Clomid, Nolvadex or Toremifene on TRT to boost FSH levels in combination with hCG for fertility?

[Dafox]

It seems to be a debatable topic whether or not there are any benefits to using Clomid or other serms on TRT.

We typically use hCG to retain fertility (or restore). The problem is that hCG does nothing for FSH. Can we use Clomid, Nolvadex or Toremifene to solve this issue? I know hMG can take care of FSH, but this is not an option in my case and I would like to entertain the idea of the possible benefits of using a serm on TRT to improve fertility.

There are plenty of studies showing either of the above mentioned serms significantly improving fertility rates in males on their own, but what is your thoughts on this for people on receiving testosterone injections?

Study 1: "Treatment with tamoxifen citrate and testosterone undecanoate improved sperm variables and led to a higher incidence of pregnancy in couples with subfertility related to idiopathic oligozoospermia."

Fertil Steril. 2003 Oct;80(4):914-20.
Effectiveness of combined tamoxifen citrate and testosterone undecanoate treatment in men with idiopathic oligozoospermia.
Adamopoulos DA, Pappa A, Billa E, Nicopoulou S, Koukkou E, Michopoulos J.
Source

Department of Endocrinology, Elena Venizelou Hospital, Athens, Greece. [email protected]
Abstract
OBJECTIVE:

To assess the effect of treatment with a combination of the antiestrogen tamoxifen citrate and the androgen testosterone undecanoate on sperm variables and pregnancy incidence in men with idiopathic oligozoospermia and couple subfertility.
DESIGN:

Prospective, randomized, placebo-controlled trial.
SETTING:

Clinical research in a tertiary care academic hospital.
PATIENT(S):

Two hundred twelve men with idiopathic oligozoospermia and 82 normozoospermic men with female factor subfertility.
INTERVENTION(S):

Oligozoospermic patients were randomly assigned to two treatment groups with tamoxifen citrate, 20 mg/d, and testosterone undecanoate, 120 mg/d (n = 106) or placebo treatment (n = 106) for 6 months. Normozoospermic men were followed for the same period. Couple counseling was part of the intervention in all groups.
MAIN OUTCOME MEASURE(S):

Pregnancy incidence and sperm characteristics after 3 and 6 months on medication and 3 months after the end of the trial.
RESULT(S):

In the active treatment group, total sperm count (median [25th, 75th percentile], 27.1 x 10(6) cells/mL [9.4, 54.0 x 10(6) cells/mL] at baseline and 61.5 x 10(6) cells/mL [28.2, 119.6 x 10(6) cells/mL] at 6 months), progressive motility (mean [+/-SD], 29.7% +/- 12.0% at baseline and 41.6% +/- 13.1% at 6 months), and normal morphology (mean, 41.2% +/- 14.0% at baseline and 56.6% +/- 11.5% at 6 months) were noted. No marked changes were observed in placebo recipients or normozoospermic men. The incidence of spontaneous pregnancy was 33.9% in the active treatment group and 10.3% in the placebo group (36 vs. 11 pregnancies), with a relative risk of 3.195 (95% CI, 2.615 to 3.765).
CONCLUSION(S):

Treatment with tamoxifen citrate and testosterone undecanoate improved sperm variables and led to a higher incidence of pregnancy in couples with subfertility related to idiopathic oligozoospermia.

Study 2: "These results indicate that the combination of tamoxifen citrate with T undecanoate not only improves significantly important seminal parameters but also compares favorably with the single treatments used."

Fertil Steril. 1997 Apr;67(4):756-62.
The combination of testosterone undecanoate with tamoxifen citrate enhances the effects of each agent given independently on seminal parameters in men with idiopathic oligozoospermia.
Adamopoulos DA, Nicopoulou S, Kapolla N, Karamertzanis M, Andreou E.
Source

Endocrine Department, Elena Venizelou Hospital, Athens, Greece.
Abstract
OBJECTIVE:

To evaluate the effects of combined tamoxifen citrate and T undecanoate treatment on seminal parameters in men with idiopathic oligozoospermia.
DESIGN:

Prospective randomized clinical study.
SETTING:

A state hospital tertiary clinic.
PATIENT(S):

Eighty oligozoospermic men were included in the protocol.
INTERVENTION(S):

Patients were randomized to receive placebo, T undecanoate (40 mg three times per day), tamoxifen citrate (10 mg two times per day), or T undecanoate plus tamoxifen citrate.
RESULT(S):

Tamoxifen citrate plus T undecanoate treatment produced a satisfactory improvement of total sperm number, motility, and functional sperm fraction after 3 and 6 months. Comparisons with other active treatment groups showed significantly higher increment values for motility and functional fraction, whereas aniline, acrosine, and free L-carnitine also were markedly better in the combination treatment group.
CONCLUSION(S):

These results indicate that the combination of tamoxifen citrate with T undecanoate not only improves significantly important seminal parameters but also compares favorably with the single treatments used. Therefore, this combination deserves a place as a first line of treatment in idiopathic oligozoospermia.

 

[CoastWatcher]

One simply doesn't use Clomid with exogenous testosterone. They work against one another. It's a counterproductive concept. See post numbers eight and nine for comments made by Dr. Justin Saya in regard to the protocols followed by Defy Medical when it comes to a restart. https://www.excelmale.com/forum/sho...-HPTA-Reset-Protocol&highlight=tamoxifen+saya

 

[Billwatts]

One simply doesn't use Clomid with exogenous testosterone. They work against one another. It's a counterproductive concept. See post numbers eight and nine for comments made by Dr. Justin Saya in regard to the protocols followed by Defy Medical when it comes to a restart. https://www.excelmale.com/forum/sho...-HPTA-Reset-Protocol&highlight=tamoxifen+saya

Would tamoxifen help with fsh while on trt?

 

[CoastWatcher]

Would tamoxifen help with fsh while on trt?

See posts eight, nine, and ten in this thread. Dr. Saya and Nelson comment on that.

https://www.excelmale.com/forum/sho...-HPTA-Reset-Protocol&highlight=tamoxifen+saya

 

[Billwatts]

See posts eight, nine, and ten in this thread. Dr. Saya and Nelson comment on that.

https://www.excelmale.com/forum/sho...-HPTA-Reset-Protocol&highlight=tamoxifen+saya

This is great thank you

 

[Dafox]

Sorry, maybe I'm being slow here, but I just don't see the connection between those answers by Dr. Nelson and Dr. Justin Saya in relation to this topic.
They are discussing HPTA restart protocols after cessation of TRT - not improving fertility on TRT using SERMS. Surely there is a difference between the two?

Furthermore, shouldn't the studies I linked indicate that there is something to be gained here or did I miss something?