Assessing the Efficacy of Clomiphene Citrate in Patients With Azoospermia and Hypoandrogenism

Inclusion Criteria: * Patients over 18 years old. * Man seeking fertility treatment. * Azoospermia confirmed in at least 2 semen analyses with centrifugation. * Testosterone \<300 ng/dL and Bioavailable Testosterone\<156 ng/dL. Exclusion Criteria: * Presence of genetic disorders: Y chromosome deletions or abnormal karyotypes. * Luteinizing hormone (LH) \>25 IU/mL. * Estradiol \> 40 ng/dL. * Hypogonadotropic hypogonadism (LH \<2 IU/mL and Follicle Stimulating Hormone (FSH) \<1 IU/mL). * Obstructive azoospermia (FSH \<7.6 IU/mL plus testicle longitudinally axis \>4.6 cm or bilateral absence of vas deferens or surgical history of vasectomy). * Clinical varicocele (palpable or visible in physical exam) * Previous history of cryptorchidism. * Use of chemotherapy, testosterone, or anti-androgen in the last two years. Partner \>40 years or female factor infertility associated. * Contraindications to clomiphene use: depression, heart and liver impairment, uncontrolled thyroid/adrenal dysfunction, organic intracranial lesions.