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Restoring testosterone rather than replacing it helps safeguard a man’s fertility

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Public Release: 27-Oct-2015

 

Wiley

Restoring testosterone production in men may be as effective as replacing it, without compromising their fertility. Two phase III clinical trials show that a drug that restores the body’s natural production of testosterone has no negative effect on a man’s sperm count while a topical testosterone gel causes a significant drop. The findings, which are published in BJU International, could change the way men are treated for low testosterone.

While testosterone replacement therapy can boost men’s energy levels, sex drive, and mood, the treatment can fool the body into thinking that it is producing enough testosterone, so that it in turn starts making less of its own. This can result in a significant decrease in sperm count–leading to infertility–because the body needs its own testosterone to produce sperm.

An alternative approach to testosterone replacement is based on restoring the body’s natural production of testosterone with drugs similar to those used to help women ovulate. Edward Kim, MD, urologist at the University of Tennessee Medical Center and Professor at the University of Tennessee Graduate School of Medicine in Knoxville, and his colleagues compared such a drug, called Enclomiphene citrate, with testosterone replacement therapy (Androgel) in overweight men with low testosterone, or hypogonadism. In the randomized studies, 44 men started on 12.5 mg of oral enclomiphene citrate daily, with 25 men being up-titrated to 25 mg; 42 men received a topical 1.62 percent AndroGel; and 41 men received a placebo. Over five months, patients had 10 clinic visits with one overnight stay.

The investigators found that Enclomiphene citrate restored blood testosterone levels to normal after 16 weeks while maintaining sperm concentrations, whereas Androgel restored blood testosterone levels but caused marked reductions in sperm concentrations by suppressing the function of the testes.

“One of the basic tenets in medicine is to do no harm. As this study has shown in a randomized, double-blind, double-dummy, placebo-controlled manner, exogenous testosterone therapy with Androgel can clearly decrease sperm production and potentially impact fertility,” said Dr. Kim. “This study confirmed that Enclomiphene can maintain spermatogenesis while restoring testosterone levels to normal.”

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Full citation: “Oral Enclomiphene Citrate Raises Testosterone and Preserves Sperm Counts in Obese Hypogonadal Men, Unlike Topical Testosterone: Restoration Instead of Replacement.” Edward D. Kim, Andrew McCullough and Jed Kaminetzky. BJU International; Published Online: October 23, 2015 (DOI: 10.1111/bju.13337).

URL Upon Publication: http://doi.wiley.com/10.1111/bju.13337

Author Contact: To arrange an interview with the author please contact Susan Wyatt of the University of Tennessee Medical Center’s press office, at SWyatt@mc.utmck.edu or +1 (865) 305-6845.

About the Journal: BJUI is a highly respected international medical journal that aims to provide the very highest standard of research and clinical information for the urological community, promoting awareness of new advances and supporting best practice in urology. Every issue gives invaluable practical information in the form of original articles, reviews, comments, translational science and surgical education articles on all aspects of urology.

About Wiley

Wiley is a global provider of knowledge and knowledge-enabled services that improve outcomes in areas of research, professional practice and education. Through the Research segment, the Company provides digital and print scientific, technical, medical, and scholarly journals, reference works, books, database services, and advertising. The Professional Development segment provides digital and print books, online assessment and training services, and test prep and certification. In Education, Wiley provides education solutions including online program management services for higher education institutions and course management tools for instructors and students, as well as print and digital content. The Company’s website can be accessed at http://www.wiley.com.

About Post Author

Ralph Turchiano

I have a strong affinity for the sciences which led me to create my sites. My compulsion for the past decade has been reviewing literally every peer-reviewed research article. Which can easily be validated by following my posts. To me, science is where the real news is, as it will mold our destiny beyond that of politics or economics. 😉 Please feel free to e-mail: 161803p314159@gmail.com
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