Design: Prospective randomized controlled trial study.

Material and Method: Between May 2013 and October 2014, 68 infertile male with semen abnormality were asked to join the present study. Informed consents were signed; all patients were divided into four groups, given placebo (control), Tamoxifen citrate 20 mg/day, Folate 5 mg/day, and Tamoxifen citrate plus Folate for continuous three months. The result of treatments i.e., semen parameters, hyaluronan binding assay, hypo-osmotic swelling test, and DNA damage test were evaluated at baseline, at the end of drugs treatment (3-month), and at 3-month after discontinuation of treatment (6-month).

Results: Tamoxifen alone caused a significant increase in sperm concentration, while Tamoxifen plus Folate significantly increased both sperm concentration and sperm motility at 3-month after treatment. Folate alone and Tamoxifen plus Folate significantly decreased DNA tail length at 3-month and at 3- and 6-month after treatment, whereas Tamoxifen alone caused no significant change in DNA tail length. Sperm DNA integrity was improved as seen by decrease in the length of DNA tail.

Conclusion: Our study indicated that Folate in combination with Tamoxifen citrate could improve sperm quality including semen parameters and sperm DNA integrity.

Keywords: Infertility, Semen quality, Tamoxifen citrate, Folate