by Ronnenberg A

Medications for Infertility in Men

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications only as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
Medications used for the treatment of male infertility include the following:

Prescription Medications

Testosterone
Common names include:
  • Androl-LA
  • Androderm
  • Delatestryl
  • Depo-testosterone
Testosterone is used in hypogonadism, hypogonadotropic hypogonadism, and delayed puberty in which the production of testosterone by the gonads is missing or inadequate. Testosterone is needed for sperm production. Testosterone can be given by mouth, injection, or patch.
Possible side effects include:
  • The development of male characteristics
  • Leg cramps
  • Fluid retention
  • Jaundice
Clomiphene Citrate
Common names include:
  • Clomid
  • Serophene
Clomiphene citrate is prescribed to men who have infertility due to hormonal imbalances. Clomiphene citrate causes an increase in luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This increases the signal to the testes to increase testosterone production and sperm production. In combination with vitamin E, clomiphene may increase sperm count, sperm mobility, and pregnancy rates.
Possible side effects include:
  • Bloating
  • Stomach pain
  • Migraines
  • Ovarian hyperstimulation syndrome with multiple pregnancies
hCG, hMG and FSH
Common names include:
  • Human chorionic gonadatropin, or hCG (Profasi, Pregnyl, Ovidrel)
  • Human menopausal gonadatropin, or hMG (Pergonal, Humegon)
  • Follicle-stimulating hormone, or FSH (Follistim, Gonal F)
These drugs are used to treat hypogonadism, which is low testosterone and sperm production. They stimulate the Leydig cells of the testes to produce more male hormones, particularly testosterone, which stimulates sperm production.
hCG is injected into the muscle two to three times a week. You may need to receive this medication for several weeks, months, or longer. If you are being treated for a low sperm count and have been on this medication for six months, your doctor may give you another hormone medication, such as menotropin or urofollitropin injection. You may need to receive both of these medications together for up to twelve additional months.
Menotropins (hMG) are a mixture of FSH and LH that are naturally produced by the pituitary gland. These are also injected into a muscle three times a week for four or more months. Usually, you will be given another medication called chorionic gonadotropin before and during treatment with menotropins.
Possible side effects include:
  • Injection site pain
  • Acne
  • Enlargement of penis and testes
  • Breast enlargement
  • Headache
  • Irritability
  • Restlessness
  • Growth of pubic hair
Bromocriptine Mesylate
  • Common name: Parlodel
This drug is prescribed for men who have elevated levels of the pituitary hormone prolactin, which interferes with other hormones. The drug is provided as a tablet, which is taken with food 1 to 3 times daily.
Possible side effects include:
  • Drowsiness
  • Dry mouth
  • Nausea
  • Headache
  • Tingling in hands and feet

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:
  • Take your medicines as directed. Do not change the amount or the schedule.
  • Do not stop taking them without talking to your doctor.
  • Do not share them.
  • Ask what results and side effects to expect. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medicines and herb or dietary supplements.
  • Plan ahead for refills so you don’t run out.

References

Demirol A, Gurgan T. Comparison of different gonadotrophin preparations in intrauterine insemination cycles for the treatment of unexplained infertility: a prospective, randomized study. Hum Reprod. 2007;22: 97-100.

Infertility. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 4, 2013. Accessed December 2, 2013.

Kosmas IP, Tatsioni A, Fatemi HM, et al. Human chorionic gonadotropin administration vs. lutenizing monitoring for intrauterine insemination timing, after administration of clomiphene citrate: a meta-analysis. Fertil Steril. 2007;87:607-612.

Male infertility. American Society for Reproductive Medicine website. Available at: http://www.asrm.org/topics/detail.aspx?id=1331 . Accessed December 2, 2013.

Revelli A, Poso F, Gennarelli G, Moffa F, Grassi G, Massobrio M. Recombinant versus highly-purified, urinary follicle-stimulating hormone (r-FSH vs. HP-uFSH) in ovulation induction: a prospective, randomized study with cost-minimization analysis. Reprod Biol Endocrinol. 2006 Jul 18;4:38.

9/2/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Ghanem H, Shaeer O, El-Segini A. Combination clomiphene citrate and antioxidant therapy for idiopathic male infertility: a randomized controlled trial. Fertil Steril. 2009 Mar 5. [Epub ahead of print]

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