Should I choose TRT or enclomiphene for my fertility goals?
TRT delivers exogenous testosterone and suppresses fertility; enclomiphene raises endogenous testosterone while preserving fertility. Men with current/near-term fertility goals route to enclomiphene; others choose by response and preference.
Full answer
TRT delivers exogenous testosterone and reliably reaches the optimization range, but suppresses LH/FSH and spermatogenesis. Enclomiphene is a SERM that blocks pituitary feedback, raises LH/FSH, and increases endogenous testosterone while preserving fertility. Men with current or near-term fertility goals route to enclomiphene. Men without fertility goals choose between the two based on response, preference, and biomarker trajectory; some start with enclomiphene and switch if response is insufficient. Both pathways require a baseline panel and recalibration.
Educational. Not a substitute for individualized provider review.
- Testosterone Optimization pathway — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-06-03