Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short‐course randomized study

Habous, Mohamad; Giona, Simone; Tealab, Alaa; Aziz, Mohammed; Williamson, Ben; Nassar, Mohammed; Abdelrahman, Zeyad; Remeah, Abdallah; Abdelkader, Mohamed; Binsaleh, Saleh; Muir, Gordon

doi:10.1111/bju.14401

Cited by 33 publications

(43 citation statements)

References 22 publications

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“…HCG use in men was subsequently studied as early as 1950 and has since been shown to effectively raise endogenous testosterone levels [56,57]. One recent study showed that hypogondal men treated with HCG monotherapy experienced an increase in their serum testosterone of approximately ~250 ng/dL with an acceptable improvement of hypogondal symptoms [57]. An additional benefit of HCG is that it acts directly on the testicle, provoking a prompt response relative to indirect medications like CC that rely on pituitary synthesis of LH.…”

Section: Human Chorionic Gonadotropinmentioning

confidence: 99%

Management of Anabolic Steroid-Induced Infertility: Novel Strategies for Fertility Maintenance and Recovery

Tatem

Beilan

Kovac³

et al. 2020

World J Mens Health

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There is often inherent conflict in the overlapping fields of male fertility and andrology. While the goal of all male fertility specialists is to facilitate and preserve biologic paternity, many practitioners also care for a significant number of patients suffering from hypogonadism. Exogenous testosterone administration, the gold standard for the management of these patients, almost universally impairs spermatogenesis and can even completely eradicate it in some men. With steady increases in both the incidence of hypogonadism and average paternal age, practitioners are now encountering hypogonadal men who desire future fertility or men suffering the effects of earlier androgenic anabolic steroid use with increasing frequency. In this manuscript, we review management strategies for these complex patients and explore novel medications that may be of use in this population.

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Section: Human Chorionic Gonadotropinmentioning

confidence: 99%

Management of Anabolic Steroid-Induced Infertility: Novel Strategies for Fertility Maintenance and Recovery

Tatem

Beilan

Kovac³

et al. 2020

World J Mens Health

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“… 35 The effectiveness of hCG alone or in combination with CC has been reported. 36 The combination of hCG + CC is a safe, low-cost and effective treatment that can be used to preserve fertility capacity. We have not been able to demonstrate that the dose of hCG is reduced in the combination of CC and hCG due to the small and rare number of samples.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Combination of Human Chorionic Gonadotropin and Clomiphene Citrate in Treatment of Male Hypogonadotropic Hypogonadism: A Prospective Study

Hung¹,

Hiền²,

Tuan

et al. 2021

RRU

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Background In this study, we evaluated MHH patients who wished to preserve fertility, assessing the efficacy of a short course (12 months) of a combined hCG +clomiphene citrate. Materials and Methods The cross-sectional study included 19 patients with hypogonadotropic hypogonadism who were admitted to the Andrology and Fertility Hospital of Hanoi between March 2016 and March 2018. Using hCG every three days in combination with clomiphene citrate 25mg per day until normal testosterone levels are reached, maintain the dose until spermatozoa are present. Results The mean age was 30.2 ± 5.6. Differences in penis length between the time before and after treatment were significant (p=0.005). The average dose of hCG using in our study was 5579 ± 1773.7 IU. After treatment 6 months and 12 months, the changes in clinical features in all patients and the total hypogonadotropic hypogonadism group were statistically significant (p<0.001). In particular, the differences in testosterone hormone levels in the partial hypogonadotropic hypogonadism group were also statistically significant (p=0.03). No adverse event was observed in our study. The number of patients appearing sperm in the semen is 9 patients (47.4%) after 12 months, but most of the sperm were completely deformed (<1%), and the average motility in the progressive motility group was below 8%. Conclusion In conclusion, a combination of hCG and clomiphene citrate may be an option for MHH patients who desired fertility. After 12 months, 47.4% of patients have sperm in semen but almost all of them were deformity. Hormone profile and secondary sexual characteristics improved significantly. There was no adverse event in our study that considered it as safe therapy.

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“…Similarly, Habous et al studied a cohort of 282 men with hypogonadism, separating them into 3 arms - CC alone, hCG alone and a combination of hCG and CC. 94 patients from this study received hCG monotherapy with 5000 IU hCG twice weekly and experienced statistically significant increases in T levels at 1 and 3 months (14). However, most of the above-mentioned studies deal with patients who desire fertility, or desire to maintain fertility, as an outcome of treatment with hCG alone.…”

Section: Discussionmentioning

confidence: 99%

Human Chorionic Gonadotropin monotherapy for the treatment of hypogonadal symptoms in men with total testosterone > 300 ng/dL

et al. 2019

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Purpose The 2018 American Urological Association guidelines on the Evaluation and Management of Testosterone Deficiency recommended that 300 ng/dL be used as the threshold for prescribing testosterone replacement therapy (TRT). However, it is not uncommon for men to present with signs and symptoms of testosterone deficiency, despite having testosterone levels greater than 300 ng/dL. There exists scant literature regarding the use of hCG monotherapy for the treatment of hypogonadism in men not interested in fertility. We sought to evaluate serum testosterone response and duration of therapy of hCG monotherapy for men with symptoms of hypogonadism, but total testosterone levels > 300 ng/dL.Materials and Methods We performed a multi-institutional retrospective case series of men receiving hCG monotherapy for symptomatic hypogonadism. We evaluated patient age, treatment indication, hCG dosage, past medical history, physical exam findings and serum testosterone and gonadotropins before and after therapy. Descriptive analysis was performed and Mann Whitney U Test was utilized for statistical analysis.Results Of the 20 men included in the study, treatment indications included low libido (45%), lack of energy (50%), and erectile dysfunction (45%). Mean testosterone improved by 49.9% from a baseline of 362 ng/dL (SD 158) to 519.8 ng/dL (SD 265.6), (p=0.006). Median duration of therapy was 8 months (SD 5 months). Fifty percent of patients reported symptom improvement.Conclusions Treatment of hypogonadal symptoms with hCG for men who have a baseline testosterone level > 300 ng/dL appears to be safe and efficacious with no adverse events.

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Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short‐course randomized study

Abstract: All three treatments were equally effective in restoring testosterone levels. Single-agent CC is simple, cheap and may be used as treatment for hypogonadism when maintenance of fertility is desired. This approach seems to be as effective as either hCG alone or a combination of hCG and CC.

Cited by 33 publications

References 22 publications

Management of Anabolic Steroid-Induced Infertility: Novel Strategies for Fertility Maintenance and Recovery

Management of Anabolic Steroid-Induced Infertility: Novel Strategies for Fertility Maintenance and Recovery

Evaluating the Combination of Human Chorionic Gonadotropin and Clomiphene Citrate in Treatment of Male Hypogonadotropic Hypogonadism: A Prospective Study

Human Chorionic Gonadotropin monotherapy for the treatment of hypogonadal symptoms in men with total testosterone > 300 ng/dL

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