogenesis in Mice. 2022;26–30.

Choy JT, Eisenberg ML. Male infertility as a window to health. Fertil Steril. 2018 Oct;110(5):810–4.

Jensen CFS, Østergren P, Dupree JM, Ohl DA, Sønksen J, Fode M. Varicocele and male infertility. Nat Rev Urol. 2017 Sep;14(9):523–33.

Katib A. Mechanisms linking obesity to male infertility. Cent Eur J Urol. 2015;68(1):79–85.

Krausz C, Riera-Escamilla A. Genetics of male infertility. Nat Rev Urol. 2018 Jun;15(6):369–84.

Khaleefah MH, Mossa HAL, Selman MO. High Institute of Infertility Diagnosis and Assisted Reproductive Technologies, Al- Nahrain University, Baghdad-IRAQ. Abstract: :22–8.

Khalaf NM, Mohammed AA, Rahim AI. The Correlation Between Sperm DNA Integrity and Conventional Semen Parameters. 2022;11(1):1–11.

Duca Y, Calogero AE, Cannarella R, Condorelli RA, Duca Y, Calogero AE, et al. Expert Opinion on Pharmacotherapy Current and emerging medical therapeutic agents for idiopathic male infertility Current and emerging medical therapeutic agents for idiopathic male infertility. Expert Opin Pharmacother [Internet]. 2018;00(00):1–13. Available from:

Plouffe LEO, Siddhanti S. The Effect of Selective Estrogen Receptor Modulators on Parameters of the Hypothalamic-Pituitary-Gonadal Axis. :251–8.

Kumar R, Gautam G, Gupta NP. Drug Therapy for Idiopathic Male Infertility : Rationale Versus Evidence. 2006;176(October):1307–12.

Cocuzza M, Agarwal A. Nonsurgical treatment of male infertility: specific and empiric therapy. Biologics. 2007 Sep;1(3):259–69.

Skorupskaite K, George JT, Anderson RA. The kisspeptin-GnRH pathway in human reproductive health and disease. Hum Reprod Update. 2014;20(4):485–500.

Organization WH. WHO laboratory manual for the examination and processing of human semen. 5th ed. World Health Organization; 2010. p. Previous editions had different title : WHO labora.

Jarow JP, Zirkin BR. The androgen microenvironment of the human testis and hormonal control of spermatogenesis. Ann N Y Acad Sci. 2005 Dec;1061:208–20.

Neto FTL, Bach PV, Najari BB, Li PS, Goldstein M. Spermatogenesis in humans and its affecting factors. Semin Cell Dev Biol. 2016 Nov;59:10–26.

Taylor P, Ramaswamy S, Weinbauer GF. Endocrine control of spermatogenesis : Role of FSH and LH / testosterone. 2015;(March):37–41.

Carreau S, Lambard S, Delalande C, Denis-Galeraud I, Bilinska B, Bourguiba S. Aromatase expression and role of estrogens in male gonad : a review. Reprod Biol Endocrinol. 2003 Apr;1:35.

Walker WH, Cheng J. FSH and testosterone signaling in Sertoli cells. Reproduction. 2005 Jul;130(1):15–28.

Zhao N, Lan X, Jun L, Li T, Min J. Treatment of idiopathic oligozoospermia with combined human chorionic gonadotropin / human menopausal gonadotrophin : A randomised , double ‐ blinded , placebo ‐ controlled clinical study. 2019;(February):1–9.

Lunenfeld B, Glezerman M. - 1970; - 1970; - 1970). 1979;11(67).

Knuth UA, Hönigl W, Bals-Pratsch M, Schleicher G, Nieschlag E. Treatment of severe oligospermia with human chorionic gonadotropin/human menopausal gonadotropin: a placebo-controlled, double blind trial. J Clin Endocrinol Metab. 1987 Dec;65(6):1081–7.

Schill WB, Jüngst D, Unterburger P, Braun S. Combined hMG/hCG treatment in subfertile men with idiopathic normogonadotrophic oligozoospermia. Int J Androl. 1982 Oct;5(5):467–77.

