Infertility among men has become a growing concern in the recent past all over the world. The trend in the male population increases with age. There is an end number of reasons for infertility and so does the treatment. Treatment depends upon the cause- Surgeries, ART, therapies, hormones, and medication. ART(Assisted Reproductive Treatment) has been a successful approach but many parents to date prefer the natural method. So they opt for oral medications as the treatment approach for infertility.
Infertility is defined as failure to conceive and occurs when either the sperm production is less or its inability to fertilize an egg. What causes infertility in men can be a medical issue or environmental concern. The most common is Varicocele, a condition due to which sperms produced are of low quantity and quality. Let us list the other reasons for infertility:
- Ejaculation and erection problems: Another main cause is when a person has difficulty in attaining an erection (erectile dysfunction) or retrograded ejaculation when semen instead of emerging out enters the bladder.
- Hormonal Imbalance: The imbalance of Testosterone or other hormones regulating testosterone usually results in hypogonadism.
- Klinefactor Syndrome: Condition where a male is born with 2 X chromosomes and 1 Y chromosome which affects the male reproductive system.
- Autoimmune antibodies: Antibodies when start attacking the sperms and try to eliminate them.
- Anatomical issues: Undescended testes or defect in transport tube that carries sperm.
- Other Medical issues: Prior surgeries, Tumors, Infection, problems with sexual intercourse
- Environmental and Other causes: Exposure to heavy metals, chemicals, X-Rays, Drug or alcohol abuse, tobacco smoking, and obesity are factors that affect sperm production and quality.
Role of Enclomiphene Citrate in combating infertility among men:
We are now clear about the concept of infertility and its reasons. Talking about treatment, an off-label drug has been proved to be efficient in the treatment of Male Fertility– Enclomiphene Citrate.
Enclomiphene Citrate is a non-steroidal selective estrogen receptor modifier and is an E- stereoisomer of clomiphene. It is antiestrogenic and acts on the pituitary gland which reduces negative feedback by Estrogen hormone on the pituitary hypogonadal axis. The drug is found to restore the normal serum levels of testosterone, Luteinizing Hormone, and Follicle Stimulating Hormone. Thereby, maintaining sperm production, and thus fertility in men.
We know that testosterone is important for the development of male reproductive and sexual organs, along with the production of bone mass and density. The treatment for infertility and hypogonadism targets both raising sperm count and reducing hypogonadism symptoms. The SERM blocks the estrogen receptors in the hypothalamus which in turn increases the LH and FSH hormone, which increases testicular hormone by Leydig cells and spermatogenesis.
Treatment with Enclomiphene is observed to be more favorable due to its impact on hypogonadal symptoms and potentially fewer side effects that are associated with other Selective Estrogen receptors modifiers. It is a well-tolerated drug with fewer negative impacts, though the long-term side effects of the drug remain unknown.
The drug is incompletely studied so much of it remains unclear. Future studies and controlled trials will determine the efficacy and use of enclomiphene among infertility patients.
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