Clomiphene citrate (Clomid) is a popular brand-name prescription medication that has been used for ovarian stimulation or ovulation induction. It has also been found to be beneficial for people of all genders experiencing infertility. Off-label, it can be used to treat infertility in people with testes, although there is less evidence to back this up. However, studies have indicated that Clomid can be effective in treating infertility in people with testes, even in cases of oligospermia. If your physician has recommended Clomid, or if you are considering it as an option, the following information can help you make an informed decision. Clomid for Men 101 Clomid is most often prescribed for male infertility, with low sperm count or low motility as the more common causes. By influencing the production of luteinizing hormones (LH), follicle-stimulating hormones (FSH), and testosterone, the drug can improve the total motile sperm count and potentially result in higher rates of spontaneous pregnancy or aid less invasive fertility interventions. Although side effects can occur, they typically resolve once the medication is stopped. The dose of Clomid may range from 12.5 to 10000 milligrams per day, with 50 mg three times/week being the most common starting dose. However, research on the optimal dose for people with testes has yet to be published. How does Clomid work and is it effective?
It is important to understand the mechanism of action of Clomid in order to appreciate why it can be prescribed for both male and female individuals. Clomid functions by inhibiting estradiol on the pituitary gland, which in turn leads to an increase in luteinizing hormone (LH) and follicle-stimulating hormone (FSH) production. This can promote sperm production. Careful monitoring of the treatment is advised, as an excessive dosage may paradoxically reduce sperm production by increasing testosterone levels. Furthermore, it is important to note that it takes time for the effect of Clomid to manifest in terms of sperm production. Generally, it takes between 90-108 days from the time sperm is produced until ejaculation. As such, individuals with testes should expect to take the medication for at least three to four months before assessing its efficacy on fertility. Side effects of taking Clomid in males Taking Clomid may result in chest muscle tenderness, changes in mood, including irritability, acne, and changes in vision. Should any of these side effects interfere with daily life, it is recommended to contact a physician. They can then decide whether to discontinue the medication, reduce the dose, or attempt to manage the side effects while continuing to take Clomid. What's the correct dosage to take? Due to the limited research on the effects of Clomid in people with testes, physicians typically initiate treatment at a low dose (25-50mg/day) and titrate up as necessary and tolerated. It is important to note that, contrary to popular belief, higher doses of Clomid are not necessarily associated with higher sperm count and motility. Therefore, it is suggested that physicians monitor their patient's hormone levels while taking the drug and adjust dosages accordingly to avoid any negative effects on fertility. Other ways of treating male factor infertility After a thorough medical examination, your doctor will review a range of factors to help determine the cause and most suitable treatment for infertility. These include age and weight, as well as any alcohol, cigarette, and drug use. Furthermore, medical conditions such as diabetes, autoimmune disorders, genetic disorders, and history of cancer and cancer treatment will be taken into account. Hormone levels will be checked to assess if there is an underlying imbalance or if the pituitary gland is functioning properly. Depending on the results, medication, surgery, or assisted insemination may be recommended. As research advances, more options to treat infertility become available. Ultimately, the best treatment plan will be discussed between you and your doctor.