Androxal in Male Infertility
Primary Purpose
Infertility
Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Enclomiphene citrate
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Infertility focused on measuring Sperm density, Testosterone, Hypogonadism
Eligibility Criteria
Inclusion Criteria:
- Men having idiopathic male infertility with sperm concentration <15million/ml (on 2 baseline semen analyses)
- Serum total testosterone < 300ng/dL if oligospermia (sperm concentration <15million/ml)
- Any testosterone if nonobstructive azoospermia (no sperm in the ejaculate)
- Men aged 18-35 living in stable relationship and desiring fertility
- Normal female partner evaluation as reported by the patient
- Ability to complete the study in compliance with the protocol
- Ability to understand and provide written informed consent
Exclusion Criteria:
- Men desiring operation for fertility (i.e. varicocelectomy) or couples desiring assisted reproductive technologies such as intrauterine insemination IUI, in vitro fertilization IVF and intracytoplasmic sperm injection ICSI) within study completion (5 months)
- Clinically significant medical condition rendering the subjects infertile including tumors of the pituitary, laboratory abnormalities
- Patients having received an investigational drug / clomiphene citrate, antioxidants, multi-vitamin in the past 30 days prior to study
- Previous treatment with androgens, estrogens, DHEA, testosterone or testosterone analogues in injectable, oral, topical or other forms for the treatment of AIHH who have not discontinued for at least 1 month prior to the start of the treatment phase
- Clinically significant abnormal findings on screening examination as determined by the investigator
- Known hypersensitivity to clomiphene citrate
- Current or history of breast cancer
- Any condition which in the opinion of the investigator would interfere with the participant's ability to provide informed consent, comply with the study instructions, possibly confound interpretation of the study results, or endanger the participant if he took part in the study
- Have received a diagnosis of irreversible infertility or compromised fertility (cryptorchidism, Kallman Syndrome, vasectomy, or tumors of the pituitary)
- Current or history of prostate cancer or a suspicion of prostate disease
- Presence or history of known hyperprolactinemia (prolactin > 17ng/dl) with or without a tumor
- Chronic use of medications use such as glucocorticoids (chronic use of inhaled or topical glucocorticoids is acceptable)
- No current drug abuse or chronic narcotic use including methadone
- Subjects with known history of HIV and/or Hepatitis C
- Subjects with end stage renal disease
- Subjects with cystic fibrosis (mutation of the CFTR gene)
- History of liver disease (including malignancy) or a confirmed AST or ALT >3 times the upper limit of normal
- History of myocardial infarction, unstable angina, symptomatic heart failure, ventricular dysrhythmia or known history of QTc interval prolongation
- History of cerebrovascular disease
- History of venous thromboembolic disease (e.g. deep vein thrombosis or pulmonary embolism)
- History of erythrocytosis or polycythemia (HCt > 54)
Sites / Locations
- Baylor College of Medicine
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Arm 1(IP)
Arm 2 (Placebo)
Arm Description
Enclomiphene citrate capsules 25 mg 1x daily for 16 weeks
Placebo capsule 1x daily for 16 weeks
Outcomes
Primary Outcome Measures
Doubling of total motile sperm count
Secondary Outcome Measures
Morning hormone levels
Assess changes in values from baseline of total morning testosterone, estrogen and dihydrotestosterone levels after 16 weeks of treatment with placebo or 25 mg Androxal
Changes in questionnaire responses
Assess change from baseline to endpoint in Androgen Deficiency Aging Male (ADAM), International Prostate Symptom Score (I-PSS), Sexual health inventory in Male (SHIM) and psychosexual daily questionnaire (PDQ)
BMI
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02160704
Brief Title
Androxal in Male Infertility
Official Title
PHASE 2b RANDOMIZED, PARALLEL, DOUBLE-BLIND, PLACEBO-CONTROLLED EXPLORATORY STUDY TO EVALUATE THE EFFICACY OF ANDROXAL IN IDIOPATHIC MALE INFERTILITY (PROTOCOL #01-14-40-08)
Study Type
Interventional
2. Study Status
Record Verification Date
July 2019
Overall Recruitment Status
Withdrawn
Why Stopped
Difficult eligibility and lack of funding
Study Start Date
September 22, 2014 (undefined)
Primary Completion Date
August 2, 2016 (Actual)
Study Completion Date
August 2, 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Baylor College of Medicine
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is an exploratory, single center, randomized, parallel, double-blind placebo- and active-controlled trial in adult males ages 18 to 35 years of age who have male infertility of unknown cause. Approximately 50 men will be randomly assigned to one of two treatment groups according to a 1:1 ratio. About half of the men will receive 25mg Androxal and half of the men will receive a placebo (non-active pill) for 16 weeks. This study will last approximately 4 months and involve up to 7 visits.
The purpose of this study is to determine the effect the Androxal on sperm production.
Detailed Description
It has been estimated that 4 to 5 million men in the United States are testosterone deficient, but fewer than 10% currently receive testosterone replacement therapy. There are many reasons for the low number of men receiving testosterone replacement therapy, one of which is the route of administration. The currently approved androgen therapies are oral products, injectables, patches, buccal systems, and gels, and each has disadvantages. Oral preparations may be associated with hepatotoxicity and produce unfavorable effects on serum lipid profiles and carbohydrate metabolism. Injectables are associated with uneven levels of serum testosterone leading to fluctuations in mood, libido, and energy levels. Patches may require intrusive preparation, cause skin irritation or not adhere properly. A testosterone gel has overcome some of the above problems and has gained acceptance, but there are indications that men do not apply the gel correctly.
