Clomid for Men: When and How It's Used for Male Fertility

What to Expect During Treatment, Side Effects, and Success Rates

family at the beach in thailand, Clomid can increase odds for pregnancy for some men
Clomid can improve sperm counts in some men. Pregnancy success rates are anywhere from 13 to 36%.. Jasper James / Getty Images

Clomid (clomiphene citrate) can be used to treat some cases of male infertility. Because Clomid only has FDA approval for treatment of female infertility, using it to treat male infertility is considered to be “off label.” 

You may think of Clomid as primarily a female fertility drug. It’s true that the majority of Clomid prescriptions are given to women. However, Clomid can also be used to increase sperm count levels or correct certain hormonal imbalances.

In some cases, Clomid may help you avoid IVF or surgical treatment. In other cases, it may help boost your odds of success after surgery or during IVF.

Here’s what you need to know about Clomid treatment for men.

Why Clomid May Be Prescribed for Men

Your doctor may prescribe Clomid if...

You have low testosterone levels. 

This is especially true if the low levels are due to what is known as hypogonadotropic hypogonadism.

While usually men being treated for low testosterone are experiencing infertility, your doctor may prescribe Clomid to treat other symptoms of hypogonadism, even if you aren’t activity trying to have a baby.

Other symptoms of hypogonadism include… :

  • Erectile dysfunction
  • Decrease is body hair growth
  • Decrease in muscle mass
  • Fatigue
  • Low libido
  • Trouble with concentration
  • Hot flashes

You’re diagnosed with idiopathic oligoasthenozoospermia. 

Idiopathic means of unknown cause. Oligoasthenozoospermia means low sperm count and poor sperm motility.

If a semen analysis finds that you have low sperm count and poor motility, but your doctor can’t explain why you’re having this problem, he may diagnose you with idiopathic oligoasthenozoospermia. Clomid is one possible treatment option.

You’re diagnosed with nonobstructive azoospermia. 

Azoospermia means there is no sperm found in the semen.

Non-obstructive means there’s no physical blockage preventing sperm from reaching the ejaculate.

With azoospermia, Clomid may be prescribed to help create and boost sperm count.

Even if that is not successful, Clomid may increase the odds of a successful sperm extraction or testes biopsy. (This is where immature sperm cells are retrieved via needle directly from the testes, and then matured in a lab environment.)   

You have a varicocele. 

One of the most common causes of male infertility is varicoceles. A varicocele is a varicose vein in the scrotum or testes.

It’s questionable whether surgery or Clomid is the best treatment. Surgery seems to boost overall semen health more so than Clomid. But which treatment is more likely to increase your odds for conception is unclear.

Depending on the age of your female partner, and whether she also has fertility problems, your doctor may suggest trying Clomid treatment first.

Then, if unsuccessful, you may elect to have a varicocelectomy. (That’s surgery to remove the varicocele.)

Typical Clomid Dosage and Treatment Protocols for Men

Clomid treatment for men is not like female infertility treatment.

Women take Clomid for about five days on specific days of the month. If it works, Clomid improves the woman’s fertility that very month.

Male treatment doesn’t work like that.

With men, Clomid is usually taken over a number of days for at least three months. It takes more time to see results, and you shouldn’t expect quick fertility improvement.

You should always follow your doctor’s instructions while taking Clomid. A few common protocols used to treat Clomid in men are:

  • Dosage of 25 mg taken daily for twenty-five days, followed by a five-day rest period. This cycle is then repeated for three months.
  • Dosage of 25 mg taken for five days, followed by five days off, for three months.
  • High dosage of 100 mg taken for 10 days, once every month, for three months.

Your doctor may prescribe an antioxidant to take with Clomid. Antioxidants like Vitamin E have been shown to further improve treatment success.

Treatment usually takes at least a month before any changes in semen can be seen, and a full three months before pregnancy rates may show improvement.

Your doctor may order occasional blood work to check your testosterone levels. He may then adjust your treatment based on the results.

Clomid Side Effects for Men

Most research on Clomid and men has found no serious adverse effects. This doesn’t mean serious adverse effects can’t happen, only that if they do, it’s rare.

Blurred vision is a possible serious side effect as if it can worsen and potentially cause permanent vision damage if left untreated. If you experience blurred vision or vision disturbances while taking Clomid, contact your doctor as soon as possible.

There’s not much information available on non-serious but still uncomfortable side effects of Clomid in men. This is because the initial research on Clomid was only in female patients. 

One study found that 5% of male patients experienced nipple tenderness.

For some men, the tenderness went away spontaneously during treatment. For others, it continued until treatment was discontinued.

