madman
Super Moderator
INTRODUCTION AND OBJECTIVE
The predictive metrics for assessing fertility outcomes following clomiphene citrate (CC) treatments are understudied. Our objective was to delineate the pretreatment sex hormones that exhibit the strongest correlation withsemen parameter improvements in CC-treated patients and to provide expected magnitude of improvement of key fertility parameters.
METHODS
Our retrospective study involved 257 subfertile men who were administered CC for a duration of 3 months. Exclusion criteria included individuals with azoospermia, those with only a single semen analysis, those with a history of hormone therapy usage, or genitourinary intervention. Men were categorized into groups of at least ten patients based on their pre-treatment levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone/estradiol (T/E) ratio, and T/LH ratio. Primary outcomes investigated include absolute changes in total testosterone (TT), sperm concentration, and total sperm count.
RESULTS
134 patients met inclusion criteria. Pre-treatment FSH and LH were inversely correlated with improvements in TT (R2 [0.67 and 0.41; p<0.001 for both), sperm concentration (R2 [0.73 and 0.76; p [0.076 and p<0.001, respectively), and sperm count (R2 [0.42 and 0.84, p [0.052 and <0.001, respectively). The T/E ratio exhibited a significant association with testosterone (p [0.0031), while the T/LH ratio did not demonstrate significant associations with any outcomes. Figure 1 provides the average magnitude of improvement of TT, sperm count, and sperm concentration by gonadotropin metrics of interest.
CONCLUSIONS
Gonadotropin measurements are sufficient in predicting improvement in sperm parameters in men using CC for 3 months compared to ratio metrics. These data may also be useful for expectation management of magnitude of improvement of key fertility parameters.
The predictive metrics for assessing fertility outcomes following clomiphene citrate (CC) treatments are understudied. Our objective was to delineate the pretreatment sex hormones that exhibit the strongest correlation withsemen parameter improvements in CC-treated patients and to provide expected magnitude of improvement of key fertility parameters.
METHODS
Our retrospective study involved 257 subfertile men who were administered CC for a duration of 3 months. Exclusion criteria included individuals with azoospermia, those with only a single semen analysis, those with a history of hormone therapy usage, or genitourinary intervention. Men were categorized into groups of at least ten patients based on their pre-treatment levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone/estradiol (T/E) ratio, and T/LH ratio. Primary outcomes investigated include absolute changes in total testosterone (TT), sperm concentration, and total sperm count.
RESULTS
134 patients met inclusion criteria. Pre-treatment FSH and LH were inversely correlated with improvements in TT (R2 [0.67 and 0.41; p<0.001 for both), sperm concentration (R2 [0.73 and 0.76; p [0.076 and p<0.001, respectively), and sperm count (R2 [0.42 and 0.84, p [0.052 and <0.001, respectively). The T/E ratio exhibited a significant association with testosterone (p [0.0031), while the T/LH ratio did not demonstrate significant associations with any outcomes. Figure 1 provides the average magnitude of improvement of TT, sperm count, and sperm concentration by gonadotropin metrics of interest.
CONCLUSIONS
Gonadotropin measurements are sufficient in predicting improvement in sperm parameters in men using CC for 3 months compared to ratio metrics. These data may also be useful for expectation management of magnitude of improvement of key fertility parameters.
