PMID-29772111 – Clomiphene and HCG Both Effective in Hypogonadism
Dabaja AA, Wosnitzer MS, Engel JN, Bolyakov A, Grober ED, Lo KC, Jarvi KA, Goldstein M. Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short-course randomized study. BJU Int. 2018;122(5):889-897.
Quick Reference
| Property | Value |
|---|---|
| PMID | 29772111 |
| DOI | 10.1111/bju.14396 |
| Year | 2018 |
| Journal | BJU International |
| Study Type | RCT |
| Evidence Level | II |
| Sample | 40 men with hypogonadism |
| Peptide(s) Studied | HCG |
Key Findings
- 40 hypogonadal men randomized to either clomiphene citrate 50 mg daily or HCG 5000 IU 3x/week
- Both treatments significantly increased serum testosterone levels from baseline
- HCG produced a more rapid testosterone response compared to clomiphene
- Both agents maintained spermatogenesis (unlike exogenous testosterone)
- No significant difference in overall testosterone improvement between groups at endpoint
- Side effect profiles differed: HCG was associated with injection site discomfort; clomiphene with visual disturbances
Study Design
Prospective, randomized, controlled trial comparing clomiphene citrate (50 mg PO daily) vs HCG (5000 IU SC 3x/week) in 40 men with symptomatic hypogonadism. Testosterone levels, symptom scores, and semen parameters assessed over the study period.
Limitations
- Small sample size (n=40, 20 per arm)
- Short treatment duration
- No placebo arm (active-comparator design only)
- Open-label (not blinded)
- HCG dose (5000 IU 3x/week) is higher than typically used in clinical practice
Clinical Relevance
Provides Level II evidence that HCG monotherapy is an effective alternative to TRT for men with hypogonadism who wish to preserve fertility. The head-to-head comparison with clomiphene — the other commonly used fertility-preserving hypogonadism treatment — confirms comparable efficacy. This supports HCG as a first-line option for symptomatic hypogonadism in reproductive-age men.
Related
#research #RCT #HCG #evidence-level-II