Treating Idiopathic Male Infertility with a Combination of Tamoxifen Citrate and a Natural Compost with Antioxidant and Androgen-Mimetic Action

Abstract

Background: We investigated the efficacy of a combination therapy with tamoxifen citrate and a natural composite containing Tribulus terrestris, alga Ecklonia bicyclis and polymers of d-glucosamine and n-acetyl d-glucosamine in treating male idiopathic infertility.
Methods: In this prospective, randomized double blind, placebo-controlled study, we enrolled ninety infertile men at our department of urology at University Federico II of Naples. Mean age was 29.2 ± 7.8 [± SD]. Inclusion criteria consisted of the repeated exhibition of oligoasthenozoospermia (OA) without detectable cause (unexplained OA). Patients were randomly assigned to three treatment groups: Group A (n=30) receiving tamoxifene citrate (20 mg/day) and a natural composite with an antioxidant and androgen-mimetic action (150 mg of alga Ecklonia Bicyclis, 396 mg of Tribulus terrestris and 144 mg of polymers of d-glucosamine and n-acetyl d-glucosamine); Group B (n=30) receiving tamoxifene citrate (20 mg/day) and Group C receiving placebo (n=30). We evaluated the number of spontaneous pregnancies, sperm volume, concentration, sperm total motility, sperm forward progressive motility, normal sperm morphology.
Results: After 6 months of therapy the number of spontaneous pregnancies was markedly higher in the Group
A (13 pregnancies, 33.3%) then the other two groups: Group B (6 pregnancies, 20%) and Group C (4 pregnancies, 13.3%). Sperm concentration improved in the Group A from a mean 8.49 × 106 cells/ml ± 5.57 at baseline to 22.1 × 106 cells/ml ± 1,63 (p ≤ 0.001). In the Group B there was an improvement from a mean 7.98 × 106 at baseline to 14.43 × 106 cells/ml ± 3,43 (p=0.002). Group C did not see a statistically significant improvement of sperm number, from a concentration of 9.65 × 106 cells/ml ± 6.54 to 10.53 × 106 cells/ml ± 8.5 (p=0.0025). In Group A, sperm total motility improved from 31% ± 11% at baseline to 40% ± 14% (p=0.007) whilst the forward progressive motility slightly improved from 5% ± 3% to 9% ± 4% (p=0.0034). In the group B and C, there were not reported statistically significant changes of motility.
Conclusions: The combination therapy with tamoxifen citrate and the natural compound with an andorgen-mimetic and antioxidant action leads to a higher incidence of pregnancy rates and gives a statistically significant improvement of semen parameters comparing with the single use of tamoxifen citrate and with the control group.

Full text

Research Article Open Access
Steroids & Hormonal Science
Iacono et al., J Steroids Hormon Sci 2013, S5
http://dx.doi.org/10.4172/2157-7536.S5-002
J Steroids Hormon Sci Hormonal Therapy ISSN: 2157-7536 JSHS, an open access journal
Keywords: Male infertility; Antioxidant; Oligospermia;
Oligoasthenozoospermia (OA); Tamoxifen citrate
Background
Infertility is one of the most important issues among married
couples and it represents a major clinical problem aecting people not
just medically but psychologically too.
It has been demonstrated that 15% of all the couples in the US are
infertile and male factor is responsible for the 25% of the cases [1].
Couples that have not achieved a pregnancy in the last 12-24
months are considered as barren.
e cause of male infertility with abnormal semen parameters
remains unknown in 25% of men [2]. In many Western countries,
women postpone their rst pregnancy until they have nished their
education and have started a career, so also female age is the important
variable inuencing outcome in assisted reproduction. In fact
compared to a woman at 25 years old, the fertility potential is reduced
to 50% at age 35, to 25% by 38 years and <5% at over 40 years [3].
Men with idiopathic infertility are prone to receive a number of
empirical therapies.
