CAUSES, DIAGNOSIS AND MANAGEMENT OF MALE INFERTILITY: PHYTOCOMPOUNDS AS NATURAL SERMs-A REVIEW

Abstract

Infertility is an inability to achieve pregnancy in spite of regular, unprotected coitus in one year. Infertility affects about 15% of couples in which the malefactor contributes to 40% worldwide. There are various risk factors, causes and treatment modalities for male infertility of which Selective Estrogen receptor modulators (SERMs) are one of the promising treatments available for treating idiopathic male infertility. Idiopathic male infertility refers to an abnormality in semen parameters without an identifiable cause and diagnosis recently known. SERMs are structurally diverse nonsteroidal compounds which bind to estrogen receptor (ER) to exert tissue-specific estrogen agonist and antagonist effects. Several compounds including clomiphene, tamoxifen, toremifene are currently available synthetic SERMs of which clomiphene and tamoxifen are commonly used in treating idiopathic male Infertility. While these compounds are effective in treating male infertility, their long-term use increases the risk of stroke, cataract, vision-threatening ocular toxicity, deep vein thrombosis, pulmonary embolism and even more. Aim of this review is to highlight the causes, diagnosis and management of male fertility and to reveal the unforeseen effect of long-term use of SERMs. Also, this article will review the safe use of phytocompounds as natural SERMs.