Bridges Naima, Trofimenko Vera, Fields Sally, Carrell Douglas, Aston Kenneth, Hotaling James
Departments of Obstetrics and Gynecology, University of California-Davis, Davis, California.
Department of Urology, University of Utah, Salt Lake City, Utah.
Urol Pract. 2015 Jul;2(4):199-205. doi: 10.1016/j.urpr.2014.10.007. Epub 2015 Apr 10.
Clomiphene citrate has long been administered with inconclusive outcomes. It has often been used as empirical treatment for male factor infertility, presumably by increasing the sperm concentration. However, to our knowledge there has been no meta-analysis of the exact impact on semen parameters. We performed a systematic review and meta-analysis of the impact of clomiphene citrate on sperm parameters in men with oligospermia.
We systematically reviewed pertinent randomized, controlled, prospective trials using the bibliographic databases MEDLINE® (1966 to 2013), Embase® (1980 to 2013) and the Cochrane Collaboration. References of selected articles were reviewed for additional relevant citations. The net treatment effect of the observed change in sperm concentration was analyzed.
Data pooled from 2 randomized, controlled trials and 1 prospective trial in men with infertility and oligospermia included a total of 197 men with a mean age of 32.8 years (range 18 to 65). In the treatment arm 115 men were treated with a minimum dose of 25 mg clomiphene citrate at least every other day for a minimum of 3 months. The placebo or no treatment arm included 82 men. Pooled meta-analysis data revealed a highly significant increase of 7.7 million sperm per ml after administering clomiphene citrate compared to placebo or no treatment. There was no evidence of significant heterogeneity across the groups.
Available data suggest that clomiphene citrate is associated with an increased sperm count compared to placebo.
枸橼酸氯米芬长期应用，但其效果尚无定论。它常被用作男性因素不育的经验性治疗药物，推测其作用机制是增加精子浓度。然而，据我们所知，尚无关于其对精液参数确切影响的荟萃分析。我们对枸橼酸氯米芬对少精子症男性精子参数的影响进行了系统评价和荟萃分析。
我们使用MEDLINE®（1966年至2013年）、Embase®（1980年至2013年）和Cochrane协作网等文献数据库，对相关的随机对照前瞻性试验进行了系统评价。对所选文章的参考文献进行了审查，以获取更多相关引文。分析了观察到的精子浓度变化的净治疗效果。
从2项随机对照试验和1项针对不育和少精子症男性的前瞻性试验中汇总的数据，共纳入197名男性，平均年龄32.8岁（范围18至65岁）。在治疗组中，115名男性接受至少隔日一次、最低剂量为25毫克枸橼酸氯米芬的治疗，疗程至少3个月。安慰剂组或未治疗组包括82名男性。汇总的荟萃分析数据显示，与安慰剂或未治疗相比，服用枸橼酸氯米芬后每毫升精子数量显著增加770万。各组之间没有显著异质性的证据。
现有数据表明，与安慰剂相比，枸橼酸氯米芬可增加精子数量。
