Alternative Pharmacological Approach to Male Infertility: Anti-Aromatase Compounds: A Systematic Review

Abstract

ABSTRACT Infertility is a reproductive system disease in which pregnancy does not occur despite long-term, regular and unprotected sexual intercourse. In the near future, it is estimated that approximately 15% of the world population will be affected by infertility and the majority of this will be male-induced infertility. In male infertility, 90% defective sperm production is effective and it is known that in infertile men, as a result of the increase in estrogen levels due to aromatase activity, the testosterone/estradiol ratio may decrease and spermatogenesis is impaired. Therefore, research on increasing intratesticular testosterone levels and improving impaired spermatogenesis has focused on aromatase inhibitors. However, since the efficacy and safety of aromatase inhibitors have not been clarified, it has been thought that anti-aromatase compounds with fewer side effects and stronger efficacy can be used as alternative therapeutic agents in the treatment of infertility. Phytoestrogens are estrogenic plant-derived compounds. Many have been shown to have aromatase inhibition, thereby increasing testosterone levels. In addition, it is known that there are different mechanisms that affect spermatogenesis apart from binding to estrogen receptors in their effects on the male reproductive system. Therefore, our aim is to review the latest developments and treatment approaches to natural polyphenolic compounds with anti-aromatase activity in male infertility. According to the literature, the most commonly used anti-aromatase compounds include resveratrol, quercetin, apigenin, and naringenin. All the compounds in this review were found to have positive effects on male infertility.