Medical Management of Male Infertility
Low testosterone, or Low T, may be responsible for male factor infertility. In addition, some men may exhibit signs and symptoms of low testosterone such as decreased energy, decreased interest in sex (libido), erectile dysfunction, or changes in mood, memory, or concentration.
When Low T causes a decrease in sperm production, a number of medication therapies have been shown to be quite successful in treating this condition. Raising the blood testosterone levels naturally increases intratesticular testosterone and provides a more favorable environment for sperm development.
While the following medications are currently only FDA approved in women, they are used off-label to treat male fertility patients with low testosterone. The following medications are safe for the testis and sperm:
- Anastrozole (Arimidex) – an oral medication that prevents the conversion of testosterone to estrogen in the male, thereby raising the natural testosterone level.
- Clomiphene citrate (commonly known as the fertility drug Clomid™) - an oral medication that naturally raises testosterone levels and blocks the effects of estrogen.
- Human Chorionic Gonadotropin (hCG) - Injections of HCG in the muscle every other day raises testosterone levels and often improves symptoms of low testosterone. It is typically combined with the pill, tamoxifen, which blocks the effects of estrogen, a byproduct of HCG use.
It should be stressed that men desiring fertility should not be given testosterone as therapy. Testosterone is a natural male contraceptive and use of testosterone agents or steroids will make men sterile.