15% of couples will have difficulty getting pregnant, half of which are related to male factors. There are many potential reasons for male fertility problems. One of these occurs when it is difficult for the testis to produce normal levels of testosterone. This is a hypogonadism.

Hypogonadism itself is a disease that can occur independently of fertility problems. The incidence of hypogonadism increases with male age. About 15% of men aged 70 or older will have clinical symptoms of hypogonadism, including low sexual desire, lack of vitality or fatigue, and erectile dysfunction in the morning.

Hypogonadism is traditionally treated with one of several testosterone preparations. One disadvantage of this is that testosterone administration effectively reduces the role of testis in testosterone production, and testis will slow down or stop its endocrine and reproductive functions through the internal feedback cycle involving the pituitary gland; In other words, the testes stop or slow down the production of testosterone and sperm.

About androxal

Androxal is a new formulation of the old drug clomiphene. Clomiphene selectively binds to some receptors in the pituitary gland, which is the main endocrine gland close to the brain. Binding to this receptor actually opens the same feedback loop and leads to more testicular stimulation, more testosterone production, and sometimes more sperm production.

Clomiphene has been approved by FDA for the treatment of female infertility. For more than 30 years, it has been a prescription drug for men. Some compounds such as clomiphene exist as isomers; That is to say, they have two forms with the same molecular structure, but the two forms mirror each other, just like the right hand and the left hand. Clomiphene is composed of two isomers; Zuclompiphene and androxal. It is speculated that the use of only one isomer of androxal may lead to fewer side effects and make the drug more effective for men.

Clinical trial results of enkomifen

Without considering the possible side effects, weehle et al. Reported the clinical trial of oncomifen in 73 men in the September issue of fertility and infertility. The men were divided into four groups: testosterone gel, 12.5 mg of encomifen, 25 mg of encomifen and placebo. The results showed that androxal could reach the same testosterone level as testosterone gel. In addition, studies have shown that the use of testosterone gel is related to the reduction of sperm production, while oncomifene maintains sperm production in men with hypogonadism.

Looking forward to the future, oncomifen will almost certainly join our drug treasure house for the treatment of hypogonadism, while maintaining sperm production. Whether it will be particularly useful in the treatment of male infertility remains to be seen.