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Tamoxifen is frequently used to treat oligospermia

Forum: TTC with Male Infertility


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May 21st, 2011, 04:27 PM
Super Mommy
Join Date: Sep 2009
Posts: 998
Tamoxifen is frequently used to treat oligospermia ( low sperm count).

Fertil Steril. 2003 Oct;80(4):914-20. Related Articles, Links

Effectiveness of combined tamoxifen citrate and testosterone undecanoate treatment in men with idiopathic oligozoospermia.

Adamopoulos DA, Pappa A, Billa E, Nicopoulou S, Koukkou E, Michopoulos J.

Department of Endocrinology, Elena Venizelou Hospital, Athens, Greece. [email protected]

OBJECTIVE: To assess the effect of treatment with a combination of the antiestrogen tamoxifen citrate and the androgen testosterone undecanoate on sperm variables and pregnancy incidence in men with idiopathic oligozoospermia and couple subfertility. DESIGN: Prospective, randomized, placebo-controlled trial. SETTING: Clinical research in a tertiary care academic hospital. PATIENT(S): Two hundred twelve men with idiopathic oligozoospermia and 82 normozoospermic men with female factor subfertility. INTERVENTION(S): Oligozoospermic patients were randomly assigned to two treatment groups with tamoxifen citrate, 20 mg/d, and testosterone undecanoate, 120 mg/d (n = 106) or placebo treatment (n = 106) for 6 months. Normozoospermic men were followed for the same period. Couple counseling was part of the intervention in all groups. MAIN OUTCOME MEASURE(S): Pregnancy incidence and sperm characteristics after 3 and 6 months on medication and 3 months after the end of the trial. RESULT(S): In the active treatment group, total sperm count (median [25th, 75th percentile], 27.1 x 10(6) cells/mL [9.4, 54.0 x 10(6) cells/mL] at baseline and 61.5 x 10(6) cells/mL [28.2, 119.6 x 10(6) cells/mL] at 6 months), progressive motility (mean [+/-SD], 29.7% +/- 12.0% at baseline and 41.6% +/- 13.1% at 6 months), and normal morphology (mean, 41.2% +/- 14.0% at baseline and 56.6% +/- 11.5% at 6 months) were noted. No marked changes were observed in placebo recipients or normozoospermic men. The incidence of spontaneous pregnancy was 33.9% in the active treatment group and 10.3% in the placebo group (36 vs. 11 pregnancies), with a relative risk of 3.195 (95% CI, 2.615 to 3.765). CONCLUSION(S): Treatment with tamoxifen citrate and testosterone undecanoate improved sperm variables and led to a higher incidence of pregnancy in couples with subfertility related to idiopathic oligozoospermia.


Fertil Steril. 1994 May;61(5):911-4. Related Articles, Links

Tamoxifen treatment in male infertility. I. Effect on spermatozoa.

Kotoulas IG, Cardamakis E, Michopoulos J, Mitropoulos D, Dounis A.

Department of Gynecology, General Hospital of Athens, Greece.

OBJECTIVE: To evaluate the effects of tamoxifen treatment on sperm density, motility, vitality, and morphology. DESIGN: Placebo-controlled, randomized study. SETTING: Outpatient department. INTERVENTIONS: Patients were assigned to two comparable groups: group A (n = 122) was treated with 10 mg tamoxifen twice daily for a period of 3 months and group B (n = 117) was given placebo for the same period of time, following a previously randomized design. MAIN OUTCOME MEASURES: In every patient sperm density, motility, viability, and morphology were evaluated 3 months after cessation of treatment. RESULTS: Mean sperm density in group A improved significantly with a more pronounced improvement in severe oligozoospermic men. Sperm density was found significantly improved compared with group B. Dead spermatozoa in group A significantly decreased after tamoxifen treatment and were also found significantly decreased compared with group B. CONCLUSION: [/B]It is concluded that tamoxifen exerts a beneficial effect on sperm density and number of live spermatozoa but it has no substantial effect in sperm motility and morphology.[/B]


Exp Clin Endocrinol. 1988 Dec;92(2):211-6. Related Articles, Links

Hormonal changes in tamoxifen treated men with idiopathic oligozoospermia.

Hampl R, Heresova J, Lachman M, Sulcova J, Starka L.

Research Institute of Endocrinology, Prague/Czechoslovakia.

Three months of tamoxifen treatment of 43 men with idiopathic oligozoospermia, out of which 20 completed the study, resulted in a significant enhancement of sperm motility, but the improvement of sperm parameters was in no relation to the FSH response to short time tamoxifen treatment. There was a significant increase of testosterone, estradiol, LH, FSH, SHBG, 17 alpha-hydroxy-progesterone and also of 11 beta-hydroxyandrostenedione, an androgen of exclusively adrenal origin, during the treatment and (with the exception of the latter), on the first week after discontinuation of the therapy. Significantly elevated testosterone and SHBG concentrations were retained still 9 weeks after finishing of the therapy. The results confirm that tamoxifen treatment provides conditions more favourable for conception and demonstrate that also adrenal steroidogenesis is positively influenced by this antiestrogen.


