Effects of Clomiphene Citrate Versus Letrozole on Semen Count and Motility in Men with Oligoasthenozoospermia in Osogbo, South- Western Nigeria: A Randomised Study

Background: Infertility is a major cause of socio-emotional and psychological burden world-wide and nearly half of all cases of infertility were as a result of male partner’s related factors of which oligoasthenozoospermia is a major contributor. Currently, different treatments have been developed to manage this deficiency and improve semen parameters but no substantial results have been documented.

Aims: This study therefore aims at evaluating the effects of clomiphene citrate versus letrozole on semen count and motility in men with oligoasthenozoospermia in Osogbo, south-western Nigeria

Study Design: A randomized control study carried out at the gynaecology clinic of LAUTECH teaching hospital, State specialist hospital and Ayomide Women’s Health Specialist Hospital and IVF Centre Osogbo, Osun State.

Methodology: One hundred and forty (140) participants were randomized into the letrozole group and the clomiphene citrate group, with 70 participants in each arm of the study. The outcome measure includes the improvement in sperm concentration and motility (assessed at 4 and 8 weeks) following 3 months of alternate day administration of clomiphene citrate and letrozole by the participants. The study compared the improvement in semen concentration and motility following administration of Clomiphene citrate versus Letrozole among men with oligoasthenozoospermia. Data collected were analysed using Statistical Package for Social Statistics (SPSS-21) software and the level of significance was set at < 0.05.

Results: Letrozole and clomiphene caused significant improvement in sperm motility and concentration with letrozole having higher improvement in both sperm concentration and motility when compared to clomiphene citrate. There was 43.65% increased sperm concentration at 4 weeks and 48.24% increased at 8 weeks post-treatment in the letrozole group, while increased sperm concentration of 17.68% at 4 weeks post-treatment and 26.27% increment at 8 weeks post-treatment in the clomiphene citrate group was observed. Also, there was 33.24% increased sperm motility at 4 weeks and 42.09% at 8 weeks post-treatment in the letrozole group, and 14.30% increased sperm motility at 4 weeks and18.56% at 8 weeks post-treatment.

Conclusion: Sperm concentration and motility in men with oligoasthenozoospermiacan be improved with Letrozole and clomiphene citrate. Higher effect was observed in Letrizole group compared to clomiphene.