Clomid for Fertility

Wife and I are trying to conceive. I’ve been on 200mg/wk test cyp (split up into twice weekly doses), HCG 250iU 3x/wk, and 1mg anastrozole divided up 2x/week…for about two years now.

I’ve had two complete semen analyses and while I don’t have the results in front of me, the count on both was low-average, motility was low-average, but strict morphology was a mere 2%…according to the docs this gives us a very small chance of conceiving naturally. The HCG has at least kept some testicular function but obviously not enough–or I’ve had the morphology problem since before TRT and it’s unrelated, which is possible as I’ve never tried to have a kid before…no way to know. But my LH and FSH are basically nil as you’d expect on TRT…other than that my labs are good and I don’t seem to have any physical problems.

Went to see a urologist today and he recommended stopping all three drugs immediately and completely. He prescribed Clomid 50mg ED for at least the next 90 days, with a hormone test in a month and another semen test in two. He said I should be fine, no need to taper because the Clomid will bump up my natural T quickly to compensate.

Does this seem like a reasonable course of action? I am planning to follow it and not change course unless I get some intolerable side effects, but would like to know what’s in store…just hoping that (a) the clomid kicks in quickly enough so that my test doesn’t crash, and (b) the dose isn’t so high as to be counterproductive or harmful…it seems to me that guys are taking far less than this (anywhere from 12.5mg EOD to 25mg ED). It also seems possible that this much clomid will drop my estrogen too far…I guess we’ll see. Anyone experience or knowledge on this?

Low-normal production is fine. The World Health Organization (WHO) considers only 4% viable morphology of a sample as normal. 2% is that far off but like the doc said is going to reduce your chances.

hCG is an LH analogue and will help the leydig cells remain volumized and producing testosterone. However FSH plays a role in how many sperm cells are allowed to live and helps maintain the blood-testes barrier. Getting both LH and FSH up should theoretically do this.

hCG turns off both LH and FSH as does high T and high E2 as far as I know.

I’m just a little surprised by the orders to discontinue from a 200mg dose without tapering. Any way you slice it prepare to do what you have to to manage stress and mood swings. Maybe plan with your wife about how it may get a bit rocky at times but that it’s for a goal you both want to meet. Good luck.

A better plan is to drop your T dose to 100mg and add Clomid. Clomid will trigger LH/FSH production on TRT up to 200mg per week. Dropping the dose to 100mg and adding Clomid should keep your T levels close to where they are now and give you the fertility results you’re after.