Restoring Testosterone Recommended to Preserve Sperm Count

Restoring production of testosterone in overweight hypogonadal men is just as effective as replacing it and helps to maintain the men’s fertility, according to a recent study.

While testosterone replacement therapy is an effective treatment method for hypogonadism, it can also result in significant reductions in sperm count, leading to infertility. Alternatively, testosterone restoration with drugs like enclomiphene citrate could prevent this side effect.
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To further examine the potential of this alternative treatment method, researchers conducted 2 parallel randomized, double-blind, double-dummy, placebo-controlled, multicenter phase III studies of overweight men between the ages of 18 and 60 years old with secondary hypogonadism.

Participants were randomized between 12.5 mg of oral enclomiphene citrate daily, 25 mg of oral enclomiphene citrate daily, topical 1.62% testosterone gel, and placebo.

After 16 weeks of follow-up, testosterone levels had increased in all treatment groups, but sperm counts had significantly decreased in the group using testosterone gel.

“Enclomiphene citrate consistently increased serum total testosterone, luteinising hormone and follicle-stimulating hormone, restoring normal levels of serum total testosterone,” they concluded.

“Enclomiphene citrate treatment maintained sperm concentrations in the normal range. The effects on total testosterone were also seen with testosterone replacement via testosterone gel but sperm counts were not maintained.”

—Michael Potts

Reference:

Kim ED, McCullough A, Kaminetsky J. Oral enclomiphene citrate raises testosterone and preserves sperm counts in obese hypogonadal men, unlike topical testosterone: restoration instead of replacement. BJU International. October 23, 2015 [epub ahead of print]. DOI: 10.1111/bju.13337.