Drug Therapy

While drug therapy is a fairly common form of fertility treatment for women, the use of fertility drugs in men is not. In fact, only about 5% of men with a hormone imbalance will be helped by medications. However, when fertility drugs are prescribed to men, it is generally for hormone imbalance issues. There are a variety of drugs that can be prescribed for male infertility. Just which you receive will depend on the problems you are experiencing.

Gonadotropins
When the hormonal imbalance is the result of disrupted signals between the hypothalamus, pituitary gland and the testes, thereby affecting sperm production, men often receive gonadotropins. This type of therapy is usually very helpful in men.

Gonadotropins are commonly used in men who have been diagnosed with unexplained infertility, abnormally low sperm count, or have less than 40% sperm motility. Common gonadotropins used in men include hCG and FSH, both of which are injectable fertility drugs.

Antiestrogen Agents
Testosterone deficiency can often be attributed to a lack of gonadotropins. To help stimulate the release of gonadotropins, men can also receive antiestrogen fertility drugs. Usual antiestrogen medications prescribed to men include tamoxifen (Nolvadex) and clomiphene (Clomid).

However, the use of antiestrogens may boost testosterone production in men to above normal levels, which can negatively impact on sperm production. Therefore, men receiving this type of therapy should have their testosterone levels monitored. Moreover, the FDA has not approved the use of Clomid in men nor has it been found to be especially effective. Side effects of clomiphene in men include weight gain or loss, vision problems, skin changes, libido changes and neurological or gastrointestinal disturbances.

Bromocriptine
Men who have an excess of prolactin in their system often experience fertility problems. This is because too much prolactin can lead to a decrease in testosterone as well as abnormal sperm. To help decrease a man’s prolactin levels and get his sperm production back on track, bromocriptine is prescribed.

To be effective, though, the medication needs to be taken for at least four consecutive weeks. Side effects of bromocriptine use in men can include high blood pressure and worsening of certain mental disorders or liver disorders while older men are more likely to experience confusion, hallucinations and uncontrolled bodily movements.

Testosterone
When a lack of testosterone production, known as hypogonadism, is the cause of your male infertility problems, synthetic testosterone may be prescribed. This type of testosterone works to mimic the natural testosterone produced in men. It can be administered through oral pills, injections or as a transdermal gel or patch.

The use of oral testosterone pills is sometimes questioned as they have been associated with elevated liver function as well as abnormalities in liver scans and biopsy. Injections are generally thought to be safer than oral pills. However, testosterone injections do not always provide a consistent level of hormones causing a man’s libido, energy levels and mood to fluctuate. Additionally, many men find the injections to be inconvenient, as they require frequent trips to the fertility specialist.

Although they can be more expensive, transdermal testosterone applications are proving to be a popular choice for an increasing number of men. Not only are testosterone gels and patches safe and efficient to use, providing a consistent level of hormone in the body, they also have relatively few side effects associated with them. Some men may experience skin irritation at the sight of application, though.

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