Otherwise while 25% of men with sperm density lower than 12.5
million per ml could father a child through spontaneous conception,
10% with a normal female partner cannot contribute to pregnancy even
with a number of more than 25 million per ml [3].
ese ndings suggest that there could be other parameters that
aect pregnancy and study outcomes based only on improvement
in semen parameters are not enough. A more eective outcome
parameter would probably be the pregnancy rate since that is the
ultimate end point of therapy. Commonly used medications include
hormonal medications as follicle stimulating hormone (FSH),
androgens (mesterolone, testosterone undecanoate/enanthate) [3,4]
and antiestrogen (tamoxifen/clomiphen citrate); antioxidant like
glutathione, lycopene, vitamin E; Sperm vitalizer as L-carnitine, coQ10.
*Corresponding author: Ruffo A, Department of Urology, University “Federico
II’’ of Naples Via S. Pansini, 5 – 80131 Naples , Italy, Tel: +39 3339323372, +39
0817462607; E-mail: antonio.ruffo7@gmail.com
Received January 28, 2013; Accepted March 13, 2013; Published March 31,
2013
Citation: Iacono F, Prezioso D , Ruffo A, Di Lauro G, Illiano E, et al. (2013) Treating
Idiopathic Male Infertility with a Combination of Tamoxifen Citrate and a Natural
Compost with Antioxidant and Androgen-Mimetic Action. J Steroids Hormon Sci
S5: 002. doi:10.4172/2157-7536.S5-002
Copyright: © 2013 Iacono F, et al. This is an open-access article distributed under
the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and
source are credited.
Treating Idiopathic Male Infertility with a Combination of Tamoxifen
Citrate and a Natural Compost with Antioxidant and Androgen-Mimetic
Action
Iacono F, Prezioso D , Ruffo A*, Di Lauro G, Illiano E, Romeo G and Romis L
Department of Urology, University “Federico II’’ of Naples, Italy
Abstract
Background: We investigated the efcacy of a combination therapy with tamoxifen citrate and a natural composite
containing Tribulus terrestris, alga Ecklonia bicyclis and polymers of d-glucosamine and n-acetyl d-glucosamine in
treating male idiopathic infertility.
Methods: In this prospective, randomized double blind, placebo-controlled study, we enrolled ninety infertile men
at our department of urology at University Federico II of Naples. Mean age was 29.2 ± 7.8 [± SD]. Inclusion criteria
consisted of the repeated exhibition of oligoasthenozoospermia (OA) without detectable cause (unexplained OA).
Patients were randomly assigned to three treatment groups: Group A (n=30) receiving tamoxifene citrate (20 mg/day)
and a natural composite with an antioxidant and androgen-mimetic action (150 mg of alga Ecklonia Bicyclis, 396 mg of
Tribulus terrestris and 144 mg of polymers of d-glucosamine and n-acetyl d-glucosamine); Group B (n=30) receiving
tamoxifene citrate (20 mg/day) and Group C receiving placebo (n=30). We evaluated the number of spontaneous
pregnancies, sperm volume, concentration, sperm total motility, sperm forward progressive motility, normal sperm
morphology.
Results: After 6 months of therapy the number of spontaneous pregnancies was markedly higher in the Group
A (13 pregnancies, 33.3%) then the other two groups: Group B (6 pregnancies, 20%) and Group C (4 pregnancies,
13.3%). Sperm concentration improved in the Group A from a mean 8.49 × 106 cells/ml ± 5.57 at baseline to 22.1 ×
106 cells/ml ± 1,63 (p ≤ 0.001). In the Group B there was an improvement from a mean 7.98 × 106 at baseline to 14.43
× 106 cells/ml ± 3,43 (p=0.002). Group C did not see a statistically signicant improvement of sperm number, from a
concentration of 9.65 × 106 cells/ml ± 6.54 to 10.53 × 106 cells/ml ± 8.5 (p=0.0025). In Group A, sperm total motility
improved from 31% ± 11% at baseline to 40% ± 14% (p=0.007) whilst the forward progressive motility slightly improved
from 5% ± 3% to 9% ± 4% (p=0.0034). In the group B and C, there were not reported statistically signicant changes
of motility.
