Evaluation of Sperm Parameters in Clinical Trial With Clomiphene Citrate of Oligospermic Men

Mićić, Sava; Dotlić, R

doi:10.1016/s0022-5347(17)48889-6

Cited by 59 publications

(41 citation statements)

References 8 publications

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“…Significant improvements in semen volume, sperm density and motility were observed in the 56 men randomized to CC therapy versus the 45 controls. Seven pregnancies were observed in the treatment group versus zero in the control group ( 15 ).…”

Section: Clomiphene Citrate (Clomid Cc)mentioning

confidence: 91%

Frontiers in hormone therapy for male infertility

Khourdaji¹,

Lee²,

Smith³

2018

Transl. Androl. Urol.

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For a significant number of couples worldwide, infertility is a harsh reality. As specialists in male infertility, much of our armamentarium lacks definitive, evidence-based therapies. For years, we have relied on manipulation of the male hormonal axis to treat those men who help carry the burden of infertility in their partnerships. Indeed, male factor infertility is the sole component of infertility in at least 20% of couples. Further compounding this dilemma is that 25% to 50% of males with infertility have no identifiable etiology and thus present a true management conundrum. This manuscript is an attempt to clarify what therapies exist for the treatment of male factor infertility. We have reviewed the relevant infertility literature honing, our focus on hormonal anomalies and their subsequent impact on fertility. Many of the therapies discussed have been utilized in practice for generations. Thus, this article attempts to provide the evidence-based literature to support the continued use of the current treatment paradigm. Furthermore, we recognize that any review beckons a discussion of what challenges and therapies await on the horizon. For instance, there has been significant interest in restoring spermatogenesis after testosterone replacement therapy (TRT). We explore the adverse long-term spermatogenic outcomes associated with TRT, which with the widespread use of TRT, will inevitably present a great challenge for male infertility specialists. Moreover, we discuss the role of varicocelectomy in the treatment of hypogonadism and infertility, review the association between growth hormone (GH) and male fertility and address the challenges presented by the rising prevalence of obesity.

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Section: Clomiphene Citrate (Clomid Cc)mentioning

confidence: 91%

Frontiers in hormone therapy for male infertility

Khourdaji¹,

Lee²,

Smith³

2018

Transl. Androl. Urol.

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“… 66 Since then, it has been used off-label to treat various subpopulations of infertile men with reported dosing schedules ranging from 25 to 50 mg administered daily, every other day or cyclically with intermittent “off periods,” all of which may be titrated based upon serum testosterone levels. 67 68 69 Several studies looking at CC use in men with secondary hypogonadism demonstrate clear improvement in serum testosterone levels, hypogonadal symptoms, and testosterone: estrogen ratios indicative of CC's positive therapeutic effects on the HPG axis. 69 70 71 Similarly, the use of CC in men with idiopathic oligospermia or azoospermia with or without hypogonadism has demonstrated favorable changes in hormone profiles and semen analyses, but data evaluating pregnancy rates have yielded conflicting results.…”

Section: Pharmacologic Agents To Restore or Maintain Spermatogenesismentioning

confidence: 99%

Recovery of spermatogenesis following testosterone replacement therapy or anabolic-androgenic steroid use

McBride

Coward

2016

Asian J Androl

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The use of testosterone replacement therapy (TRT) for hypogonadism continues to rise, particularly in younger men who may wish to remain fertile. Concurrently, awareness of a more pervasive use of anabolic-androgenic steroids (AAS) within the general population has been appreciated. Both TRT and AAS can suppress the hypothalamic-pituitary-gonadal (HPG) axis resulting in diminution of spermatogenesis. Therefore, it is important that clinicians recognize previous TRT or AAS use in patients presenting for infertility treatment. Cessation of TRT or AAS use may result in spontaneous recovery of normal spermatogenesis in a reasonable number of patients if allowed sufficient time for recovery. However, some patients may not recover normal spermatogenesis or tolerate waiting for spontaneous recovery. In such cases, clinicians must be aware of the pathophysiologic derangements of the HPG axis related to TRT or AAS use and the pharmacologic agents available to reverse them. The available agents include injectable gonadotropins, selective estrogen receptor modulators, and aromatase inhibitors, but their off-label use is poorly described in the literature, potentially creating a knowledge gap for the clinician. Reviewing their use clinically for the treatment of hypogonadotropic hypogonadism and other HPG axis abnormalities can familiarize the clinician with the manner in which they can be used to recover spermatogenesis after TRT or AAS use.

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“…Significant improvements in sperm density and motility were observed in the treated group. Seven pregnancies were reported in the treated group, while no pregnancies were observed in the control group (30). Wang et al randomized 46 men with idiopathic oligospermia to 6 months of treatment with a placebo, CC (25 or 50 mg/day), mesterolone (100 mg/day), or pentoxifylline (1,200 mg/day) or 4 months of treatment with testosterone enanthate (100 or 250 mg every other week).…”

Section: Therapeutic Approachesmentioning

confidence: 87%

Testosterone replacement in the infertile man

Majzoub

Sabanegh

2016

Transl. Androl. Urol.

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Hypogonadism is a common clinical condition affecting men of different age groups. In addition to its sexual consequences, it has several implications posing significant concerns for a man’s health and well-being. Recent advances in testosterone (T) supplementation have facilitated hypogonadism treatment. Despite that, patients complaining of infertility or seeking conception are still hindered by the unfavorable effects supplemental T has on testicular function. Consequently, alternative approaches that can stimulate endogenous T production are favored. Selective estrogen receptor modulators, gonadotropins and aromatase inhibitors (AIs) can be successful in restoring serum T levels, preserving fertility, and providing symptomatic relief.

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Evaluation of Sperm Parameters in Clinical Trial With Clomiphene Citrate of Oligospermic Men

Cited by 59 publications

References 8 publications

Frontiers in hormone therapy for male infertility

Frontiers in hormone therapy for male infertility

Recovery of spermatogenesis following testosterone replacement therapy or anabolic-androgenic steroid use

Testosterone replacement in the infertile man

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