Behre HM, Greb RR, Mempel A, Sonntag B, Kiesel L, Kaltwaßer P, et al. Significance of a common single nucleotide polymorphism in exon 10 of the follicle-stimulating hormone ( FSH ) receptor gene for the ovarian response to FSH : a pharmacogenetic approach to controlled ovarian hyperstimulation. :451–6.

Simoni M, Santi D, Negri L, Hoffmann I, Muratori M, Baldi E, et al. Treatment with human, recombinant FSH improves sperm DNA fragmentation in idiopathic infertile men depending on the FSH receptor polymorphism p.N680S: A pharmacogenetic study. Hum Reprod. 2016;31(9):1960–9.

Nordhoff V, Sonntag B, von Tils D, Götte M, Schüring AN, Gromoll J, et al. Effects of the FSH receptor gene polymorphism p.N680S on cAMP and steroid production in cultured primary human granulosa cells. Reprod Biomed Online. 2011 Aug;23(2):196–203.

Lu DİMTUĞ. Aromatase inhibitors in infertile patients : effects on seminal parameters , serum and seminal plasma testosterone levels , and estradiol levels during short-term follow-up Aromatase inhibitors in infertile patients : effects on seminal parameters , serum. 2009;39(4):1–7.

Bibancos M, Cavagnoli M, Bonetti TCS, Semaco E, Motta ELA, Serafini PC. Letrozole Therapy for Obstructive Azoospermic Men before in vitro Fertilization (IVF) treatment with Percutaneous Epididymal Sperm Aspiration. JBRA Assist Reprod. 2015 Nov;19(4):230–4.

Cavallini G, Beretta G, Biagiotti G. Preliminary study of letrozole use for improving spermatogenesis in non-obstructive azoospermia patients with normal serum FSH. Asian J Androl [Internet]. 2011;13(6):895–7. Available from:

Cavallini G, Biagiotti G, Bolzon E. Multivariate analysis to predict letrozole efficacy in improving sperm count of non-obstructive azoospermic and cryptozoospermic patients: a pilot study. Asian J Androl. 2013 Nov;15(6):806–11.

Saylam B, Efesoy O, Cayan S. The effect of aromatase inhibitor letrozole on body mass index, serum hormones, and sperm parameters in infertile men. Fertil Steril. 2011 Feb;95(2):809–11.

Kooshesh L, Bahmanpour S, Zeighami S, Nasr-esfahani MH. Effect of Letrozole on sperm parameters , chromatin status and ROS level in idiopathic Oligo / Astheno / Teratozoospermia. 2020;2:1–9.

Males I, Emqn EAA, Protocol PCR, Abdulwahid MJ, Al-attar MS. Molecular Diagnosis of Y-Chromosome Microdeletions in Some Kurdish. 2022;

Jawed HM, Jebur MS. The impact of gram positive bacteria on semen quality in infertile men and assessment antibiotic Susceptibility profile مييقتو مقعلاب نيباصملا لاجرلا ىدل يونملا لئاسلا ةدوج ىلع مارجلا ةبجوم ايريتكبلا ريثأ ت ةيويحلا تاداضملا ةيساسح. 2022;4(1):81–102.

Jayasena CN, Radia UK, Figueiredo M, Revill LF, Dimakopoulou A, Osagie M, et al. Reduced Testicular Steroidogenesis and Increased Semen Oxidative Stress in Male Partners as Novel Markers of Recurrent Miscarriage. Clin Chem. 2019 Jan;65(1):161–9.

Darbandi M, Darbandi S, Agarwal A, Sengupta P, Durairajanayagam D. Reactive oxygen species and male reproductive hormones. 2018;1–14.

Aitken RJ, Roman SD. Antioxidant systems and oxidative stress in the testes (Reprinted from Molecular Mechanisms in Spermatogenesis, 2007). Oxid Med Cell Longev. 2008;1(1):15–24.



How to Cite

Abdulkhaleq A, AL-kawaz U. Correlation between post-tamoxifen hormonal changes and seminal fluid analysis parameters improvement. IJEIR [Internet]. 2020 Aug. 8 [cited 2024 Jun. 18];10(2):1-13. Available from:



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