Men who have either a low sperm count or a sperm motility problem may benefit from medications, if they have hormonal dysfunction (hormonal problems). They should consult their urologist about a few drugs approved by the FDA for the treatment of male infertility. Generally speaking, the medications listed below work by a series of complex interactions that regulate specific biochemical’s that are ultimately responsible for the production of both male and female hormones and sperm maturation.
CLOMIPHENE CITRATE:
Clomid, Serophene
Clomiphene citrate is commonly used to treat ovulatory problems in women, however it has been shown to be effective in some men. Clomiphene belongs to class of medications known as anti-estrogens. As an anti-estrogen, clomiphene citrate interferes with a biochemical process called feedback that regulates the amount of gonadotropin releasing hormone (GnRh) that is released from the hypothalamus. Clomiphene citrate’s affect upon the hypothalamus leads to an increase in GnRH output. The pituitary gland responds to the GnRH by increasing the amount of follicle stimulating hormone (FSH) and luteinizing hormone (LH), which are responsible for stimulating testosterone and sperm production. In theory the net result is an increased sperm count. Clomiphene citrate is available in pill form and is taken for up to 6 months to see an improvement. A daily dose of 25 to 50 mg is the current recommended dose.
HUMAN MENOPAUSAL GONADOTROPIN hMG:
Pergonal, Metrodin, Humegon, Repronex, Gonal-F, Fertinex
Human menopausal gonadotropins are commonly used in the treatment of both male and female infertility. They consist of gonadotropins (hormones that stimulate gonadal function) that are obtained from urine of menopausal women after undergoing a purification process. Also, these drugs are currently produced by a technique called recombinant technology, which does not require using human urine as the source. The dosages are more precise. These medications are available only in an injectable form. Injections are usually administered 2 to three times per week for men, but daily in women. They work differently than clomiphene citrate by acting directly on the cells in the testes. A functioning central nervous system is required for clomiphene citrate to work, but only a testicle for the gonadotropins to work. The net result is an increase in testosterone and sperm production. Today, with the great pregnancy rates from in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI), many couples would rather go directly to these new modalities instead of waiting to see if the injectable medications will work. It could take months to see any benefit.
HUMAN CHORIONIC GONADOTROPIN (hCG):
In certain instances men with low sperm counts due to endocrine (hormonal) abnormalities because of pituitary problems, can benefit from treatment with hCG. hCG is often used a to treat men who have undergone surgery for removal of the pituitary gland. hCG is a hormone mainly known for its role in stimulating progesterone production in women. It has been shown that spermatogenesis (production of sperm) can be restored in men suffering from low sperm production by administration of hCG.
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