Temporal Changes of Clomiphene on Testosterone Levels and Semen Parameters in Subfertile Men
Purpose: Clomiphene citrate (CC) is prescribed off-label in men to improve testosterone and sperm parameters, but the duration of treatment needed to reach maximal benefit remains unclear. Our objective was to examine temporal effects of CC on total testosterone (TT) and semen analysis (SA) using...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Sexual Medicine and Andrology
2023-01-01
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| Series: | The World Journal of Men's Health |
| Subjects: |
| _version_ | 1828085940329906176 |
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| author | Tommy Jiang John T. Sigalos Vadim Osadchiy Alvaro Santamaria Michael H. Zheng Neilufar Modiri Keith V. Regets Jesse N. Mills Sriram V. Eleswarapu |
| author_facet | Tommy Jiang John T. Sigalos Vadim Osadchiy Alvaro Santamaria Michael H. Zheng Neilufar Modiri Keith V. Regets Jesse N. Mills Sriram V. Eleswarapu |
| author_sort | Tommy Jiang |
| collection | DOAJ |
| description | Purpose: Clomiphene citrate (CC) is prescribed off-label in men to improve testosterone and sperm parameters, but the duration
of treatment needed to reach maximal benefit remains unclear. Our objective was to examine temporal effects of CC on
total testosterone (TT) and semen analysis (SA) using longitudinal follow-up data in treated men.
Materials and Methods: We analyzed an IRB-approved database of men treated with CC (25 mg q.d. or 50 mg q.o.d.) from
January 2016 through May 2021. We identified patients with 3, 6, 9, and 12 month follow-up data for TT and 3, 6, and 9
month follow-up SA. Mean absolute changes in TT and sperm concentration compared to baseline were calculated, along
with 95% confidence intervals. Men with prior genitourinary procedures or hormone therapy were excluded. Paired t-tests
were used to compare TT and sperm concentration at each time point to baseline (alpha=0.05).
Results: One hundered thirty-four men received CC, mean age 37.7 years (SD 6.7, range 24–52). TT at all follow-ups (3, 6,
9, and 12 months) were available for 25 men, and SA at 3, 6, and 9 months for 26 men. Baseline TT was 358±145 ng/dL and
sperm concentration was 13±17.2 M/mL. Significant improvement in TT was identified at 3 months (62.7 ng/dL, 95% CI:
0.49–125.0, p=0.048), additional benefit at 6 months (181.8 ng/dL, 95% CI: 114.1–249.5, p<0.01), and plateau at 9 and 12
months. Improvement in sperm concentration was first observed at 9 months (20.7 M/mL, 95% CI: 10.2–31.2, p<0.01). Semen
volume and sperm motility did not change.
Conclusions: Duration of treatment with clomiphene may impact testosterone and sperm concentration, and the historical 3
month milestone may be insufficient for clinical and research evaluation. Men taking CC may experience plateau in TT at 6
months and first benefit in sperm concentration at 9 months. |
| first_indexed | 2024-04-11T04:47:49Z |
| format | Article |
| id | doaj.art-72eab6da0cd0417790bace42993b27fd |
| institution | Directory Open Access Journal |
| issn | 2287-4208 2287-4690 |
| language | English |
| last_indexed | 2024-04-11T04:47:49Z |
| publishDate | 2023-01-01 |
| publisher | Korean Society for Sexual Medicine and Andrology |
| record_format | Article |
| series | The World Journal of Men's Health |
