Clomiphene Citrate (Clomid)
A rare cause of male infertility is when the production of sperm and testosterone is low because the requests for production from the brain are below where they need to be. This is called hypogonadotropic hypogonadism. It is often detected during an evaluation of a semen analysis with very few (oligospermia) or no sperm (azoospermia). While specific causes are occasionally diagnosed (a problem with the hypothalamus in the brain called Kallmann’s Syndrome or a malfunction in the pituitary), it is not unexpected to not find any specific cause at all. This is called idiopathic hypogonadotropic hypogonadism. Men with this condition are a select population that may benefit from medications that manipulate the way your brain and testicles communicate.
Clomiphene citrate is a non-steroidal estrogen-related medication that is taken by mouth. It can help by recommending that the brain (pituitary and hypothalamus) send more requests for sperm production down to the testicle. These hormonal requests are made by increasing the production of follicle-stimulating hormone (FSH).
Recent evidence suggests that an improvement in sperm count and pregnancies may be seen with clomiphene citrate therapy (Whitten et al. Fertility & Sterility 86(6): 1664, Dec 2006). Additionally, preliminary studies indicate that while some men may remain azoospermic, these men may benefit from a increased sperm retrieval rate from the testicles in preparation for In Vitro Fertilization (Hussein et al. Journal of Andrology 26(6): 787, Nov/Dec 2006).
Dr. Kuang and his team at the Southwest Fertility Center for Men during your evaluation will help you determine whether you are candidate for medical therapies and whether it is a viable treatment option that meets your reproductive needs and timetable.