MP31-17 PRE-TREATMENT SEX HORMONE LEVELS AND SPERM CONCENTRATION INFLUENCE MAGNITUDE OF RESPONSE TO CLOMIPHENE IN SUBFERTILE MEN

Abstract

You have accessJournal of UrologyInfertility: Therapy (MP31)1 Sep 2021MP31-17 PRE-TREATMENT SEX HORMONE LEVELS AND SPERM CONCENTRATION INFLUENCE MAGNITUDE OF RESPONSE TO CLOMIPHENE IN SUBFERTILE MEN Tommy Jiang, Alvaro Santamaria, Neilufar Modiri, Michael Zheng, Vadim Osadchiy, John Sigalos, Jesse Mills, and Sriram Eleswarapu Tommy JiangTommy Jiang More articles by this author , Alvaro SantamariaAlvaro Santamaria More articles by this author , Neilufar ModiriNeilufar Modiri More articles by this author , Michael ZhengMichael Zheng More articles by this author , Vadim OsadchiyVadim Osadchiy More articles by this author , John SigalosJohn Sigalos More articles by this author , Jesse MillsJesse Mills More articles by this author , and Sriram EleswarapuSriram Eleswarapu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002035.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Selective estrogen receptor modulators (SERMs) are known to improve sperm counts. Men with low testosterone and gonadotropins are thought to benefit most from SERMs like clomiphene, though predictors of efficacy have not been robustly characterized. We sought to identify changes in sperm counts with clomiphene, stratifying by pre-treatment sex hormones and sperm parameters. METHODS: With IRB approval, we retrospectively analyzed sex hormone levels and sperm parameters in subfertile men before and after 3 months of clomiphene (25 mg qd or 50 mg qod) during 10/2015-6/2020. Men were stratified by initial hormone levels (T≥300 vs T<300, LH≥7 vs LH<7, FSH≥7 vs FSH<7) and separately by initial sperm concentration (azoospermia, oligozoospermia, and normospermia). Men who previously underwent hormone therapy, genital surgery, or conceived a pregnancy were excluded. Student t-test was conducted with α=0.05. RESULTS: Out of 137 patients, 34% improved, 13% worsened, and 53% had no change in sperm concentration categorization (Fig. 1). 77% of azoospermic men had no change in sperm concentration. Table 1 summarizes changes in T and semen analyses stratified by initial parameters. No significant difference was found in magnitude of changes in semen parameters stratified by testosterone. Men with lower LH had greater improvements in total sperm count (TSC) and total motile sperm count (TMSC). Men with lower FSH had greater improvements in T, sperm concentration, and TSC. Azoospermic men showed least improvement across all semen parameters. No significant differences in magnitude of improvement were observed between oligozoospermia sub-categorizations (mild, moderate, severe) and normospermia. CONCLUSIONS: Not all patients experience the same benefit from clomiphene. Our data suggest that men with azoospermia do not significantly benefit. Degree of non-azoospermia did not affect magnitude of improvement. Men with lower gonadotropin levels may expect greater degree of improvement in both hormone and semen parameters. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e561-e562 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tommy Jiang More articles by this author Alvaro Santamaria More articles by this author Neilufar Modiri More articles by this author Michael Zheng More articles by this author Vadim Osadchiy More articles by this author John Sigalos More articles by this author Jesse Mills More articles by this author Sriram Eleswarapu More articles by this author Expand All Advertisement Loading ...