Idiopathic male infertility - comparative study of the efficacy of empiric therapy with Clomiphene and Spermox ®
Cordeiro, A1; Lopes, S2; Mota, P3; Torres, J.P.3; Morais, N1; Anacleto, S1; Nogueira, VH1; Carvalho, AP1; Lima, E3
1: Department of Urology of Hospital Braga, Portugal; 2: ICVS – Life and Health Sciences Research Institute; 3: Department of Urology of Hospital Braga, Portugal; CVS – Life and Health Sciences Research Institute
Objective: Determine the effect of empirical treatment with clomiphene (anti-oestrogen) and/or Spermox ® (antioxidant) in pregnancy rate and the variation in sperm parameters in men with idiopathic infertility.
Materials and methods: We constructed a retrospective sample of 36 patients receiving empiric therapy for idiopathic male infertility, of which 15 were treated with clomiphene 50mg per day and 21 with clomiphene 50mg per day plus Spermox ® 1 sachet per day. We evaluated sperm parameters before and after 3 months of treatment. Subsequently the pregnancy rate was also estimated.
Results: Compared with the literature data the observed pregnancy rate (53.7%; 8/15) was above that of patients without medication (13.3%). There were no significant differences between the two types of medication (p=0.12). Patients with medication also demonstrated a significant increase in the following sperm parameters: total count (p=0.008), total mobility (p=0.001), progressive mobility (p=0.003) and vitality (p=0017). It was observed a statistically significant decrease (p=0.014) in the sperm volume, meanwhile the percentage of normal forms showed no significant differences with the treatment (p=0.538). In addition, there were not found significant differences in the semen analyses parameters by type of medication used. However, the results of logistic regression showed that patients treated with clomiphene were 10 times more likely to became pregnant (OR=10.00) than patients taking clomiphene association with Spermox ®.
Conclusions: Empirical therapy of idiopathic male infertility can significantly increase the rate of pregnancy and most semen parameters (total count, total and progressive mobility and vitality), with the use of clomiphene alone being associated more likely with pregnancy than the association.
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