Male Fertility Drugs: Medications Used To Treat Male Infertility

Doctor prescribing man a male fertility drug.

What Are Male Fertility Drugs?

Some men who have infertility may be able to increase their sperm count by taking certain medications. Male fertility drugs can alter a man’s hormones by increasing levels of free testosterone and decreasing estrogen levels, leading to improved sperm production.

Some of the most common medications used to treat male infertility include:

  • Clomid or Clomiphene
  • Anastrazole or arimidex
  • Human chorionic gonadotropin (hCG)

While these treatments work by improving testosterone levels, the use synthetic testosterone injections for treating male infertility should be avoided. This is because this type of treatment can actually decrease sperm count.

Fertility drugs can generally be taken by mouth, except for hCG which must be injected. Like most drugs, these medications may cause side effects. Talk to your doctor about which medication may be right for you.

Here is a closer look at each of these drugs, including how they work and their potential side effects.

Clomid (Clomiphene)

Clomid is the brand name of the drug clomiphene. While this drug is currently approved for use by the FDA to treat infertility in women, it is often prescribed “off-label” for use in men with poor sperm counts due to low testosterone levels.

How Does Clomid Work?

Clomiphene works by increasing hormones produced by the pituitary gland. This gland secretes certain hormones into the bloodstream that are important for reproduction. The increase in these reproductive hormones triggers testosterone production and sperm formation in the testes.

Having higher amounts of these hormones in the body helps reduce the symptoms of low-T, boost your sperm count, and possibly even improve non-obstructive azoospermia (a blockage preventing sperm from mixing with the semen).

Extensive research involving men with low testosterone has shown sustained increases in testosterone levels and muscle strength, decreased fatigue, and improvements in sexual function when taking clomiphene. Additionally, some studies saw up to 10% of men with azoospermia experiencing a return of sperm in their semen after taking the drug for 3 months.

Side Effects of Clomid

Some potential side effects of taking Clomid could include:

  • Increased sex drive
  • Mood changes
  • Aggressiveness
  • Hair loss
  • Blurry vision
  • Headaches
  • Enlarged prostate
  • Breast tenderness
  • Acne

Anastrozole (Arimidex)

Anastrozole (sold under the brand name Arimidex) is a drug used to treat breast cancer in post-menopausal women because it decreases the amount of estrogen the body. Since the growth of certain breast cancers is increased by the presence of estrogen, anastrozole helps to slow or reverse the growth of these breast cancers.

How Does Anastrozole Work?

When prescribed to men, anastrozole causes testosterone levels to rise while reducing the levels of estrogen in the body. Anastrozole has been shown to decrease the symptoms associated with low testosterone in men, such as decreased muscle mass, fatigue, erectile dysfunction and low sex drive.

Additionally, it has been shown to boost sperm production and increase the chances for sperm recovery in men with azoospermia or who have low sperm counts.

Side Effects of Anastrozole

The side effects of Anastrozole may include any of the following:

  • Nausea
  • Difficulty sleeping
  • Bone pain
  • Coughing
  • Elevated red blood cell count
  • Elevated liver enzymes

Other side effects which are rare but can be serious include:

  • Formation of blood clots
  • Developing cataracts
  • A severe rash that results from drug intolerance (Stevens-Johnson Syndrome)

hCG (Human Chorionic Gonadotropin)

HCG (Human Chorionic Gonadotropin) is commonly referred to as the “pregnancy hormone” because it is made by cells formed in the placenta. In fact, pregnancy tests measure hCG levels in a woman’s urine to determine whether she is pregnant.

How Does hCG Work?

In men, hCG has similar effects to luteinizing hormone (LH). LH prompts the Leydig cells of the testicles to begin producing testosterone. Additionally, LH stimulates sperm production in the seminiferous tubules located within the testes.

Doctors may prescribe hCG to men in order to address hypogonadism (low testosterone) and infertility. Using hCG can increase the body’s production of testosterone and sperm cells, which can help increase fertility.

hMG

If sperm count has not shown improvement after six months, your doctor may recommend the addition of hMG (human menopausal gonadotropin) injections to your treatment plan. HMG is made from a combination of hormones that that support the reproductive system and are produced by the pituitary gland naturally.

If hMG is added to the treatment plan, it may need to be taken with the hCG treatments for up to an additional year before results are seen.

hCG Side Effects

Side effects of hCG treatments could include any of the following:

  • Pain, swelling and/or redness at the injection site
  • Gynecomastia (enlarged breasts)
  • Changes in sex drive
  • Mood swings
  • Stomach pain
  • Nausea, vomiting
  • Changes in energy levels
  • Weight gain
  • Elevated red blood cell count
  • Increased risk of blood clots
  • Prostate enlargement

Monitoring Your Treatments

Patients on any of these medications should schedule a follow-up appointment within two weeks to undergo lab testing in order to ensure that the medications are working properly.

You will normally be tested to measure your testosterone, hemoglobin, and PSA levels (abnormally high PSA levels are linked with an increased risk for prostate cancer). You will likely return for testing every few months for the first year of treatment, and then once a year thereafter.

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