Men who undergo vasectomy reversal and have low testosterone should not be treated with testosterone replacement, as it will suppress sperm production. There is no clear answer in the scientific research on whether Clomiphene Citrate, a commonly used medication to treat low testosterone in men who want to maintain fertility potential in a way that is not detrimental for sperm, actually improves semen parameters on not. Some research have shown some improvement in some semen parameters, and other studies have shown no impact. At the 2017 American Society for Reproductive Medicine annual expo and scientific meeting, Dr. Kavoussi’s research was presented on factors that might potentially predict which patients may respond to Clomiphene Citrate with an improvement in semen parameters. Ultimately, the data showed no significant difference in sperm count or semen volume, but an improvement in sperm motility. There were no predictive factors that identified in which men had this improvement. Dr. Kavoussi states, “We believe further study is required, as the answers are unclear. There is not enough solid evidence that Clomiphene Citrate improves semen parameters at this time. That being said, it should be one of the treatments of choice for men with low testosterone undergoing vasectomy reversal to restore fertility.”
