Injection
Gonadorelin
A copy of the brain's own GnRH signal that keeps the testes producing testosterone and sperm, used alongside testosterone therapy and in fertility care. Prescribed and dosed by a licensed physician.
Starting at $159/mo
Men's healthFertilityFDA-approved
RxPrescription onlyTaken by mouth · Once a day · 25 mg · Men's health · Fertility · FDA-approved
Starting at $69/mo
FDA-approved clomiphene citrate 50 mg tablets, taken as half a tablet a day, to help men raise their own testosterone while preserving sperm production.
How many tablets per month?
You'll receive 15 tablets per month. $89 billed monthly. Cancel anytime.
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
Every plan includes
(KLOM-i-feen)
Clomiphene blocks estrogen's signal in the brain, so the pituitary releases more LH and FSH and the testes make more testosterone and sperm. In men it is used off-label.
LH + FSH
the two pituitary hormones clomiphene raises
Approved for women's fertility; used off-label in men with low testosterone who want to keep fertility.

Day 1
US-licensed physician reviews your fertility goals, testicular health, and plans on testosterone therapy. Discussion of clomiphene vs. enclomiphene vs. hCG or combination.
Week 1
Start clomiphene 25–50 mg daily or hCG 500–2,500 IU once weekly, depending on your plan. Baseline semen analysis or testicular ultrasound may be ordered to track changes.

Weeks 4–8
LH and testosterone levels rise as clomiphene/hCG stimulates the testicles. Testicular function is preserved. Sperm production remains normal or improves.

Month 2–3
Follow-up labs (LH, FSH, testosterone, sperm count). Dose adjusted if needed. If combining hCG with testosterone therapy, check testosterone levels.

Beyond
Continue fertility support as long as you take testosterone therapy. If you stop testosterone, fertility usually returns within 3–6 months with continued clomiphene/hCG support.
Testicles stay healthy
size and function maintained on testosterone therapy
Sperm production continues
fertility potential preserved even during testosterone use
Faster recovery if you stop
endogenous testosterone and sperm return quickly when therapy ends
Lab monitoring required
LH, FSH, sperm count tracked to ensure response
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
Important safety information and common side effects
Clomiphene, enclomiphene, and hCG are prescribed off-label to preserve fertility and testicular function during testosterone therapy. Common side effects: mild headache, mood changes, abdominal discomfort. Clomiphene and enclomiphene may cause visual changes (blurred vision, floaters) in ~1% of users, report immediately if vision changes occur. hCG carries a small risk of ovarian hyperstimulation-like syndrome in some men if doses are very high. Tell your physician about prior fertility issues, current fertility plans, or any family history of gynecomastia or testicular disease. Stop and seek care for severe vision changes, severe headache, or testicular pain.
Clomiphene is approved for female ovulation; its use in men is off-label. The male evidence is observational case series and small reviews, not large randomized trials.
In a prospective study of young hypogonadal men, most seeking fertility, clomiphene was given for a mean of 19 months. The authors reported it as a safe and effective alternative to testosterone for men who want to keep fertility. This is a case series with no control group.
Katz et al., BJU Int 2012A larger series of 400 men treated for a mean of 25.5 months (range 0 to 84) reported no significant adverse event and few side effects. Results did not differ between men treated for more or less than three years.
Krzastek et al., J Urol 2019A review of nine clomiphene studies in male infertility found that only one showed a significant gain in pregnancy rate, while most showed higher sperm concentrations. Clomiphene was well tolerated at doses used for infertility.
Willets et al., Reprod Sci 2013What the studies found
These are the results of observational series of clomiphene citrate in men with a clinic setting, not of a trial against placebo. Compounded and generic tablets were not the product in these reports in all cases, and dosing varies. Clomiphene is used off-label in men.
What this does not say
Studies in men with secondary hypogonadism show clomiphene raises testosterone into the normal range in most, without lowering sperm counts.
Mood changes and visual disturbances can occur; stop and call your physician if you notice blurred vision or flashes of light.
Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Taken by mouth, once a day. The starting prescription is one half tablet (25 mg) each time. Your physician sets your own dose and it is printed on your label.
15 tablets at the starting strength, shipped to your door from a licensed US pharmacy.
The tablet is the FDA-approved product, split in half for a 25 mg dose. Compounded capsules come in exact doses. Your physician chooses.
Not always. If you are not concerned about fertility or testicular size, and your testosterone therapy is working well, neither is necessary. But if you want to preserve sperm production, prevent testicular atrophy, or plan a family in the future, your physician will recommend one.
Yes. Some physicians combine them for synergistic fertility preservation: clomiphene stimulates the pituitary (LH/FSH), hCG directly stimulates the testicles (testosterone/sperm). This combination is off-label but used clinically.
Yes, usually within 3–6 months if you used clomiphene or hCG alongside testosterone. Without fertility support, recovery can take 6–12 months or longer. This is why fertility preservation on testosterone is important if you plan a family.
Initial baseline: before starting or at first visit. Then: every 3–6 months on clomiphene/hCG, or annually if on testosterone long-term. Semen analysis is the gold standard for sperm count; testicular ultrasound tracks size.

Clomiphene educational content reviewed by our physician
Scott Nass, MD Doctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
Injection
A copy of the brain's own GnRH signal that keeps the testes producing testosterone and sperm, used alongside testosterone therapy and in fertility care. Prescribed and dosed by a licensed physician.
Starting at $159/mo
Capsule
A low-dose aromatase inhibitor for men on testosterone therapy whose blood work shows high estradiol, easing breast tenderness and water retention. Slow-release capsule, prescribed and dosed by a licensed physician.
9 capsules per month
Starting at $63/mo
Capsule
Anastrozole, an aromatase inhibitor used in men to control estrogen levels during testosterone therapy. Prescribed and dosed by a licensed physician.
9 capsules per month
Starting at $63/mo
Tablet
FDA-approved anastrozole tablets, an aromatase inhibitor used at low doses in men on testosterone therapy whose estradiol runs high. Prescribed by a licensed physician only after blood work.
5 tablets per month
Starting at $63/mo
Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.