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Medikamentöse Therapiemöglichkeiten des Oligo-Astheno-Teratozoospermie-Syndroms

Drug therapy options for oligoasthenoteratozoospermia syndrome

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Zusammenfassung

Die medikamentösen Therapiemöglichkeiten des Oligo-Astheno-Teratozoospermie- (OAT-)Syndroms sind vielschichtig. Als klassische Indikationen kommen hierbei hormonelle Störungen sowohl auf hypothalamischer, als auch auf hypophysärer Ebene sowie (sehr viel seltener) die Hyperprolaktinämie in Frage. Weiter gut medikamentös behandelbar sind v. a. akute oder chronische urogenitale Infektionen und Ejakulationsstörungen. Weil häufig keine Ursache für das OAT-Syndrom gefunden werden kann, wird v. a. bei diesen Patienten seit Jahrzehnten mit unterschiedlichen medikamentösen Ansätzen eine Verbesserung der Ejakulatqualität versucht. Die Gabe von Antiöstrogenen, Antioxidantien, Hormonen und Spurenelementen ist in diesem Zusammenhang zu erwähnen. Die Studienlage hierzu ist aber diskrepant und muss kritisch bewertet werden. Dieser Artikel versucht eine Übersicht der aktuellen medikamentösen Therapieoptionen zu geben, erfolglose frühere Anwendungen zu nennen und einen Blick in zukünftige Konzepte zu werfen.

Abstract

Medical treatment of oligoasthenoteratozoospermia (OAT) syndrome includes many different treatment concepts. The targeted causes in the treatment of OAT syndrome are either hormonal, as for example hypothalamic, pituary, or, seldom, hyperprolactinemic disturbances, or acute or chronic urogenital infections, as well as ejaculatory disorders. Often no pathogenic reason for OAT syndrome can be found and targeted. Most treatment concepts in the past tried to improve sperm quality. Administration of antiestrogens, antioxidants, hormones, and micronutrients has been tried and used to improve spem quality. The present article provides an overview of current medical treatment options for OAT syndrome, including former unsuccessful treatment concepts. The article furthermore sketches out potential treatment options, which might be available in the future.

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  1. Urologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, Campus Großhadern, Klinikum der Universität München, Marchioninistraße 15, 81377, München, Deutschland

    M. Trottmann, M. Dickmann, C.G. Stief & A.J. Becker

  2. Andrologicum München, München, Deutschland

    F.M. Köhn

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  1. M. Trottmann
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Trottmann, M., Köhn, F., Dickmann, M. et al. Medikamentöse Therapiemöglichkeiten des Oligo-Astheno-Teratozoospermie-Syndroms. Urologe 50, 8–16 (2011). https://doi.org/10.1007/s00120-010-2437-y

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