Clomiphene citrate treatment in oligozoospermia: comparison between two regimens of low-dose treatment

Clomiphene citrate (CC) is a well-known drug in fertility clinics that is used for increasing gonadotropin secretion. The present study was planned in order to evaluate the efficiency of a new regimen of treatment by 25 mg on alternate days (group A), compared to a daily dose of 25 mg (25 days on, 5 days off, group B), for 4 months. Semen quality was assessed in two matched groups, which consisted of 45 and 44 normogonadotropic oligoterato-asthenozoospermic (OTA) men, respectively. Nine men in group A and 22 in group B did not respond to therapy by improvement in semen quality. The statistical evaluation of the results revealed group A to yield the highest improvement in sperm concentration (P less than 0.0008) and total sperm count (P less than 0.004). Sperm motility was improved only in group A. No changes were recorded in the morphology of the sperm cells or in semen volume. Pregnancy rate after 6 months of follow-up was 26.7% and 20.5%, in couples of groups A and B, respectively. This study implicates the use of CC (25 mg on alternate days) in andrologic clinics as one of the recommended drugs for normogonadotropic OTA subfertile men in order to achieve a significant increase in sperm concentration and total sperm count.