Shukla Joyutpala, Moni Shamsun Nahar, Hasan Muhammad Mubasshir, Islam Muhammad Ariful, Shikha Amitun Nessa, Jahan Nur-Wa-Bushra, Ishrat Shakeela
Department of Reproductive Endocrinology & Infertility, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Clin Exp Reprod Med. 2025 Sep;52(3):252-258. doi: 10.5653/cerm.2024.07353. Epub 2025 Jan 21.
The aim of this study was to observe the effect of clomiphene citrate on sperm parameters in infertile men diagnosed with idiopathic oligoasthenozoospermia.
This randomized controlled trial involved 50 infertile men diagnosed with idiopathic oligoasthenozoospermia, all of whom had normal serum testosterone and follicle-stimulating hormone levels. The participants were divided into two groups. The first group (n=25) received a daily dose of 50 mg of clomiphene citrate in tablet form for 3 months, while the second group (n=25) was given a placebo. Sperm concentration, sperm motility, and serum testosterone levels were measured at the start of the study and after 3 months of treatment. Changes in these parameters were then assessed and compared between the two groups.
There was a significant increase in the mean sperm count (9.17±4.11 million/mL vs. 13.88±7.27 million/mL), progressive motility (14.67±7.03 vs. 21.42±11.9), total motile sperm count (3.53±3.08 million vs. 7.81±7.10 million), and mean serum testosterone levels (371.97±88.51 ng/dL vs. 805.94±290.77 ng/dL) in the clomiphene citrate group. In contrast, the changes in the placebo group were not significant. Post-treatment severe oligozoospermia was substantially lower in the clomiphene citrate group (odds ratio, 0.31) compared to the placebo group. Additionally, half of the participants in the clomiphene citrate group experienced a statistically significant upgrade in World Health Organization (WHO) sperm concentration categories, versus 27.3% in the placebo group.
Clomiphene citrate improves sperm count and motility, leading to upgrades in WHO sperm concentration categories in infertile men with idiopathic oligoasthenozoospermia.
本研究旨在观察枸橼酸氯米芬对诊断为特发性少弱精子症的不育男性精子参数的影响。
这项随机对照试验纳入了50名诊断为特发性少弱精子症的不育男性，他们的血清睾酮和促卵泡激素水平均正常。参与者被分为两组。第一组（n = 25）每天口服50毫克枸橼酸氯米芬片剂，持续3个月，而第二组（n = 25）给予安慰剂。在研究开始时和治疗3个月后测量精子浓度、精子活力和血清睾酮水平。然后评估并比较两组这些参数的变化。
枸橼酸氯米芬组的平均精子计数（917±411万/mL对1388±727万/mL）、前向运动率（14.67±7.03对21.42±11.9）、总活动精子数（353±308万对781±710万）和平均血清睾酮水平（371.97±88.51 ng/dL对805.94±290.77 ng/dL）均有显著增加。相比之下，安慰剂组的变化不显著。与安慰剂组相比，枸橼酸氯米芬组治疗后严重少精子症的发生率显著降低（优势比，0.31）。此外，枸橼酸氯米芬组中有一半的参与者在世界卫生组织（WHO）精子浓度分类中出现了具有统计学意义的提升，而安慰剂组为27.3%。
枸橼酸氯米芬可改善精子计数和活力，使诊断为特发性少弱精子症的不育男性的WHO精子浓度分类得到提升。