Andrologia. 1987 May-Jun;19(3):333-41. Related Articles, Links

[Therapeutic results with tamoxifen in oligospermia. II. Hormonal analysis and semen parameters]

[Article in German]

Schieferstein G, Adam W, Armann J, Bantel E, Corlin R, Egenrieder H, Fierlbeck G, Hook B, Schiek A, Schubring G, et al.

During a five months lasting treatment with tamoxifen (2 X 10 resp. 2 X 20 mg daily) a significant increase of testosterone, LH, FSH, estradiol, free testosterone and SHBG was found. The prolactin levels diminished. In semen analysis the values of pH and fructose decreased within the normal range. The sperm density increased significantly, but we could not ascertain whether a dosage of 2 X 20 mg/die will provide better therapeutic results. Furthermore the hormonal and seminal investigations described in this paper did not allow to predict those patients who would be good responders on tamoxifen therapy. Tamoxifen seems to be effective in normo-, but also in hypo- and hypergonadotropic patients.


Horm Res. 1987;28(2-4):219-29. Related Articles, Links

Antiestrogens as treatment of female and male infertilities.

Buvat J, Buvat-Herbaut M, Marcolin G, Ardaens-Boulier K.

Centre d'Etude de la Pathologie de l'Appareil Reproducteur et de la Psychosomatique (EPARP), Lille, France.

Antiestrogens are widely used to treat eugonadal anovulation, luteal phase deficiency (LPD) and oligospermia. This paper reviews the rationales, endocrine effects, profertility effects and side effects of these treatments. Furthermore, we present our own experience of the use of antiestrogens in this field. We have compared the results of clomiphene citrate (CC) to those of tamoxifen (TAM) in a randomized study including 66 infertile women presenting eugonadal anovulation (n = 26) or LPD (n = 40). Both drugs obtained the same pregnancy rate of 80% at 9 months in the anovulatory patients. Conversely, CC was superior to TAM in the LPD cases (pregnancy rates at 6 months of respectively 40 and 11%). The abortion rates were of 11% on CC versus 36% on TAM. Both drugs significantly increased the luteal phase length and plasma progesterone level to the same extent. The results of endometrial biopsies suggest that the difference in their effects on female fertility could result from a detrimental effect of TAM on endometrium. The rates of the side effects proved to be almost identical on both drugs. Thus the use of TAM is not justified as a first-step treatment in ovulation disturbances. TAM should be reserved for patients who experience severe visual side effects on CC. We have also tested TAM in 100 subfertile males. In the 92 oligospermic males, TAM significantly increased the mean sperm count only in the normogonadotropic patients, but as much whether oligospermia was idiopathic or not. Sperm improvement was not significantly related to any hormone criterion except basal serum FSH. The cumulative pregnancy rate was of 41.2% at 1 year. Whether TAM actually improves male fertility, and is superior to CC in this indication, remains to be confirmed in controlled studies.


Acta Eur Fertil. 1985 Sep-Oct;16(5):361-4. Related Articles, Links

Treatment of idiopathic oligozoospermia with tamoxifen.

Brigante C, Motta G, Fusi F, Coletta MP, Busacca M.

Eighteen subfertile men, with idiopathic normogonadotropic oligozoospermia were treated with an antiestrogenic compound, tamoxifen (Nolvadex), at the dose of 20 mg/day for four months. Hormonal parameters (LH, FSH, Testosterone, Prolactin) were evaluated before treatment and after 45 and 90 days of therapy. Serum LH, FSH and Testosterone increased significantly after 45 days of tamoxifen treatment. Seminal analyses, performed before and after three months of therapy showed improvements in sperm motility and in sperm density. By our clinical findings, tamoxifen can be considered a useful approach for an empiric treatment of idiopathic oligozoospermia.


Andrologia. 1985 Jul-Aug;17(4):369-78. Related Articles, Links

Effect of lower versus higher doses of tamoxifen on pituitary-gonadal function and sperm indices in oligozoospermic men.

Dony JM, Smals AG, Rolland R, Fauser BC, Thomas CM.

Administration of the antiestrogen tamoxifen for one month to 12 patients with idiopathic oligozoospermia significantly increased the mean basal testosterone (T) level and the responses of luteinizing hormone (LH) and follicle stimulating hormone (FSH) to constant luteinizing hormone releasing hormone (LHRH) infusion but did not significantly influence the mean oestradiol (E2) levels or the E2 over testosterone ratio. Mean sperm concentration and total sperm output increased by about 70% after a mean treatment period of 5.5 +/- 0.4 months. No statistically significant difference was found between the two subgroups of patients treated with either the lower (5 or 10 mg once daily) or higher dose of tamoxifen (10 mg twice daily) with respect to basal or LHRH stimulated gonadotropin and testosterone response or the E2/T ratio and the effect on sperm density and total sperm output. In both subgroups the sperm motility and morphology remained unchanged. In conclusion higher doses of tamoxifen in this study prove not to be superior to lower doses in improving mean sperm density and total sperm output. The relative small percentage of patients achieving normalisation of only these sperm parameters pleads for further search for more effective selection of patients and other more effective treatment modalities in patients with idiopathic oligozoospermia.


