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Clomid for Men: Does It Increase Fertility?

Overview

Clomid is a popular brand name and nickname for generic clomiphene citrate. It’s an oral fertility medication approved by the U.S. Food and Drug Administration (FDA) for use in women who are unable to become pregnant. It affects the hormone balance within the body and promotes ovulation.

Clomid is only approved by the FDA for use in women, but it’s sometimes prescribed off-label as an infertility treatment in men. Learn more about off-label prescription drug use.

Is Clomid an effective treatment for male infertility? Read on to learn more.

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How it works

How does Clomid work?

Clomid blocks the hormone estrogen from interacting with your pituitary gland. When estrogen interacts with the pituitary gland, less luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are produced. This leads to a decrease in testosterone and therefore decreased production of sperm. Because Clomid blocks estrogen’s interaction with the pituitary gland, there is an increase in LH, FSH, and testosterone in the body.

Optimal dosing in men hasn’t been established. The dose given can range from 12.5 to 400 milligrams (mg) per day. A recent review recommends starting dosage at 25 mg three days per week and then increasing to a dose of 50 mg per day as needed. High doses of Clomid can actually have a negative effect on sperm count and motility.

Indications

When is Clomid prescribed?

Clomid is prescribed off-label for male infertility, particularly where low testosterone levels are observed. According to the U.S. Centers for Disease Control and Prevention, both a male and a female factor are identified in 35 percent of couples that struggle to conceive. In 8 percent of couples, only a male factor is identified.

Many things can contribute to infertility in men. These include:

  • injury to the testicles
  • age
  • excess weight or obesity
  • heavy use of alcohol, anabolic steroids, or cigarettes
  • hormonal imbalance, caused by improper function of the pituitary gland or exposure to too much estrogen or testosterone
  • medical conditions, including diabetes, cystic fibrosis, and some types of autoimmune disorders
  • cancer treatment involving certain types of chemotherapy or radiation
  • varicoceles, which are enlarged veins that cause the testicles to overheat
  • genetic disorders, such as a microdeletion in the Y-chromosome or Klinefelter syndrome

If your doctor suspects male infertility, they’ll order a semen analysis. Your doctor will use a sample of your semen to assess the sperm count as well as sperm shape and movement.

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Side effects

What are the side effects of this medication?

The possible side effects of Clomid include:

  • tenderness of the pectoral muscle
  • irritability
  • acne
  • acceleration of prostate cancer growth (if cancer is already present)
  • changes in your vision that are caused by a swelling of the pituitary gland (rare)

The side effects of Clomid are typically reversible if you stop taking the drug. If you experience any of the side effects listed above while taking Clomid, you should stop taking Clomid and contact your doctor.

Efficacy

Efficacy for fertility

A recent review of Clomid use in male infertility found mixed results regarding efficacy.

Some of the studies reviewed demonstrated a moderate improvement in sperm count in men with low sperm count or unexplained infertility. But others indicated no improvement when compared to either placebo or an untreated control. This was especially true when looking at pregnancy outcomes.

A recent study showed an increase in pregnancies when infertile men took a combination of Clomid and vitamin E when compared to placebo. However, the study didn’t compare the Clomid/vitamin E group with a group taking Clomid alone. So it’s unclear if combining Clomid with vitamin E increases efficacy.

Another recent review of studies suggested that the most likely population to receive a benefit from Clomid treatment is men with both unexplained infertility and normal to below-average sperm motility and shape. It’s believed that men in this population would be able use Clomid to reach a sperm count that would make them good candidates for artificial insemination.

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Other treatments

Other treatments for male factor infertility

Depending on the cause, male infertility may be treated using several different methods:

Medications

There are other medications available that your doctor can prescribe for hormonal imbalance. These drugs also increase the amount of testosterone and decrease the amount of estrogen in the body.

  • Human chorionic gonadotropin (hCG) can be given as an injection and can stimulate the testes to generate testosterone.
  • Anastrozole (Arimidex) is a drug that was developed for breast cancer. It prevents testosterone from being converted to estrogen within the body.

Surgery

If you have a blockage that prevents transportation of sperm, your doctor may recommend surgery to repair this. Surgery can also correct varicoceles.

Artificial insemination

In this treatment, a special preparation of sperm is placed into a woman’s uterus. Before artificial insemination, the woman may take medication that promotes ovulation. Read these encouraging artificial insemination success stories.

In vitro fertilization

In vitro fertilization (IVF) involves handling both the egg and the fertilized embryo outside of the body. Eggs are removed from the woman’s ovaries using a needle. The eggs are then combined with sperm in the laboratory. The resulting embryo is then returned to the woman’s body.

A specific form of IVF called intracytoplasmic sperm injection (ICSI) can be used in cases of male infertility. ICSI involves injection of a single sperm into the egg.

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Takeaway

The takeaway

Clomid is typically used as an infertility treatment in women. It’s not approved by the FDA for use in men, but it’s often prescribed off-label for treatment of male infertility.

Taking Clomid can lead to an increase in testosterone and sperm count, but studies on its efficacy in men have had mixed results.

There are additional treatments for male infertility, including:

  • other medications
  • surgery to remove blockages
  • artificial insemination
  • IVF

Talk to your doctor about your options if you have concerns about male fertility factors. Check out Healthline’s state of fertility report for more information about current attitudes, awareness, options, and costs associated with infertility.

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