درمان اوليگو اسپري ايديوپاتيك با داروهاي آنتي استروژنيك

Oligospermia with Antiestrogens

Introductiom To evaluate the necessity of adjustment of antiestrogens dose according to change in serum testosterone levels in the treatment of idiopathic oligospermia in infertile men. Material and Methods: This study performed on 160 infertile men with idiopathic oligospermia treated with clomiphene citrate In 125 patients (group I) serum testosterone levels was below upper limit of normal (>750 ng/mg), three weeks after beginning treatment. In other 35 patients (group II) serum testosterone levels raised over normal. Of patients with over normal testosterone level in 20 patients (group IIA) drug dose reduced to half and in 15 remained (group IIB) continued previous dose. After three weeks we repeated testosterone level. Semen analysis was repeated after 6 months in all patients. In all groups mean sperm count after treatment was compared with before treatment by paired students tests. Results: Six months after treatment in group I, mean sperm count increase from (9.6 ± 3.7) x 106 / ml to (13.1 ± 3.9) x 106 /ml that was significant statistically. In group IIA serum testosterone levels three weeks after decline drug dose dropped to normal range and mean sperm count increased from (9.8 ± 3.6) x 106 / ml to (13.9 ± 4.2) x 106/ ml that like group I was significant statistically. In group IIB, that did not decrease drug dose, testosterone levels remained over normal (>750 ng/ml) and mean sperm count from (9.6 ± 3.4) x 106 / ml got to (9.3 ± 3.6) x 106 / ml that was insignificant statistically. Conclusion: We recommend serum testosterone level must be measured 3 weeks after the beginning of the antiesterogene treatment and secondary adjusting the drug dose to keep testosterone level normal range in infertile men.