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Enclomiphene is a nonsteroidal selective estrogen receptor modulator (SERM) of the triphenylethylene group, developed primarily for the treatment of male secondary hypogonadism. It acts as an estrogen receptor antagonist in the hypothalamus and pituitary gland, blocking negative feedback from estrogen on the hypothalamic-pituitary-gonadal axis. This leads to increased secretion of gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH), which together stimulate testicular testosterone production while preserving or enhancing sperm production and fertility. Unlike traditional testosterone replacement therapy, which can suppress natural gonadotropin release and impair fertility, enclomiphene raises serum testosterone levels without these drawbacks. It is one of two stereoisomers of clomifene; specifically, it is the (E)-isomer with more antiestrogenic properties compared to zuclomifene[2][5][6][7].
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