Table 4.
Medications used to treat oligozoospermia in infertile men
| Medication Class | Indication | Dose | Example Drugs (Trade Names)/Notes |
|---|---|---|---|
| Clear benefit | |||
| β-human chorionic gonadotropin | Hypogonadotropic hypogonadism | 1000–2500 IU SQ 2–3 times weekly (titrated to serum testosterone) | Generica (Novarel®†, Pregnyl®) (Overle®)b |
| Follicle- stimulating hormone | Hypogonadotropic hypogonadism | 75–300 IU SQ 2–3 times weekly | Urofollitropinc (Bravelle®); menotropins with combined FSH/LH activityc (Menopur®); Follitropin alphab (Follistim®, Gonal F®) |
| Human luteinizing hormone | Hypogonadotropic hypogonadism | 75 IU SQ daily | Lutropin alphab (Luveris®)d (not recommended-use hCG) |
| Alpha-agonists | Retrograde ejaculation | 60 mg po q 6 h × six doses prior to ejaculation | Pseudoephedrine (Sudafed®); contraindicated in hypertension |
| Gonadotropin- releasing hormone | Hypogonadotropic hypogonadism | 25-600 ng/kg SQ every 2 h | Generic; requires continuous pulsatile infusion, supply issues |
| Dopamine agonists | Hyperprolactinemia | 0.25-1.5 mg po 1-2 times weekly | Cabergoline (Dostinex) |
| Phosphodiesterase inhibitors | Erectile dysfunction | 25-100 mg po prn 25-100 mg po prn 5-20 mg po prn | Sildenafil (generic); Vardenafil (Levitra®); Tadalafil (Cialis®) |
| Possible benefit | |||
| Selective estrogen receptor modulators | Idiopathic male infertility | 25-50 mg po daily | Clomipheme citratee (generic); potential adverse effects on mood, bone, and sexual function |
| Aromatase inhibitors | Idiopathic male infertility | 1 mg po daily to twice weekly | Anastrazolee (generic); potential mood, sexual function, and bone mineral density concerns |
| Experimental | |||
| Retinoid acid analogs | Idiopathic male infertility | 20 mg po bid × 6 months | Isotretinoine ; adverse events include depression and elevated triglycerides. Requires registration for prescription |
Abbreviations: FSH, follicle-stimulating hormone; LH, luteinizing hormone.
aDerived from urine of pregnant women.
bProduced by recombinant DNA technology.
cDerived from urine of post-menopausal women.
dNot available in the United States.
eNot Food and Drug Administration–approved for the treatment of male infertility.