How to sway my doctor about the use of hCG and Clomiphene?

[Randy]

Hi Guys,

We had a productive meeting with the Medical Director (Fertility Department) from one of our main Hospitals on Friday. He's admitted they are behind on the latest research regarding the use of hCG and Clomifene and it's not an area they are experienced with.

My objective is to have them review the use of both for guys on TRT, guys coming off TRT and to restore fertility in men.

I've looked at almost all of the studies I can find (through excellent forums like this one)... however given he's busy and has limited capacity to take too much more on... what would be the 1-3 best/main/most compelling studies you would send him?

Thanks for your help!

 

[Vince]

you may have read this https://www.excelmale.com/forum/sho...e-Testicular-Shrinkage-and-Preserve-Fertility but if not you can print it for you doctor

 

[Randy]

Yes, thanks. Doctors want to see "credible studies" (large, double-blind, placebo-controlled, etc.)...

These are the ones I've already emailed them...

Clomiphene studies are linked as follows:


1. Oral Enclomiphene Citrate Stimulates the Endogenous Production of Testosterone and Sperm Counts in Men with Low Testosterone: Comparison with Testosterone Gel
http://onlinelibrary.wiley.com/doi/10.1111/jsm.12116/abstract

2. Clomiphene citrate is safe and effective for long-term management of hypogonadism.
http://www.ncbi.nlm.nih.gov/pubmed/22458540

3. Outcomes of clomiphene citrate treatment in young hypogonadal men
http://www.ncbi.nlm.nih.gov/pubmed/22044663

4. Clomiphene citrate and testosterone gel replacement therapy for male hypogonadism: efficacy and treatment cost.
http://www.ncbi.nlm.nih.gov/pubmed/19694928

5. Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit?
http://www.nature.com/ijir/journal/v15/n3/full/3900981a.html

6. Hypogonadism, ADAM, and hormone replacement
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3126089/


Human Chorionic Gonadotropin (hCG) studies as follows:


1. Low-Dose Human Chorionic Gonadotropin Maintains Intratesticular Testosterone in Normal Men with Testosterone-Induced Gonadotropin Suppression
http://press.endocrine.org/doi/full/10.1210/jc.2004-0802

2. Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy.
http://www.ncbi.nlm.nih.gov/pubmed/23260550

3. Exogenous testosterone: a preventable cause of male infertility
http://www.amepc.org/tau/article/view/2249/3145

4. Maintenance of spermatogenesis in hypogonadotropic hypogonadal men with human chorionic gonadotropin alone.
http://www.ncbi.nlm.nih.gov/pubmed/12444893

5. Effects of three different medications on metabolic parameters and testicular volume in patients with hypogonadotropic hypogonadism: 3-year experience.
http://www.ncbi.nlm.nih.gov/pubmed/23278834

 

[Nelson Vergel]

Randy

That was very nice of you to paste these references. Thank you so much.

 

[Gene Devine]

Yes indeed, very nice work Randy!

 

[Randy]

All good! I've spend a huge amount of time researching this to educate myself! he he

Now I'm using this to educate the Doctors! OMG

I even went to the extent of highlighting the key points for them... and they still didn't read it!

 

[Gene Devine]

All good! I've spend a huge amount of time researching this to educate myself! he he

Now I'm using this to educate the Doctors! OMG

I even went to the extent of highlighting the key points for them... and they still didn't read it!

So if they didn't read it, what was your outcome? How did things end up?

 

[Randy]

Firstly they said this...

"In the meantime, Prof ___ explains that this type of treatment is not provided by ____ as part of publicly funded fertility treatment. To date we regard the use of clomiphene in the context you describe as insufficiently evidence based and we have no clinical experience with this. We do run reproductive endocrinology clinics, but these are primarily geared towards fertility treatment. Private consultation with reproductive endocrinologists from a general medical endocrinology background, rather than with our reproductive endocrinologists who come from a fertility background, might be another setting in which this question could be raised."

I then had the meeting with him and he basically said he was open to looking at it as they should always keep an open mind(!)...

He suggested I send him a few specific questions and the related studies so he can review and give his opinion...

 

[Nelson Vergel]

Now on TRT plus HCG to preserve fertility
Clomid, Fertility, and Restarting TRT after Successful Pregnancy
Is Clomid (Clomiphene) Effective to Increase Testosterone, Fertility and Sperm Volume?

 

[Randy]

Guys, if you haven't seen it already!

Preserving fertility in the hypogonadal patient: an update
http://www.ajandrology.com/preprintarticle.asp?id=142772