Role of clomiphene citrate therapy in men with oligospermia

Abstract AR

Objective : To determine if treatment with clomiphene citrate can improve the parameters of seminal fluid analysis in oligospermic men and to determine if there is any impact on pregnancy rates.

Methods : 102 physically healthy oligospermic men with infertile marriages of more than 3 years, who were being seen at the King Hussein Medical Center for infertility, were enrolled in this study.

All patients had no benefit from other non-hormonal empirical therapy.

Rigid criteria of selection were applied.

Pretreatment serum levels of follicle stimulating hormone had to be in the normal or low-normal range.

After obtaining basal seminal fluid analysis parameters, the patients were randomly divided into two groups.

Sixty patients were given clomiphene citrate, 25mg/day for 25 days followed by a break of 5 days, for 4 cycles.

Forty-two patients received no medication and were used as the control group during the study period.

Hormonal assay and seminal fluid analysis were repeated 8 weeks after completion of the therapy.

Results : In the treatment group, there was a significant increase in sperm density, but little change in morphology or motility.

Serum levels of follicle stimulating hormone, luteinizing hormone, and testosterone were also elevated at the end of the treatment period.

The wives of 12 patients became pregnant within 6 months of the start of the study.

Only minor side effects of treatment were noted.

In the control group, there was no significant change in the hormonal assay or seminal fluid analysis results at the end of the study period.

There were 3 pregnancies in this group.

Cwefajti)*: Anti-estrogen treatment in the form of low-dose clomiphene citrate may be an effective treatment for properly selected oligospermic men.