Clomiphene for Male Infertility

Abstract

Objective:

To review the use of clomiphene for the treatment of male infertility.

Data Sources:

A MEDLINE search covering the years 1966 through 1994 was used to identify pertinent literature.

Study Selection:

Only placebo-controlled studies using dosages of clomiphene 25–50 mg/d for at least 3 months were reviewed.

Data Extraction:

Because there are numerous uncontrolled reports claiming success with clomiphene for the treatment of male infertility, only controlled studies with clomiphene 25–50 mg/d are discussed. This dosage range was selected because higher dosages of clomiphene may suppress spermatogenesis.

Data Synthesis:

Although the study conducted by the World Health Organization demonstrated an increase in both sperm count and motility after clomiphene treatment, no difference in pregnancy rates between the clomiphene-treated and placebo groups was observed. No significant difference in pregnancy rates was seen in a randomized trial comparing clomiphene with vitamin C. Of the four studies discussed, only one concluded that clomiphene was effective in increasing sperm concentration and pregnancy rates. However, the results do not establish a causal role for clomiphene.

Conclusions:

To assess the efficacy of clomiphene for the treatment of male infertility, better-designed studies need to be done. Information regarding comparability of female cohorts should be included, and results should be stratified according to the severity of oligospermia.