(181) Combination Clomiphene Citrate and Anastrozole Therapy Iimproves Semen Parameters in a Multi-institutional Cohort of Men with Idiopathic Infertility

Abstract Introduction Clomiphene citrate (CC), a selective estrogen receptor modulator, and anastrozole, aromatase inhibitor, are common empiric medical therapies for men with idiopathic infertility. The effects of jointly administering these agents not well understood. Objective objective this study is to compare semen parameters in treated clomiphene anastrozole (CC-A) combination therapy those taking alone. Methods We performed multi-center, retrospective cohort infertility prescribed at two tertiary referral institutions. Demographic, laboratory, prescription data were captured. subset patients CC the time initiation identified. Patients pre-treatment normozoospermia, recent or current exogenous testosterone human chorionic gonadotropin use, previous orchiectomy, scrotal surgery during treatment period excluded. Outcome measures included changes World Health Organization sperm concentration category (WHO-SCC) following therapy. Linear logistic regression models constructed evaluate association outcomes. Results 72 analysis cohort, including 54 alone 18 on who subsequently started (CC-A). Men CC-A relative monotherapy older (40 vs. 35 years, p=0.03) had lower BMI (30 34 kg/m^2, p=0.05), respectively. Pre-treatment LH levels (5.6 7.6 IU/L, p=0.25) (336 vs 263 ng/dL, p=0.32) similar. Baseline (3.7 2.3 M/mL, p=0.26) motility (41 36%, p= 0.17) also comparable. However, post-treatment median (6.9 3.4M/mL, p=0.02) change mean (17.5 6.2 significantly higher group. Univariate linear revealed an between use CCA increase (p=0.05). Despite differences, WHO-SCC upgrade rates groups comparable (56 39%, p=0.22) setting similar (7.4 8.6 p=0.5), FSH (8.6 9.4 IU/mL, p=0.19), (537 415 p=0.09). Conclusions Combination was associated modest benefits when compared monotherapy. using offers small, but significant, clinical benefit over infertile Disclosure No