Q. How to maintain sperm count through treatment?

Answered by
Dr. Deep Dutta
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 14, 2016 and last reviewed on: May 31, 2023

Hi doctor,

I am suffering from hypogonadotropic hypogonadism. I am taking HCG 5000 and HMG 150 injection twice a week. My sperm production has started from azoospermia. We have done IVF and it was successful. My doctor asked to take testosterone injection, but if I take this my sperm production will be stopped. I want to know how to keep sperm production active. Please let me know the available option to maintain the sperm. I heard about Clomiphene citrate 50 mg or Enclomiphene citrate 25 mg treatment. Please help me with that.



Welcome to

HCG (human chorionic gonadotropin) and HMG (human menopausal gonadotropin) are excellent choices to ensure a good sperm production, which is needed for fertility that you have achieved. However, this treatment combination rarely leads to normal testosterone levels, which is needed for good muscle mass and general well being. Testosterone injections will be ideal for the same, cheaper and easier to take. Yes, it will reduce your sperm count, which is reversible once it is stopped. Hence, unless you want to have a second child soon, there is no rationale to continue the difficult regimen of HCG and HMG injections. You can conveniently switch to testosterone injection now. Then a few years later, we can stop the testosterone injection and go back to HMG with HCG if you plan a second child. Clomiphene citrate will not help in hypogonadotropic hypogonadism.

Thank you doctor,

I want to keep the sperm production till the delivery. I am fine with taking injection once in a week. What is the main difference of Clomiphene and Enclomiphene?



Welcome back to

Clomiphene will not work for you. It needs an intact hypothalamic pituitary testis axis to work. You do not have that because of hypogonadotropic hypogonadism and you do not have LH (luteinizing hormone) and FSH (follicle stimulating hormone) production from your pituitary for Clomiphene to work. That is the reason you are getting HCG and HMG injections, which mimic the work of LH and FSH produced from pituitary. If you wish, you may continue this treatment of HCG and HMG till delivery. It will not cause any harm.

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