Conclusions: The combination therapy with tamoxifen citrate and the natural compound with an andorgen-mimetic
and antioxidant action leads to a higher incidence of pregnancy rates and gives a statistically signicant improvement
of semen parameters comparing with the single use of tamoxifen citrate and with the control group.

Citation: Iacono F, Prezioso D , Ruffo A, Di Lauro G, Illiano E, et al. (2013) Treating Idiopathic Male Infertility with a Combination of Tamoxifen Citrate
and a Natural Compost with Antioxidant and Androgen-Mimetic Action. J Steroids Hormon Sci S5: 002. doi:10.4172/2157-7536.S5-002
Page 2 of 6
J Steroids Hormon Sci Hormonal Therapy ISSN: 2157-7536 JSHS, an open access journal
Of the many causes of male infertility, oxidative stress (OS) has
been shown to aect the fertility status and for this reason it has been
widely studied in the past few years.
Spermatozoa, like all other aerobic cells are particularly susceptible
to oxidative stress induced damage because of the large polyunsaturated
fat content in their membranes. Men with high ROS may have a lower
fertility potential compared to those with low ROS [5].
High levels of reactive oxygen species in semen have been correlated
with reduced sperm motility and damage to sperm nuclear DNA [5].
For example, IL-1 α, IL-1 β and tumor necrosis factorα (TNF-α),
stimulate sperm peroxidation by increasing ROS generation [6]; IL-6
has been shown to play a pivotal role in the induction of capacitation
and the acrosomal reaction in sperm [7]. However, high levels of
cytokines in the semen have been correlated with sperm injury, most
notably cell membrane lipid peroxidation in the presence of elevated
IL-6 [6,8]. Further, increased levels of IL-6 have also been noted in the
seminal uid of infertile men [9].
Also, IL-1, IL-6, IL-8 and TNF have all been shown to induce
increased ROS production, leading to increased sperm cell membrane
lipid peroxidation [6,8,10].
Interferon gamma (IFN-γ) and TNFα have been shown to decrease
the motility of spermatozoa.
is condition is common in cases of genitourinary tract infections
and inammation, in which oxidative mechanism produce the
oxidative stress [11].
Antioxidants in seminal plasma are the most important form of
protection available to spermatozoa against ROS [6,12].
at is why it is commonly used to prescribe antioxidant oral
therapy for the idiopathic male oligoastenospermia to decrease
oxidative stress and improve fertility.
Antiestrogens have been one of the oldest and most commonly
prescribed forms of therapy for idiopathic male infertility. ese drugs
inhibit the negative feedback eect of estrogen on the hypothalamus
and pituitary, increasing endogenous gonadotropin secretion.
Antiestrogen therapy was reported to yield pregnancy rates
ranging from 20%–40% following 6-9 months of therapy [13] from the
hypothalamus and FSH and LH secretion directly from the pituitary,
increasing their levels, thereby stimulating spermatogenesis [14].
Pregnancy rates following varicocelectomy were approximately
40% [15].
Methods
is is a prospective, randomized double blind, placebo-controlled
study. We enrolled ninty infertile men attending our department of
urology at University Federico II of Napsssles. Mean age of male partner
was 29.2 ± 7.8 [±SD] while female partner mean age was 27.4 ± 6.8 [±
SD]. We included a minimum of 1 year of regular unprotected sexual
activity without achieving pregnancy. Inclusion criteria consisted of
the repeated exhibition of oligoasthenozoospermia without detectable
cause (unexplained OA). We evaluated the number of spontaneous
pregnancy, sperm volume and concentration, sperm total motility,
forward progressive motility and normal morphology.
Exclusion criteria included cases with known etiology or
leukocytospermia, and alterated testicular volume, varicocele (as
detected by clinical examination and ultrasonography) or an abnormal
FSH level. Couples with combined male and female factors were
excluded. Patients signed a informed consent explaining the nature of
the study, the possibility of treatment failure, and possible side eects.
ey underwent a clinical evaluation including history taking, general
examination, and genital examination for possible causes of infertility.
