by Ronnenberg A

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:

  • Leg cramps
  • Fluid retention
  • Yellowing of the skin and whites of the eyes— 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 gonadotropin (hCG)
  • Human menopausal gonadotropin (hMG)
  • Follicle-stimulating hormone (FSH)

These drugs are used to treat hypogonadism, which is low testosterone and sperm production. They stimulate the Leydig cells of the testicles to produce more male hormones, particularly testosterone, which stimulates sperm production.

hCG is injected into the muscle 2-3 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 6 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 12 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 3 times a week for 4 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 testicles
  • Breast enlargement
  • Headache
  • Irritability
  • Restlessness
  • Growth of pubic hair
Bromocriptine Mesylate

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 1-3 times daily.

Possible side effects include:

  • Drowsiness
  • Dry mouth
  • Nausea
  • Headache
  • Tingling in hands and feet

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Do not share your prescription medication.
  • Medications can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medication, including over-the-counter products and supplements.
  • Plan ahead for refills as needed.

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(1):97-100.

Infertility in men. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T902812/Infertility-in-men  . Updated December 4, 2017. Accessed December 18, 2017.

Kosmas IP, Tatsioni A, Fatemi HM, Kolibianakis EM, Tournaye H, Devroey P. Human chorionic gonadotropin administration vs. lutenizing monitoring for intrauterine insemination timing, after administration of clomiphene citrate: a meta-analysis. Fertil Steril. 2007;87(3):607-612.

Male infertility/andrology. American Society for Reproductive Medicine website. Available at: http://www.reproductivefacts.org/topics/topics-index/male-infertility. Accessed December 18, 2017

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;4:38.

9/2/2010 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T902812/Infertility-in-men  : Ghanem H, Shaeer O, El-Segini A. Combination clomiphene citrate and antioxidant therapy for idiopathic male infertility: a randomized controlled trial. Fertil Steril. 2010;92(7):2232-2235.

Revision Information

  • Reviewer: EBSCO Medical Review Board Adrienne Carmack, MD
  • Review Date: 11/2018
  • Update Date: 12/18/2017