Optimal Hypogonadism Treatment for Men of Reproductive Age

ABSTRACT: Purpose: The purpose of this article is to review the treatment options for hypogonadism in men of reproductive age. Method: A PubMed literature search was conducted with search terms hypogonadism, testosterone replacement, Clomid or clomiphene citrate therapy, and ‘hypogonadism and fertility’. One hundred eighteen pertinent articles were retrieved. This was further narrowed down to 45 results after excluding articles with unrelated data. The ‘full text’ search was further narrowed down to 15 articles that encompassed the data specific to this topic and they serve as the basis for this clinical review. Results: There are several evidence-based articles providing evidence of better reproductive outcomes and overall better adverse effect profile with the use of clomiphene citrate therapy versus standard testosterone replacement therapy. Conclusion: Hypogonadism is an increasing problem encountered by primary providers, urologists, and endocrinologists affecting men of varying ages and reproductive states. It is important to implement a comprehensive evaluation when encountering these patients to ensure the safest, most appropriate treatment is administered. Based on current literature for men wishing to maintain fertility, clomiphene citrate, a selective estrogen receptor modulator appears to be the best option to increase testosterone levels, preserve fertility, and result in minimal adverse effects compared to traditional testosterone replacement therapy in men of reproductive age. Keywords: hypogonadism, testosterone replacement, Clomid or clomiphene therapy, and ‘hypogonadism and fertility