Most of the side effects seen in women are caused by estrogen changes. Because estrogen levels in men are lower than in women, men are less likely to experience some of the more uncomfortable side effects that women may experience.

With that said, estrogen-related side effects may occur in men taking Clomid. 

Will Clomid Treatment in Men Increase the Risk of Twins?

No, Clomid does not increase the risk of twins when taken for male infertility.

When women take Clomid, it boosts ovulation. This may lead to having two eggs released instead of just one. If two eggs are ovulated, and both become fertilized, a woman may become pregnant with twins.

In men, Clomid is boosting sperm count and health. More sperm does not lead to an increased chance of twins.

Clomid Success Rates for Male Infertility

Success can be defined in two different ways:

  • improvement in sperm health and testosterone levels
  • increased pregnancy rates

What kind of pregnancy rate can you expect?

Your personal situation will depend not only on your fertility but also your partner’s fertility.

In studies including only couples facing male infertility, pregnancy rates after Clomid treatment vary. Some studies show no improvement while others show a fertility boost.

The average pregnancy rate is around 13 to 15%.

A small but interesting study found that Clomid along with antioxidant treatment (like Vitamin-E) significantly raised pregnancy rates, up to 36%.

One meta-analysis looked at the results of several studies on Clomid and male infertility, specifically, men experiencing idiopathic low sperm count and/or poor sperm motility.

This study found that treatment with Clomid, compared to no treatment, increased sperm concentration by about 5% and improved sperm motility by about 4%.

Reproductive hormone levels also significantly improved with Clomid treatment, with FSH levels rising 4% overall and testosterone levels rising 54%.

Perhaps the most important news for those trying to conceive, pregnancy rates doubled with Clomid treatment when compared to those who received no treatment.

What about men experiencing azoospermia? (That's no sperm at all found in semen.)

In one study, Clomid helped 64.3% of the men to produce sperm, with semen analysis results showing between 1 and 16 million sperm per milliliter.

For the men who did not produce sperm after Clomid treatment, all patients in this study had enough sperm to be retrieved using testicular sperm extraction. The extracted sperm could then be used for ICSI-IVF treatment.

More on male fertility:


Hussein A1, Ozgok Y, Ross L, Niederberger C.  Clomiphene Administration for Cases of Nonobstructive Azoospermia: A Multicenter Study. J Androl. 2005 Nov-Dec;26(6):787-91; discussion 792-3.

Handbook of Andrology: Why evaluate the infertile male in the era of ART? American Society of Andrology. Accessed July 15, 2014.

Chatterjee S1, Chowdhury RG, Khan B. “Medical management of male infertility.” J Indian Med Assoc. 2006 Feb;104(2):74, 76-7.

Chua ME1, Escusa KG, Luna S, Tapia LC, Dofitas B, Morales M. “Revisiting oestrogen antagonists (clomiphene or tamoxifen) as medical empiric therapy for idiopathic male infertility: a meta-analysis.” Andrology. 2013 Sep;1(5):749-57. doi: 10.1111/j.2047-2927.2013.00107.x.

George B1, Bantwal G. “Endocrine management of male subfertility.” Indian J Endocrinol Metab. 2013 Oct;17(Suppl1):S32-S34.

Ghanem H1, Shaeer O, El-Segini A. “Combination clomiphene citrate and antioxidant therapy for idiopathic male infertility: a randomized controlled trial.” Fertil Steril. 2010 May 1;93(7):2232-5. doi: 10.1016/j.fertnstert.2009.01.117. Epub 2009 Mar 6.

Katz DJ1, Nabulsi O, Tal R, Mulhall JP. “Outcomes of clomiphene citrate treatment in young hypogonadal men.” BJU Int. 2012 Aug;110(4):573-8. doi: 10.1111/j.1464-410X.2011.10702.x. Epub 2011 Nov 1.

Patankar SS1, Kaore SB, Sawane MV, Mishra NV, Deshkar AM. “Effect of clomiphene citrate on sperm density in male partners of infertile couples.” Indian J Physiol Pharmacol. 2007 Apr-Jun;51(2):195-8.

Unal D1, Yeni E, Verit A, Karatas OF. “Clomiphene citrate versus varicocelectomy in treatment of subclinical varicocele: a prospective randomized study.” Int J Urol. 2001 May;8(5):227-30.

Whitten SJ1, Nangia AK, Kolettis PN. “Select patients with hypogonadotropic hypogonadism may respond to treatment with clomiphene citrate.” Fertil Steril. 2006 Dec;86(6):1664-8. Epub 2006 Sep 27.

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