Male patients that have low testosterone, but are trying to conceive should refrain from testosterone completely until after they conceive. The reason is that testosterone will result in a decrease in sperm count and thus reduce the probabilities of successful conception. Clomid for men is used when low sperm count is caused by low testosterone levels. In a subset of the male population, a low sperm count is caused by a low testosterone level.
Our Doctors recommend a Clomid/hCG/anastrozole protocol for male patients that fit this criteria. This protocol will raise testosterone levels and sperm count concurrently.
Clomid is a fertility medication. It is a SERM (selective estrogen receptor modulator). By blocking estrogen receptors in the hypothalamus it causes increased production of gonadotropin, luteinizing hormone (LH), and follicle stimulation hormone (FSH). This in turn causes increased testicular activity to produce testosterone and sperm. Higher levels of these hormones can improve sperm count, morphology, and motility. Our Doctors prescribe this together with anastrozole to reduce the risk of SHBG over-production.
In normal patient physiology, the gonadotropins are released from the pituitary gland which stimulate the testes for testosterone production. A small amount of testosterone is then converted into estrogen which becomes the “off” signal for the pituitary to stop producing testosterone. In obese and insulin resistant patients, adipose tissue also produces estrogen which signals the pituitary gland to stop producing hormones. Clomid helps by blocking that estrogen feedback and reducing the “off” signal to the pituitary, so that it can further stimulate the testes to produce testosterone. This way, clomiphene helps to interrupt the pathway that leads to hypogonadotropic hypogonadism.