Andrologia. 1985 May-Jun;17(3):285-90. Related Articles, Links

Treatment of oligozoospermia by tamoxifen: no evidence for direct testicular action.

Krause W, Hubner HM, Wichmann U.

The improvement of impaired spermatogenesis by tamoxifen is well documented. The antiestrogen seems to act via an enhancement of gonadotropin release from the hypophysis, but there is evidence for a direct testicular effect. Thus we studied the serum levels of gonadotropins and steroid hormones in 22 patients with idiopathic oligozoospermia. To study the direct testicular effect, we tested the response of 5 normal males to hCG prior to and after the application of tamoxifen. FSH levels showed a continuous increase in the patients during the three months of treatment, while the stimulation by LH-RH was not altered. In the case of LH the basal as well the stimulated levels increased. Mean levels of testosterone, 17-hydroxyprogesterone, androstenedione and estradiol increased significantly during treatment. Sperm counts of patients were found to be considerably higher after three months. In the normal males no differences in steroid levels as a response to hCG with and without tamoxifen treatment occurred. Our results give evidence, that the hormonal changes occurring under tamoxifen treatment are not due to a direct testicular effect.


Arch Androl. 1985;15(1):83-8. Related Articles, Links

Tamoxifen and oligospermia.

Noci I, Chelo E, Saltarelli O, Donati Cori G, Scarselli G.

Thirty normogonadotropic oligospermic males were administered Tamoxifen (20 mg/day) for 4 months. A complete evaluation of seminal parameters before and after treatment was performed. An increase of both mean sperm concentration and total sperm count was noted after treatment with Tamoxifen (p less than 0.05), whereas no variation was observed for semen volume, sperm morphologic characteristics, or sperm motility. Hormonal patterns of 5 of these subjects before, during, and after 3 months of treatment with Tamoxifen showed a progressive increase of gonadotropin (especially LH) and 17 beta E2 values; testosterone variations were minimal, and PRL showed a slight decrease.


Hautarzt. 1981 Jun;32(6):306-8. Related Articles, Links

[Experiences with the antiestrogen tamoxifen in the therapy of oligozoospermia]

[Article in German]

Schill WB, Landthaler M.

Thirty-three subfertile men with idiopathic normogonadotropic oligozoospermia were treated with daily 2 x 10 mg tamoxifen, a nonsteroidal antiestrogen, for a period of five months. The statistical evaluation of the semen parameters yielded a significant increase of the sperm count and the total sperm output after three months of treatment with a further increase after five months. The percentage of motile spermatozoa increased already after one month and remained significantly increased during the whole treatment period. Progressive motility, sperm morphology, ejaculate volume and seminal plasma fructose were not affected. Side effects were not observed. The conception rate was 38 per cent within a period of one year.


Eur Urol. 1981;7(5):283-7. Related Articles, Links

Tamoxifen treatment in oligozoospermia.

Bartsch G, Scheiber K.

This study of the effects of long-term tamoxifen administration on semen analysis of oligospermic males confirms the potential therapeutic efficacy in normogonadotrophic oligospermia. 38 out of the 56 patients responded well to long-term treatment with 30 mg tamoxifen daily. According to the nomenclature of Eliasson, 32 patients reached normal sperm density and 16 patients normal sperm motility after tamoxifen treatment. In the group of responders a pregnancy rate of 34% is obtained. As far as the endocrinological parameters are concerned normogonadotrophic patients (responders and non-responders) showed an increase in testosterone, 17beta-estradiol, LH and FSH levels, whereas the levels of prolactin and testosterone/estradiol-binding globulin remained unchanged. No alterations at all were seen with regard to semen volume, during the time of tamoxifen treatment.


Andrologia. 1980 Nov-Dec;12(6):546-8. Related Articles, Links

Tamoxifen treatment of oligozoospermia.

Schill WB, Landthaler M.

33 subfertile men with idiopathic normogonadotropic oligozoospermia were treated with the non-steroidal antiestrogen tamoxifen. A significant improvement of sperm count, total sperm output and sperm motility was observed.

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August 4th, 2011, 10:34 PM
Join Date: Aug 2011
Posts: 3
Hey friend, thanks for providing detailed information about the medicine.This is really helpful. You have explained every aspect of it in detail.
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August 13th, 2011, 09:12 AM
Super Mommy
Join Date: Sep 2009
Posts: 998
Your welcome, my DH has been taking it about 4 months now and his count and motility has more then doubled.
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