A Prospective Comparative Trial of a Gonadotropin-Releasing Hormone Analogue with Clomiphene Citrate for the Treatment of Oligoasthenozoospermia

Background: We undertook a prospective trial to compare the efficacy and adverse effects of a gonadotropin releasing-hormone analogue (CnRHa) and clomiphene therapy for idiopathic normogonadotropic oligoasthenozoospermia (INOA).
Methods: Between January and December 1995, 44 newly-diagnosed INOA patients were randomly allocated to treatment with GnRHa or clomiphene citrate. Efficacy was assessed by measuring changes in semen parameters prior to and after 3 months of treatment. Twenty-three INOA patients underwent GnRHa therapy with 15 μg of diluted buserelin acetate given once a day intranasally, and 21 INOA patients were treated with 50 μg of clomiphene citrate daily by oral administration.
Results: The mean sperm density in the GnRHa group increased from 1 6.1 times 10⁶/mL to 26.9 times 10⁶/ml(P < 0.05), while the mean sperm density did not change significantly in the group treated with clomiphene. Similarly, the mean sperm motility increased from 35.9% to 43.9% in the GnRHa group (P < 0.05), but did not significantly change in the clomiphene group. No adverse effects were observed in either group.
Conclusion: This GnRHa treatment protocol can be administered as an outpatient and is hoped to benefit INOA patients.