As we discussedlast time, in some men, FSH and/or LH production is low. This results in a low testosterone level as well as a very low sperm count.
Once the urologist has eliminated an anatomic cause for the problem, we can treat these men with clomiphene citrate (Clomid), the same drug that we give women who are not ovulating correctly. When given to men, Clomid causes an increase in FSH and LH secretion– leading to an increase in both sperm production and testosterone secretion.
Guys may need to take Clomid for at least 3-4 months to see the optimal effect, as it takes 90-108 or so days from the time a sperm is made until it is ejaculated. Clomid comes in 50 mg tablets and the typical starting dose for a man is either 50 mg every other day or 25 mg daily. About three weeks after a man starts taking Clomid, we will recheck his FSH, LH, and testosterone levels to make sure that they are not too high. If the testosterone level gets above the normal range, it can actually cause the sperm count to go down, rather than up.
As those of you who have seen us in the office or visited our website know, we perform a lot of research at TFC – both on female and male infertility. Some of you may have even participated in some of our studies.
We performed a study several years ago in which we gave Clomid 25 mg/day to infertile men with low FSH, LH, and testosterone levels. Each man took Clomid for at least 110 days.
We saw statistically significant increases in FSH, LH, and testosterone levels. More importantly, the average sperm concentration rose from 15.2 million/mL to 62.8 million/mL. Sperm motility also significantly increased, but there was no significant increase in normal morphology. We were most pleased by the fact that, although each of these infertile couples was planning on doing IVF due to significant male factor, 58.3% were actually able to conceive without IVF due to the tremendous increase in sperm quality we achieved with Clomid.
This study received significant notoriety when we presented these results at the annual meeting of the American Society for Reproductive Medicine (ASRM), and several other investigators have subsequently found the same results that we reported. As a result of both our study and those that have followed, the use of Clomid in men with low sperm counts and low hormone levels has significantly increased to the point that Clomid is now a well-accepted treatment for many men with male factor infertility.
For more information about this study, or other studies conducted here at TFC, please visit:
Tags: clomiphene citrate (Clomid), FSH and/or LH production in men, low sperm count, low testosterone level, sperm motility, use of Clomid in men with low sperm counts | Category: Low Sperm Counts, Male Infertility, Semen Analysis