| spelling | doaj.art-72eab6da0cd0417790bace42993b27fd2022-12-27T08:35:54ZengKorean Society for Sexual Medicine and AndrologyThe World Journal of Men's Health2287-42082287-46902023-01-0141119820310.5534/wjmh.220010Temporal Changes of Clomiphene on Testosterone Levels and Semen Parameters in Subfertile MenTommy Jiang0https://orcid.org/0000-0002-1199-0615John T. Sigalos1https://orcid.org/0000-0001-9458-9626Vadim Osadchiy2https://orcid.org/0000-0003-0492-9987Alvaro Santamaria3https://orcid.org/0000-0002-7953-4253Michael H. Zheng4https://orcid.org/0000-0001-5760-0486Neilufar Modiri5https://orcid.org/0000-0003-1465-0808Keith V. Regets6https://orcid.org/0000-0002-9563-4211Jesse N. Mills7https://orcid.org/0000-0002-7833-7071Sriram V. Eleswarapu8https://orcid.org/0000-0003-1852-4833Division of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USADivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USADivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USADivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USADivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USADivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USADivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USADivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USADivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USAPurpose: Clomiphene citrate (CC) is prescribed off-label in men to improve testosterone and sperm parameters, but the duration of treatment needed to reach maximal benefit remains unclear. Our objective was to examine temporal effects of CC on total testosterone (TT) and semen analysis (SA) using longitudinal follow-up data in treated men. Materials and Methods: We analyzed an IRB-approved database of men treated with CC (25 mg q.d. or 50 mg q.o.d.) from January 2016 through May 2021. We identified patients with 3, 6, 9, and 12 month follow-up data for TT and 3, 6, and 9 month follow-up SA. Mean absolute changes in TT and sperm concentration compared to baseline were calculated, along with 95% confidence intervals. Men with prior genitourinary procedures or hormone therapy were excluded. Paired t-tests were used to compare TT and sperm concentration at each time point to baseline (alpha=0.05). Results: One hundered thirty-four men received CC, mean age 37.7 years (SD 6.7, range 24–52). TT at all follow-ups (3, 6, 9, and 12 months) were available for 25 men, and SA at 3, 6, and 9 months for 26 men. Baseline TT was 358±145 ng/dL and sperm concentration was 13±17.2 M/mL. Significant improvement in TT was identified at 3 months (62.7 ng/dL, 95% CI: 0.49–125.0, p=0.048), additional benefit at 6 months (181.8 ng/dL, 95% CI: 114.1–249.5, p<0.01), and plateau at 9 and 12 months. Improvement in sperm concentration was first observed at 9 months (20.7 M/mL, 95% CI: 10.2–31.2, p<0.01). Semen volume and sperm motility did not change. Conclusions: Duration of treatment with clomiphene may impact testosterone and sperm concentration, and the historical 3 month milestone may be insufficient for clinical and research evaluation. Men taking CC may experience plateau in TT at 6 months and first benefit in sperm concentration at 9 months.clomiphene citratemale infertilityselective estrogen receptor modulatorsemen analysistestosterone |
| spellingShingle | Tommy Jiang John T. Sigalos Vadim Osadchiy Alvaro Santamaria Michael H. Zheng Neilufar Modiri Keith V. Regets Jesse N. Mills Sriram V. Eleswarapu Temporal Changes of Clomiphene on Testosterone Levels and Semen Parameters in Subfertile Men The World Journal of Men's Health clomiphene citrate male infertility selective estrogen receptor modulator semen analysis testosterone |
| title | Temporal Changes of Clomiphene on Testosterone Levels and Semen Parameters in Subfertile Men |
| title_full | Temporal Changes of Clomiphene on Testosterone Levels and Semen Parameters in Subfertile Men |
| title_fullStr | Temporal Changes of Clomiphene on Testosterone Levels and Semen Parameters in Subfertile Men |
| title_full_unstemmed | Temporal Changes of Clomiphene on Testosterone Levels and Semen Parameters in Subfertile Men |
| title_short | Temporal Changes of Clomiphene on Testosterone Levels and Semen Parameters in Subfertile Men |
| title_sort | temporal changes of clomiphene on testosterone levels and semen parameters in subfertile men |
| topic | clomiphene citrate male infertility selective estrogen receptor modulator semen analysis testosterone |
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