Previous studies showed that Androxal significantly increases total testosterone levels in men with low values at baseline. Additional studies found not only was Androxal non inferior to a topical gel, it was found to maintain sperm counts in the normal range.
Subjects will be randomized into one of the two treatment arms, using a block size of 4. The order in which the treatments are assigned in each block is randomized and this process is repeated for consecutive blocks of subjects until all subjects are randomized. This process ensures that after every fourth randomized subject, the number of subjects in each treatment group is equal.
To allow subjects in screening once the target 50 subjects have been enrolled and to account for dropouts, 75 randomization codes will be generated. As subjects are enrolled in the study, they will be assigned unique consecutive numbers starting at 001. At least 50 subjects who meet all the entry criteria will be randomized 1:1 such that approximately 25 subjects are assigned to the Androxal treatment arm and approximately 25 subjects are assigned to the placebo arm.
Placebo controlled studies are the gold standard of clinical trials and should be attempted whenever the indication and current medical practice will allow. This study is investigating a product to increase sperm concentration in subjects with idiopathic male infertility and secondary hypogonadism, low testosterone. Subjects with idiopathic male infertility do not require treatment to be healthy and approximately 18 weeks on a placebo is unlikely to harm the subjects in any way. Standard of care for idiopathic male infertility today allows subjects and physicians the option to not medically treat the disease. Therefore, the use of a placebo control in this study is well justified and will provide the best mechanism to assess treatment effect.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Infertility
Keywords
Sperm density, Testosterone, Hypogonadism
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Arm 1(IP)
Arm Type
Experimental
Arm Description
Enclomiphene citrate capsules 25 mg 1x daily for 16 weeks
Arm Title
Arm 2 (Placebo)
Arm Type
Placebo Comparator
Arm Description
Placebo capsule 1x daily for 16 weeks
Intervention Type
Drug
Intervention Name(s)
Enclomiphene citrate
Other Intervention Name(s)
Androxal
Intervention Description
25 mg daily for 16 weeks
Intervention Type
Other
Intervention Name(s)
Placebo
Other Intervention Name(s)
sugar pill
Intervention Description
placebo daily for 16 weeks
Primary Outcome Measure Information:
Title
Doubling of total motile sperm count
Time Frame
16 weeks
Secondary Outcome Measure Information:
Title
Morning hormone levels
Description
Assess changes in values from baseline of total morning testosterone, estrogen and dihydrotestosterone levels after 16 weeks of treatment with placebo or 25 mg Androxal
Time Frame
16 weeks
Title
Changes in questionnaire responses
Description
Assess change from baseline to endpoint in Androgen Deficiency Aging Male (ADAM), International Prostate Symptom Score (I-PSS), Sexual health inventory in Male (SHIM) and psychosexual daily questionnaire (PDQ)
Time Frame
16 weeks
Title
BMI
Time Frame
16 weeks
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
35 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Men having idiopathic male infertility with sperm concentration <15million/ml (on 2 baseline semen analyses)
Serum total testosterone < 300ng/dL if oligospermia (sperm concentration <15million/ml)
Any testosterone if nonobstructive azoospermia (no sperm in the ejaculate)
Men aged 18-35 living in stable relationship and desiring fertility
Normal female partner evaluation as reported by the patient
Ability to complete the study in compliance with the protocol
Ability to understand and provide written informed consent
Exclusion Criteria:
Men desiring operation for fertility (i.e. varicocelectomy) or couples desiring assisted reproductive technologies such as intrauterine insemination IUI, in vitro fertilization IVF and intracytoplasmic sperm injection ICSI) within study completion (5 months)
Clinically significant medical condition rendering the subjects infertile including tumors of the pituitary, laboratory abnormalities
Patients having received an investigational drug / clomiphene citrate, antioxidants, multi-vitamin in the past 30 days prior to study
Previous treatment with androgens, estrogens, DHEA, testosterone or testosterone analogues in injectable, oral, topical or other forms for the treatment of AIHH who have not discontinued for at least 1 month prior to the start of the treatment phase
Clinically significant abnormal findings on screening examination as determined by the investigator
Known hypersensitivity to clomiphene citrate
Current or history of breast cancer
Any condition which in the opinion of the investigator would interfere with the participant's ability to provide informed consent, comply with the study instructions, possibly confound interpretation of the study results, or endanger the participant if he took part in the study
Have received a diagnosis of irreversible infertility or compromised fertility (cryptorchidism, Kallman Syndrome, vasectomy, or tumors of the pituitary)
Current or history of prostate cancer or a suspicion of prostate disease
Presence or history of known hyperprolactinemia (prolactin > 17ng/dl) with or without a tumor
Chronic use of medications use such as glucocorticoids (chronic use of inhaled or topical glucocorticoids is acceptable)
No current drug abuse or chronic narcotic use including methadone
Subjects with known history of HIV and/or Hepatitis C
Subjects with end stage renal disease
Subjects with cystic fibrosis (mutation of the CFTR gene)
History of liver disease (including malignancy) or a confirmed AST or ALT >3 times the upper limit of normal
History of myocardial infarction, unstable angina, symptomatic heart failure, ventricular dysrhythmia or known history of QTc interval prolongation
History of cerebrovascular disease
History of venous thromboembolic disease (e.g. deep vein thrombosis or pulmonary embolism)
History of erythrocytosis or polycythemia (HCt > 54)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Larry I. Lipshultz, MD
Organizational Affiliation
Baylor College of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
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Androxal in Male Infertility
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