Investigations for the male partner included semen analysis according
to World Health Organization criteria [16]. Only couples with no
female factor infertility were included in the study.
Patients were blindly randomized into three groups: Group A
(time of infertility 2.4 ± 1.2 years [± SD]) receiving a combination of
an antiestrogen [tamoxifen citrate 20 mg/day] and a natural composite
with an antioxidant and androgen-mimetic action [150 mg of alga
Ecklonia Bicyclis, 396 mg of Tribulus terrestris and 144 mg of polymers
of d-glucosamine and n-acetyl d-glucosamine (Tradamix®); n=30];
Group B (time of infertility 2.2 ± 1.1 years [± SD]) receiving tamoxifen
citrate (n=30) and Group C (time of infertility 1.9 ± 1.0 years [± SD]
receiving placebo (n=30). Treatment was continued for 6 months. All
statistical measurements were performed using ANOVA tests. We
wanted to have a level of signicance with p<0.05.
Results
Aer 6 months of therapy the cumulative number of pregnancy
was markedly higher in the Group A (13 pregnancies, 33.3%) then
the other two groups: Group B (6 pregnancies, 20%) and Group C (4
pregnancies, 13.3%). is dierence is statistically signicant (p=0.023)
(Table 1).
In the tables 1 and 2, are reported the changing in semen parameters
before and aer treatment in the three groups.
Sperm concentration signicantly improved in the Group A from
a mean 8.49 × 106 cells/ml ± 5,57 at baseline to 22.1×106 cells/ml ± 1,63
(p ≤ 0.001) comparing with the tamoxifen recipients (Group B) where
the was an improvement from a mean 7.98 × 106 at baseline to 14.43 ×
106 cells/ml ± 3.43 (p=0.002). Group C had an improvement of sperm
number, from a concentration of 9.65 × 106 cells/ml ± 6.54 to 10.53
×106 cells/ml ± 8.5 (p=0.0025) (Table 2A).
Group Cases Pregnancies
(1-3 mo)
Pregnancies
(3-6 mo)
Total
pregnancies
Tamoxifen+Tradamix®30 6 7 13 (33.3%,
p=0.025)
Tamoxifen 30 3 3 6 (20%,
p=0.032)
Placebo 30 2 2 4 (13.3%,
p=0.038)
Table 1: Pregnancy rates in the 3 Groups.
Table 2A: Semen parameters before treatment in the 3 Groups.
Semen parameters before treatment
Group Volume (ml) Count (× 106) TM (%) FPM (%) ABF (%)
Tamoxifen+Tradamix®2.4 8.49 31 5 37
Tamoxifen 2.2 7.98 30 8 39
Placebo 2.5 9.65 29 6 37
Table 2B: Semen parameters after treatment in the 3 Groups.
Semen parameters after treatment
Group Volume (ml) Count (× 106) TM (%) FPM (%) ABF (%)
Tamoxifen+Tradamix®3.2 22.1 40 7 35
Tamoxifen 2.7 21.6 35 5 38
Placebo 2.9 10.53 30 4 48

Citation: Iacono F, Prezioso D , Ruffo A, Di Lauro G, Illiano E, et al. (2013) Treating Idiopathic Male Infertility with a Combination of Tamoxifen Citrate
and a Natural Compost with Antioxidant and Androgen-Mimetic Action. J Steroids Hormon Sci S5: 002. doi:10.4172/2157-7536.S5-002
Page 3 of 6
J Steroids Hormon Sci Hormonal Therapy ISSN: 2157-7536 JSHS, an open access journal
In Group A sperm total motility improved from 31% ± 11%
at baseline to 40% ± 14% (p=0.007) whilst the forward progressive
motility slightly improved from 5% ± 3% to 9% ± 4% (p=0.0034). For
the other two groups there were not reported statistically signicant
changes of motility (Table 2B).
