Introduction
Infertility and
hypogonadism in males can greatly affect their reproductive health and overall well-being. Since exogenous
testosterone administration for
hypogonadism management may disrupt the normal hormonal cascade necessary for spermatogenesis,
clomiphene citrate (CC) and
enclomiphene citrate (EC) are medications often used to manage
hypogonadism and
male infertility. This study aims to directly compare the effects of CC and EC on serum
testosterone levels and semen parameters in men to determine which medication may have an advantage in managing these conditions. Materials and methods We retrospectively analyzed ≥18-year-old men presenting with primary
infertility, abnormal semen parameters, or
hypogonadism who received CC or EC monotherapy for at least three months between January 2021 and December 2022. We compared baseline and follow-up
hormone levels, semen parameters, and demographics. Variables were compared using paired and unpaired t-tests. Significance was assessed at p<0.05. Results A total of 46 men received EC and 32 men received CC. The median age was 42 (IQR: 34-47.75) years in men who received EC and 41 (IQR: 36-44) years in men who received CC (p=0.450). The two treatment groups exhibited a significant increase in serum total
testosterone, while only EC had a statistically significant increase in FSH and LH. Semen volume and concentration did not significantly change with either treatment. Sperm motility increased in both groups, but total motile sperm count (TMSC) only significantly increased in men who received EC. Conclusions Our study found that EC and CC are effective treatments in increasing total
testosterone without negatively affecting spermatogenesis. EC demonstrated to be more effective in raising gonadotropin levels and TMSC.