Evidence map›Paper›PMID 35280658›Full record

ArticleTranslational andrology and urology2022

Initial gonadotropin levels and sperm parameters differentiate the response to clomiphene citrate in subfertile men.

Tommy Jiang, Vadim Osadchiy, Alvaro Santamaria, Michael H Zheng, Neilufar Modiri, John T Sigalos, Keith V Regets, Jesse N Mills, Sriram V Eleswarapu

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Translational andrology and urology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Tommy JiangDivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Vadim OsadchiyDivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Alvaro SantamariaDivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Michael H ZhengDivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Neilufar ModiriDivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
John T SigalosDivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Keith V RegetsDivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Jesse N MillsDivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Sriram V EleswarapuDivision of Andrology, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
University of California, Los Angeles · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Efficacy of clomiphene citrate (CC) in the treatment of male subfertility remains unclear, with inconsistent results in the literature and limited guidance from professional organizations. We sought to stratify the response to clomiphene in men based on their initial gonadotropins and semen parameters. Methods: We conducted a retrospective analysis of 234 patients from an academic center who took CC for subfertility. Patients with pre-treatment and 3 months follow-up total testosterone (TT) and semen analyses were included. Patients with previous hormone therapy, genitourinary surgery, prior success in conceiving pregnancy, or only one semen analysis were excluded. Primary outcomes were magnitudes of improvement in TT and semen parameters at 3 months. Student's Results: One hundred and thirty-seven patients met inclusion criteria. Thirty-four percent of patients experienced improvement in sperm concentration after 3 months of CC treatment, 13% decreased, and 53% showed no change. Using a pre-treatment TT cutoff of 300 ng/dL and gonadotropin thresholds of 7 miU/mL, initial TT did not affect magnitude of improvement in semen parameters, while lower initial gonadotropins showed statistical improvement across all outcomes. Multivariate analysis showed pre-treatment follicle stimulating hormone (FSH) was inversely correlated with improvement in TT [odds ratio (OR): 2.64e-05, 95% confidence interval (CI): 1.32e-09 to 5.28e-01, P=0.04] and sperm concentration (OR: 0.22, 95% CI: 5.70e-02 to 8.48e-01, P=0.03). We also provide initial gonadotropin cutoffs that suggest statistical benefit from CC use. Conclusions: Men with lower gonadotropin levels may expect greater degree of improvement in both hormone and semen parameters with use of CC. Men with azoospermia do not benefit based on semen analyses alone. Degree of non-azoospermia does not affect magnitude of improvement. CC had decreasing efficacy at higher initial gonadotropin levels. These data may provide guidance in stratifying and counseling men for CC treatment.

Indexed as

Clomiphene citrate (CC)male subfertilitysemen parameterstestosterone

Identifiers

PMID35280658
PMCPMC8899152
OpenAlexW4212866839

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.