Seminal volume did not change aer the treatment in the Group A
(2.47 ± 1.4 at baseline, 2.9 ± 1.6 at 6 months) and no dierence from
Group B and placebo recipients (Group C) were observed.
No remarkable dierence in sperm form was reported.
Discussion
In this study, we evaluated the eectiveness of the combination of
tamoxifen citrate and this natural compost in treating idiopathic male
infertility. Combination therapy for male infertility has been evaluated
by other investigators. Comhaire et al. [17] studied 30 men with
infertility and female partners with no demonstrable cause of infertility
who received conventional treatment according to the guidelines of
the World Health Organization [16], and either a strong antioxidant,
astaxanthin (16 mg/day), or a placebo for 3 months. e results revealed
total pregnancy rates of 10.5% among the placebo cases, compared with
54.5 in the active treatment arm (p=0.028).
Our results (Table 1) are similar with the findings of Adamopolous
and Comhaire, and suggest that combination therapies for male
infertility should be further evaluated [18,19].
A recent short review assessing evidence-based treatments for male
infertility show many methodological difficulties with these works [20]
given by the short duration of most of these studies. Although married
couples are allowed 1 year of unprotected intercourse to conceive before
a diagnosis of infertility is made, most studies allow only an average of 3
months of observation, even if seminal parameters improve. Results of
medical treatment in terms of cumulative pregnancy rates may dier if
the observation period is long enough. is has been clearly suggested
by the improved pregnancy rate aer 6 months shown in our work as
well as by Adamopolous et al. [18] and Ghanem et al. [20]. is study
suggests that combination of an antiestrogen with a substance with an
antioxidant and androgen-mimetic action is a valid therapy for men
with oligoasthenozoospermia.
is composite (Tradamix®) contains these three compounds: alga
Ecklonia bicyclis, Tribulus terrestris and polymers of d-glucosamine
and n-acetyl-d-glucosamine.
Alga bicyclis is a macro algae widely distributed along the Pacic
coast of central Japan and Korea where, when conditions are suitable,
forming extensive underwater meadows (kelp forests), oen mixed.
e biological properties attributed to these species are instead traced
to the presence of particular secondary metabolites also known as
the phlorotannins and made the union of various units of the same
monomer, the 1,3,5-triidrossi phenol or phloroglucinol. So far a
dozen such compounds has been identied, the most important
of which are shown in the gures [21-24]. Right now, more than
20,000 new compounds have been isolated from marine organisms;
numbers of these naturally occurring derivatives are developed as
potential candidates for pharmaceutical applications. Phlorotannins
are secondary metabolites distributed in a variety of plants. ey are
phloroglucin derivatives with a variety of biological functions in vitro
and in vivo, such as a strong radical scavenging and antioxidant action
[25,26].
Ecklonia cava radical scavenger activity 10-100 powerful than any
other polifenol terrestris plants, including green tea catechins, which
have only 3-4 fenolic and rings that are commonly considered among
the most eective antioxidant molecules. Common polyphenols are
soluble in water also and have a relatively short half-life introduced
into the body. All phlorotannins had antioxidant properties in vitro,
especially, bieckol, dieckol and phlorofucofuroeckol [26] (Figures 1-3).
Inammatory cells might generate and release a number of
inammatory mediators: for example, proinammatory cytokines and
inammatory cytokines, such as interleukins [27-30], TNF-α [27-30],
p53 [31], cytochrome P-450 [27-32] and NADPH-cytochrome P-450
[27-31] causing abnormal metabolism of the hypoxanthine/xanthine
oxidase system and the xanthine/xanthine oxidase system, producing
many abnormal metabolites [27-33].
ese inammatory cells and reactions might also activate and
release a large amount of COX-2 [27-29] transcription NF-k B [27-29]
iNOS, and an amount of inammatory oxidants and other chemokines
[27,34,35] and without question, they might induce, generate and
release a large number of O2
-
, ·OH, NO and other free radicals, as well
as O2, H2O2, and other ROS [27,28,31,33,34]. Excessive free radicals and
ROS, as strong oxidants, might aects replication and transcription
OH
OH
OH
OH
OH
OH
OH
OH
HO
HO
HO
HO
O
O
O
O
O
O
Figure 1: Bieckol.
