SynthesisBMC urology2024
Pharmacological non-hormonal treatment options for male infertility: a systematic review and network meta-analysis.
Synthesis in BMC urology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT07109622 (A Randomized, Double-blind, Placebo-controlled Pilot Study to Evaluate the Efficacy of LN18178 on Improving Sperm Virility), which is not on this map. Cited by 8 papers.
What it found
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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.
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.
A Randomized, Double-blind, Placebo-controlled Pilot Study to Evaluate the Efficacy of LN18178 on Improving Sperm Virility (Sperm Motility, Sperm Concentration, and Sperm Morphology)
Who cites it
8 citing papers in PubMed.
- Effectiveness of clomiphene citrate on total motile sperm count and hormonal profile in men with clinical infertility.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2026Article
- Novel Diagnostic Algorithm for Azoospermia: The Role of 17-Hydroxyprogesterone and Round Spermatids in Normogonadotropic Azoospermia.Diagnostics (Basel, Switzerland) · 2026Review
- Prostatitis-Related Male Infertility: From Inflammation and Dysbiosis to Sperm DNA Damage.Diagnostics (Basel, Switzerland) · 2026Review
- Treatment Options for Improving The Semen Quality in Obese Men: A Scoping Review.Journal of multidisciplinary healthcare · 2026Review
- Correction: Pharmacological non-hormonal treatment options for male infertility: a systematic review and network meta-analysis.BMC urology · 2025Article
- Protective Role of Sphingosine-1-Phosphate During Radiation-Induced Testicular Injury.Antioxidants (Basel, Switzerland) · 2024Review
- Hormonal Therapy Before Sperm Retrieval in Men With Non-Obstructive Azoospermia: From Controversy to Precision Using the APHRODITE Criteria.Reproductive medicine and biologyReview
- The WHO 2025 Guideline for the Prevention, Diagnosis and Treatment of Infertility: A Comprehensive Review with Focus on Male Reproductive Health.International braz j urol : official journal of the Brazilian Society of UrologyReview
Corrections and comments
- Erratum issued
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMale factor infertility affect up to 50% of couples unable to conceive spontaneously. Several non-hormonal pharmacological treatments have been proposed to boost spermatogenesis and increase chances of conception in men with infertility. Still, no clear evidence exists on the most effective treatment strategy.
objectiveWe aimed to compare the effectiveness of non-hormonal pharmacological treatment options for men with infertility using a systematic review and network meta-analysis.
methodsWe searched MEDLINE, EMBASE, and CENTRAL until October 2023 for randomised/quasi-randomised trials that evaluated any non-hormonal pharmacological treatment options for men with idiopathic semen abnormalities or those with hypogonadism. We performed pairwise and network meta-analyses using a random effect model. We assessed risk of bias, heterogeneity, and network inconsistency. We calculated the mean rank and the surface under the cumulative ranking curve (SUCRA) for each intervention the maximum likelihood to achieve each of reported outcomes. We reported primarily on sperm concentration and other important semen and biochemical outcomes using standardised mean difference (SMD) and 95% confidence-intervals(CI).
resultsWe included 14 randomised trials evaluating four treatments (Clomiphene citrate, Tamoxifen, Aromatase inhibitors, anti-oxidants) and their combinations in 1342 men. The overall quality of included trials was low. Sperm concentration improved with clomiphene compared to anti-oxidants (SMD 2.15, 95%CI 0.78-3.52), aromatase inhibitor (SMD 2.93, 95%CI 1.23-4.62), tamoxifen (SMD - 1.96, 95%CI -3.57; -0.36) but not compared to placebo (SMD - 1.53, 95%CI -3.52- 0.47). Clomiphene had the highest likelihood to achieve the maximum change in sperm concentration (SUCRA 97.4). All treatments showed similar effect for sperm motility, semen volume, and normal sperm morphology. FSH levels showed significant improvement with clomiphene vs.anti-oxidant (SMD 1.48, 95%CI 0.44-2.51) but not compared to placebo. The evidence networks for LH and testosterone suffered from significant inconsistency (p = 0.01) with similar trend of improvement with clomiphene compared to other treatments but not compared to placebo.
conclusionThere is insufficient evidence to support the routine use of Clomiphene, tamoxifen, and aromatase inhibitors to optimise semen parameters in men with infertility. Future randomised trials are needed to confirm the efficacy of clomiphene in improving fertility outcomes in men. PROSPERO: CRD42023430179.
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