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 (GnRHa) 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 microg of diluted buserelin acetate given once a day intranasally, and 21 INOA patients were treated with 50 mg of clomiphene citrate daily by oral administration.


RESULTS
The mean sperm density in the GnRHa group increased from 16.1 x 10(6)/mL to 26.9 x 10(6)/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.


CONCLUSIONS
This GnRHa treatment protocol can be administered as an outpatient and is hoped to benefit INOA patients.
Matsumiya
K
K
Department of Urology, Osaka University Medical School, Suita, Japan.
Kitamura
M
M
Kishikawa
H
H
Kondoh
N
N
Fujiwara
Y
Y
Namiki
M
M
Okuyama
A
A
D000281:Administration, Intranasal; D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D002996:Clomiphene / Q000008:administration & dosage*; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D008297:Male; D009845:Oligospermia / Q000188:drug therapy*; D011446:Prospective Studies; D013081:Sperm Motility
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D002996:Clomiphene; D007987:Gonadotropin-Releasing Hormone