Suggesting long term SERM use in replacement of a bio identical testosterone does not seem like the brightest idea. There have been reports of blurred vision, floaters in the eyes, and more (look on pubmed under just about any SERM, but specifically clomid).

In my opinion it would be much safer to suggest recombinant FSH and LH. The brain testes axis seems to have the least amount of atrophy over time from anecdotal experiences of those online and in a few case reports. I do not think HCG should be used long term due to the non-bio identical nature, but it is a good short term LH mimic if my memory serves me correctly. Would be a great addition to a TRT protocol.