Clomiphene treatment of the idiopathic hypofertile male: high-dose, alternate-day therapy.

Increasing reports suggest that clomiphene citrate (clomid) is useful in the treatment of idiopathic hypofertile males. Recent studies have advocated low-dose, cyclic therapy (25 mg daily for 25 days, 5 days' rest) and, although significant clinical responses have been reported, the hormone response has been erratic. This study of 53 patients, given high-dose, alternate-day therapy (100 mg three times/week), shows an over-all positive response rate of 66% and a pregnancy rate of 26%. Significant gonadotropin and testosterone surges were seen in the responders, but a selective lack of a follicle-stimulating hormone surge was noted in a small group of nonresponders. Clomiphene given in this dosage seems to be safe for periods of up to 15 months and appears to be a rational and useful agent for the treatment of this patient group.