OH
OH
OH
OH
OH
OH
OH
OH
HO
HO
HO
O
O
O
O
O
O
O
Figure 2: Dieckol.

Citation: Iacono F, Prezioso D , Ruffo A, Di Lauro G, Illiano E, et al. (2013) Treating Idiopathic Male Infertility with a Combination of Tamoxifen Citrate
and a Natural Compost with Antioxidant and Androgen-Mimetic Action. J Steroids Hormon Sci S5: 002. doi:10.4172/2157-7536.S5-002
Page 4 of 6
J Steroids Hormon Sci Hormonal Therapy ISSN: 2157-7536 JSHS, an open access journal
of mtDNA and results in a decline in mitochondrial function which
in turn leads to enhanced ROS production and further damage to
mtDNA [36].
In the Ecklonia cava there are molecules that are able to reduce the
response inammatory, partially neutralizing the inammatory damage
caused by ROS and in part by slowing the gaming lipoxygenase and
inhibiting the formation of prostaglandin E2, a powerful inammatory
mediator. Jung et al. revealed that dieckol inhibits LPS-induced NO
and PGE2 [37] production in a concentration-dependent manner
and inhibits inducible iNOS and COX-2 in BV2 microglia without
causing [38,39]. Alga ecklonia treatment signicantly reduced NF-kB
translocation and DNA-binding in LPS-stimulated BV2 microglia [39]
and p38 mitogen-activated protein kinases (MAPKs) activation [37].
Phlorotannins suppresses the induction of cytokines by LPS, as well
as iNOS and COX-2 expression, by blocking NF-kappaB and MAPK
activationas well as reactive oxygen species (ROS) production [39].
ese ndings provide mechanistic insights into the anti-inammatory
and neuroprotective actions of EC in BV2 microglia [40]. It also
signicantly reduced the generation of proinammatory cytokines,
such as interleukin (IL)-1β and tumor necrosis factor (TNF)-α.
Kim et al. revealed extracts reduced the concentrations of IL-4 and
IL-5 by 66% and 84%, respectively, and resulted in a 73% reduction in
the secretion of TNF-α [35].
e second compound contained in the composite used in this
therapy is Tribulus terrestris. is plant native of India, but now present
in most of North America has a weed Active ingredients: protodioscin.
e plant contains also avonoids, alkaloids and amides, although its
properties seem to be completely attribuited to protodioscin (Figure 4).
e parts used are the seeds and fruits, and, more generally, the
aerial parts of the plant. e protodioscin is a steroidal saponin, which is
about 45% of the extract obtained from aerial parts of Tribulus terrestris
(Figure 4). e substance is able to increase the endogenous production
of testosterone, dihydrotestosterone, a hormone luteinizing hormone
(LH), dehydroepiandrosterone (DHEA) and dehydroepiandrosterone
sulfate (DHEA-S) [40]. Because of these eects in experimental animals
there is an increase in spermatogenesis and the frequency of matches
[41]. In the rabbit in particular has been shown that the compound
stimulates the release of nitric oxide (NO) by vascular endothelium
of the corpora cavernosa thereby having a pro-erectile eect [41].
e mechanism behind this eect appears to involve the pathway of
steroid hormones [41]. Although humans protodioscin is used for the
treatment of erectile dysfunction [42, 43].
A study conducted on 150 italian patients aected by erectile
dysfunction treated with the same composite containing Tribulus
terrestris, alga Ecklonia bicyclis and polymers of d-glucosamine
and n-acetyl-d-glucosamne showed and improvement of 28% of the
testosterone levels from a baseline mean value of 5.3 ± 1.1 ng/ml to 6.8
± 1.6 (p<0.01) post treatment [44].
