SERMS during TRT for Fertility

Discussion in 'Men's Health Forum' started by dmore, May 14, 2015.

  1. dmore

    dmore Member

    Has anyone ever recommended or tried clomid for men on TRT in order to maintain fertility?
    Anyone have experiences?

  2. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    The lab values are needed for any possible explanation. I sense sloppy work.

    From the same group:

    Koukkou E, Billa E, Kapolla N, Pappa A, Venaki E, et al. An empiric treatment for idiopathic oligozoospermia revisited: a 20-year investigative saga. Andrologia. 2012;44(5):337-42.

    A series of studies aiming at introducing an effective treatment for idiopathic oligozoospermia was conducted in a step-wise fashion spanning over a 20-year period.

    The concept was that co-administration of an accessory gland-stimulating androgen, testosterone undecanoate (40 mg t.i.d.) and the FSH raising anti-oestrogen tamoxifen citrate (10 mg b.i.d.) may improve sperm parameters.

    A prerequisite for such an effect was the demonstration that testosterone undecanoate had no suppressing action on pituitary-testicular axis.

    In this context, initial studies demonstrated no change in basal or stimulated gonadotrophin and testosterone secretion in short- or long-term protocols.

    Two subsequent trials with this combination showed a marked improvement of sperm parameters and pregnancy incidence, with a seasonal variation noted in response to treatment, this being higher during the cold seasons of autumn and winter.

    Regarding the mechanism of testosterone undecanoate's action, a recent study from our unit showed that its administration resulted in a marked rise of serum DHT levels. Because this steroid is an epididymal function promoter, it appears that its contribution in the combination is mediated mainly through its DHT raising effect.

    By and large, this empiric approach for the treatment of idiopathic oligozoospermia was satisfactorily documented after a 20-year investigative saga.
    Dr JIM and dmore like this.
  3. dmore

    dmore Member

    Thanks for your input Dr Scally.
    If I may quote:
    "testosterone undecanoate had no suppressing action on pituitary-testicular axis."

    So basically they are saying Nebido, in particular, has no suppressing action, thus it won't affect HTPA axis being it the reason why SERMS still boost fertility?
    So the same won't happen with other esters?
  4. Brez

    Brez Junior Member

    Is it the testosterone in conjunction with tomoxafin that significantly raises dht or the testosterone by itself?
  5. dmore

    dmore Member

    Looks like test itself, in the case of this study in particular, undecanoate ester.
  6. killler

    killler Member

    Not is Andriol,the oral test which mainly converts to DHT and anecdotally it does not supress you much.
  7. Dr JIM

    Dr JIM Member

    Agreed !
  8. Dr JIM

    Dr JIM Member

    And I’d start by comparing
    LH/FSH levels to the dosage and dosing intervals.