Effectiveness of clomiphene citrate on total motile sperm count and hormonal profile in men with clinical infertility
Year: 2026
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Infertility affects 15% of couples worldwide, yet evidence for empiric therapy in idiopathic male factor infertility is limited. Clomiphene citrate (CC), a selective estrogen receptor modulator that stimulates gonadotropins, is widely prescribed, but its impact on total motile sperm count (TMSC) and reproductive hormones remains uncertain. This study evaluated CC therapy and subsequent changes in TMSC and hormones in infertile men. METHODS: This single-center, retrospective cohort included 60 men ≥18 years with idiopathic infertility treated with CC between January 2022 and November 2024. The primary outcome was change in TMSC; secondary outcomes were changes in testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and 17-hydroxyprogesterone (17-OHP) before and after CC. Hormonal changes were assessed with paired t-tests; primary vs. secondary infertility with independent t-tests; and predictors of TMSC change with multivariable linear regression. RESULTS: Sixty men (mean age 35.6±4.6 years) were treated for 12.9±6.1 months. Following CC, mean TMSC increased by 13.1 million (p=0.005), 17-OHP by 1.8 nmol/L, testosterone by 9.9 nmol/L, FSH by 4.9 IU/L, LH by 4.8 IU/L, and estradiol by 53.9 pmol/L (all p<0.001). TMSC change was not linked to age, body mass index (BMI), baseline hormones, or treatment duration. Men with primary (n=46) vs. secondary infertility (n=14) demonstrated similar TMSC and hormonal changes. CONCLUSIONS: CC was associated with higher TMSC and reproductive hormones. Response was independent of age, BMI, baseline hormones, and duration. Larger, prospective studies are needed to confirm findings and guide candidate selection.
DOI: 10.5489/cuaj.9493
Institution: University of Manitoba
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7138203761
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