Clomifene 50mg tablets

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.ProsperoCRD42023430179.

Abstract licence: CC BY

ObjectiveThis study aimed to evaluate the efficacy and safety of selective estrogen receptor modulators (SERMs), specifically clomiphene and enclomiphene, in treating men with functional hypogonadism.Materials and methodsA systematic search was conducted in PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov for randomized controlled trials comparing SERMs with placebo, testosterone (T) gel, or human chorionic gonadotropin (hCG), up to July 2024. The primary endpoints were total testosterone (TT), follicle-stimulating hormone (FSH), and luteinizing hormone (LH). Weighted mean differences (MDs) and risk ratios (RRs) were calculated for continuous and binary endpoints, respectively, with 95% confidence intervals (CIs).ResultsSERM therapy significantly improved TT (MD: 273.76 ng/dL; 95% CI: 191.87-355.66 ng/dL; p ConclusionSERM therapy is associated with significantly improved levels of TT, LH, and FSH in hypogonadal men compared to placebo, and significantly enhanced levels of LH and FSH compared to T gel. The findings suggest that SERM therapy effectively increases TT levels in men with functional hypogonadism and should be considered as an alternative to T gel therapy.

Abstract licence: CC BY

ObjectivePolycystic ovary syndrome (PCOS) is an endocrine gynecological disease affecting many women of reproductive age. Clomiphene is the first-line treatment for PCOS patients, but most individuals may be resistant to it. This study aims to assess the efficacy of dexamethasone and clomiphene in the treatment of PCOS patients, and to provide a theoretical basis for clinicians to study and treat PCOS.MethodsChinese and English databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang Medical Network, and VIP Information Chinese Journal Service Platform (VIP) were searched from the inception to January 2023. Review Manager and Stata software were used for meta- analysis. The risk of bias of eligible studies were assessed using Cochrane's risk of bias tool. Publication bias was assessed by funnel plots, Begg's and Egger's tests.ResultsA total of 12 literatures were finally included, with a total of 1270 PCOS patients. Compared with the control group, dexamethasone combined with clomiphene could significantly improve pregnancy (RR = 1.71, P ConclusionThe treatment of dexamethasone combined with clomiphene is helpful to improve the ovulation and pregnancy rate in patients with PCOS, and improve the hormone levels of patients.

Abstract licence: CC BY

BackgroundPCOS is a common endocrine gynecological disorder, and its associated hormonal abnormalities and ovulatory dysfunction are leading causes of infertility. Ovulation induction is considered a fundamental treatment for PCOS patients. Clomiphene and letrozole are currently widely used ovulation-inducing agents. This study employs meta-analysis to comprehensively and systematically evaluate the clinical efficacy and adverse effects of letrozole combined with clomiphene in the treatment of PCOS.ObjectiveThe aim of this study is to compare the clinical efficacy and adverse effects of letrozole combined with clomiphene in the treatment of PCOS, providing a theoretical basis for therapeutic decision-making.MethodsRCTs on letrozole combined with clomiphene for PCOS were retrieved from databases including PubMed, EMBASE, Cochrane Library, CNKI, Wanfang Medical Network, VIP Chinese Journal Service Platform, and CBM, with the search period spanning from database inception to March 2025. Data analysis was performed using Review Manager 5.3 and Stata software. Dichotomous variables were analyzed using RR with 95% CI, while continuous variables were assessed using SMD with 95% CI. The Cochrane Risk of Bias tool was used to evaluate the bias and risk of eligible studies. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in included studies.ResultsA total of 10 studies involving 931 PCOS patients were included. Compared with the control group, letrozole combined with clomiphene significantly improved pregnancy rates (RR = 1.50, 95% CI: 1.228-1.77, P ConclusionLetrozole combined with clomiphene therapy helps improve ovulation rates, pregnancy rates, and hormonal levels in PCOS patients.

Abstract licence: CC BY-NC-ND