I think I saw a video a while back with @Nelson Vergel saying some men use Enclomiphene while on TRT and some inexplicably become fertile using that method. What are the cons of trying that? If I wanted to throw that Hail Mary, what dose of Enclomiphene should I use?
Enclomiphene on TRT for Fertility
- Thread starter jc2c
- Start date
Assuming secondary hypogonadism, then with few exceptions enclomiphene will not restore or maintain fertility with any form of TRT that keeps serum testosterone at mid to high levels continuously. These forms of TRT include injections of testosterone esters, topical testosterone products and pellets. It has been demonstrated by Maximus that at least one form of oral testosterone is short-acting enough to be amenable to stimulation by enclomiphene.
The reason why enclomiphene is usually ineffective with TRT is because there is independent negative feedback by androgens at the hypothalamus. A SERM such as enclomiphene only blocks negative feedback from estrogens.
If you want to try it anyway then you might be interested in my speculation about cistanche, which perhaps would ameliorate the negative feedback by androgens.
The cons are primarily the hassle and expense. There's also uncertainty about the long-term effects of SERM/SARM use. It's not clear how selective these are for the target receptors in the HPTA. There's at least suspicion that enclomiphene can dampen libido via effects on other brain areas.
The reason why enclomiphene is usually ineffective with TRT is because there is independent negative feedback by androgens at the hypothalamus. A SERM such as enclomiphene only blocks negative feedback from estrogens.
If you want to try it anyway then you might be interested in my speculation about cistanche, which perhaps would ameliorate the negative feedback by androgens.
The cons are primarily the hassle and expense. There's also uncertainty about the long-term effects of SERM/SARM use. It's not clear how selective these are for the target receptors in the HPTA. There's at least suspicion that enclomiphene can dampen libido via effects on other brain areas.
Nelson Vergel
Founder, ExcelMale.com
https://www.excelmale.com/threads/safety-and-efficacy-of-enclomiphene-compared-to-clomiphene-in-men-with-low-testosterone.29915/
Both clomiphene (Clomid) and its isomer enclomiphene are used off-label to treat men with low testosterone who wish to preserve fertility[1][2].
The study retrospectively analyzed 66 men who were prescribed clomiphene and later switched to enclomiphene at a university hospital between January 2021 and December 2022[1][2].
All patients had baseline labs before clomiphene, follow-up labs before switching, and then labs after switching to enclomiphene; adverse events were tracked during both treatment periods[1][2].
Adverse events monitored included depressive thoughts, weak muscle strength, gynecomastia, mood changes, agitation, and changes in estradiol and hematocrit[1].
Adverse event rates:
On clomiphene, 18.18% of men experienced adverse events.
On enclomiphene, only 3.45% of men experienced adverse events—a statistically significant reduction[1][2].
Neither medication resulted in any serious adverse events[1].
Testosterone response:
Both drugs led to significant increases in testosterone, with no statistically significant difference in the magnitude of testosterone improvement between clomiphene and enclomiphene (t-value = 0.883; p = 0.379)[1][2].
On average, testosterone increased 149.33 ng/dL from baseline on clomiphene, and a further 108.55 ng/dL after switching to enclomiphene[1].
Estradiol (estrogen) response:
Clomiphene caused a significant increase in estradiol (+17.25 pg/mL).
Enclomiphene did not cause a significant increase in estradiol (–0.29 pg/mL)[1][2].
Hematocrit:
No significant difference in change in hematocrit between the two medications[1].
Duration:
Men stayed on clomiphene for an average of 32.92 months before switching to enclomiphene[1].
Conclusion:
Enclomiphene provides similar improvements in testosterone compared to clomiphene but with a much lower rate of adverse events, especially related to mood and estrogenic side effects[1][2].
The study supports enclomiphene as a safer, equally effective alternative to clomiphene for hypogonadal men seeking to maintain fertility[1][2].
Larger, long-term studies are needed to confirm these findings and further assess the long-term safety of enclomiphene[1][2].
Both clomiphene (Clomid) and its isomer enclomiphene are used off-label to treat men with low testosterone who wish to preserve fertility[1][2].
The study retrospectively analyzed 66 men who were prescribed clomiphene and later switched to enclomiphene at a university hospital between January 2021 and December 2022[1][2].
All patients had baseline labs before clomiphene, follow-up labs before switching, and then labs after switching to enclomiphene; adverse events were tracked during both treatment periods[1][2].
Adverse events monitored included depressive thoughts, weak muscle strength, gynecomastia, mood changes, agitation, and changes in estradiol and hematocrit[1].
Adverse event rates:
On clomiphene, 18.18% of men experienced adverse events.
On enclomiphene, only 3.45% of men experienced adverse events—a statistically significant reduction[1][2].
Neither medication resulted in any serious adverse events[1].
Testosterone response:
Both drugs led to significant increases in testosterone, with no statistically significant difference in the magnitude of testosterone improvement between clomiphene and enclomiphene (t-value = 0.883; p = 0.379)[1][2].
On average, testosterone increased 149.33 ng/dL from baseline on clomiphene, and a further 108.55 ng/dL after switching to enclomiphene[1].
Estradiol (estrogen) response:
Clomiphene caused a significant increase in estradiol (+17.25 pg/mL).
Enclomiphene did not cause a significant increase in estradiol (–0.29 pg/mL)[1][2].
Hematocrit:
No significant difference in change in hematocrit between the two medications[1].
Duration:
Men stayed on clomiphene for an average of 32.92 months before switching to enclomiphene[1].
Conclusion:
Enclomiphene provides similar improvements in testosterone compared to clomiphene but with a much lower rate of adverse events, especially related to mood and estrogenic side effects[1][2].
The study supports enclomiphene as a safer, equally effective alternative to clomiphene for hypogonadal men seeking to maintain fertility[1][2].
Larger, long-term studies are needed to confirm these findings and further assess the long-term safety of enclomiphene[1][2].
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