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

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

family at the beach in thailand, Clomid can increase odds for pregnancy for some men
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You may think of Clomid as primarily a female fertility drug—and it's true that it only has FDA approval for treatment of female infertility. But Clomid can be used to treat some cases of male infertility. These cases are considered "off-label" use.

Clomid may help male fertility in a few ways. It can help increase sperm count levels and correct hormonal imbalances. It can also help you avoid IVF or surgical treatment.

In other cases, it may help boost your odds of success after surgery or during IVF.

If you're wondering if Clomid can help you, take some time to explore its success rate and potential side effects. This way you can make an educated and empowered decision and have a substantial conversation with your doctor.

Why Clomid May Be Prescribed for Men

Your doctor may prescribe Clomid in the following situations.

You have low testosterone levels.

While men being treated for low testosterone usually experience infertility, your doctor may especially consider prescribing Clomid if the low levels are due to hypogonadotropic hypogonadism. Even if you're not actively trying to have a baby, Clomid may help with symptoms of hypogonadism, including:

  • 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 (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. 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.

You should always follow your doctor’s instructions while taking Clomid. A few common protocols used include:

  • Dosage of 25 mg taken daily for twenty-five days, followed by a five-day rest period. This cycle is 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.

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

Clomid Side Effects in Men

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

More Serious Side Effects

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.

Uncomfortable Side Effects

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

Generally, 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.

One study did find that 5 percent of male patients experienced nipple tenderness. For some men, the tenderness went away spontaneously during treatment. For others, it continued until treatment was discontinued.

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? The average pregnancy rate is around 13 to 15 percent, and in studies including only couples facing male infertility, pregnancy rates after Clomid treatment vary.

What the Research Says

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

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

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

Men Experiencing Azoospermia

That's no sperm found in the semen at all.

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.

A Word From Verywell

In some cases, your doctor will prescribe Clomid for reasons other than infertility. Whether or not this is the case, make sure to understand the potential side effects and work hand-in-hand with your doctor to follow the prescribed treatment protocol. This way you'll see the safest and likely the best results.

In the case that you're taking Clomid to improve fertility, it may provide you and your partner some hope. Remember that your personal situation will depend on your fertility and your partner’s fertility, so don't feel discouraged if Clomid doesn't work. Once again, understand the research and work hand-in-hand with your doctor to explore your options.

Sources:

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.

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