Polymers of d-glucosamine and n-acetyl-d-glucosamine acts on as
a nitric oxide synthetase (NOS) stimulator [44] (Figure 5).
Nitric oxide (NO) is a free radical generated from the oxidation
of L-arginine to L-citrulline by reduced nicotinamide adenine
dinucleotide phosphate (NADPH)-dependent nitric oxide synthase
(NOS). Nitric oxide is diusible, multifunctional, and acts as a
transcellular messenger, being implicated in numerous physiologic and
pathologic conditions [45].
Nitric oxide, at physiologic concentrations, is relatively nonreactive,
but most of its actions are mediated by activation of cyclic guanosine
monophosphate production [46]. It is reported that NO modulates
sexual and reproductive functions in mammalian species [47,48]. e
presence of NO in seminal plasma has been conrmed [49]. e source
of NO in seminal plasma may be either male reproductive organs or
macrophages [50,51]. e production of NO in human and animal
sperm has also been reported [50,51].
Nitric oxide is reported to be a novel mediator of sperm function
[52]. It has both positive and negative eects. e positive modulation
reects the role of NO in physiologic processes like sperm capacitation
[52] and acrosome reaction [53].
HO
OH
OH
OH
OHOH
OH
OH
HO
O
O
O
O
O
Figure 3: Phlorofucofuroeckol.
O
O
O
O
OO
HO
HO
OH
OH
OH
HO
HO
HO
OH
OH
OH
O
O
O
H
H
H
H
H
HO
HO
Figure 4: Protodioscin contained in Tribulus terrestris.
CH2OH CH2OH CH2OH
O
O
O
OOOH
OH
OHOH
NH2NH2NH2
OH
n
Figure 5: Polymers of d-glucosamine and n-acetyl-d-glucosamine.

Citation: Iacono F, Prezioso D , Ruffo A, Di Lauro G, Illiano E, et al. (2013) Treating Idiopathic Male Infertility with a Combination of Tamoxifen Citrate
and a Natural Compost with Antioxidant and Androgen-Mimetic Action. J Steroids Hormon Sci S5: 002. doi:10.4172/2157-7536.S5-002
Page 5 of 6
J Steroids Hormon Sci Hormonal Therapy ISSN: 2157-7536 JSHS, an open access journal
Conclusion
In conclusion, in this study we investigated that the association of
an antiestrogen and a natural compound containing antioxidant and
androgen-mimetic substances is a valid, safe and eective therapy for
treating men with idiophatic oligoasthenozoospermia.
In fact we have demonstrated that the use of this combination
signicantly improves the number and the motility of sperms.
Furthermore there is an improvement of the pregnancy rate comparing
with the group taking just tamoxifen citrate and to placebo recipients.
is treatment protocol is inexpensive, safe, and easy to administer.
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Citation: Iacono F, Prezioso D , Ruffo A, Di Lauro G, Illiano E, et al. (2013) Treating Idiopathic Male Infertility with a Combination of Tamoxifen Citrate
and a Natural Compost with Antioxidant and Androgen-Mimetic Action. J Steroids Hormon Sci S5: 002. doi:10.4172/2157-7536.S5-002
Page 6 of 6
J Steroids Hormon Sci Hormonal Therapy ISSN: 2157-7536 JSHS, an open access journal
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This article was originally published in a special issue, Hormonal Therapy
handled by Editors. Dr. Ratna K Vadlamudi, University of Texas San Antonio,
TX, USA; Dr. Baharudin Bin Abdullah, School of Medical Sciences, Health
Campus USM, Malaysia
Citation: Iacono F, Prezioso D , Ruffo A, Di Lauro G, Illiano E, et al. (2013)
Treating Idiopathic Male Infertility with a Combination of Tamoxifen Citrate and
a Natural Compost with Antioxidant and Androgen-Mimetic Action. J Steroids
Hormon Sci S5: 002. doi:10.4172/2157-7536.S5-002
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