Since male infertility can be caused by different factors, different prescription medications can be offered by physicians on a case-by-case basis. Hormone replacement therapy can be recommended in cases where infertility is caused by high or low levels of certain hormones or problems with the way the body uses hormones: Clomiphene (Clomid is the brand name) is FDA-approved for female infertility, but doctors can also prescribe clomid for men for off-label use. It is usually given to men who have a low sperm count caused by low testosterone levels. Clomiphene is used to increase the hormones released from the pituitary gland, which in turn, stimulates the production of testosterone and sperm within the testes. Boosted levels of these reproductive hormones will reduce the symptoms of hypoandrogenism (low testosterone), increase sperm count, and potentially help to improve non-obstructive azoospermia. Large-scale studies have found sustained increases in testosterone and improved erectile function among men who have hypoandrogenism. Research also showed that up to 10 percent of azoospermic men saw a return of sperm to the ejaculate after three months of taking clomiphene. The second hormone replacement treatment, anastrozole or arimidex, was originally developed for breast cancer, but has become a viable off-label drug for specific groups of infertile men. Anastrazole prevents testosterone from changing into estradiol. This mechanism helps testosterone levels rise and lowers estrogen levels. Anastrozole has been found to reduce male hypoandrogenism symptoms such as low libido, and erectile dysfunction. It is also been shown to improve sperm production and sperm recovery rates in men who are azoospermic or have a low sperm count. Lastly, human chorionic gonadotropin (hCG) is a hormonal treatment that can also be used to increase testosterone levels in men who suffer from symptoms of low testosterone or hypogonadism. hCG works by directly stimulating the testes to make testosterone and improve sperm production. Research has found hCG to increase energy, libido, strength, and mood in hypogonadic men, including men who are hypogonadic for unknown causes as well as in men with lower testosterone production due to long-term testosterone replacement therapy. The boost in testosterone production from hCG can also raise the likelihood of successful sperm retrieval in men with non-obstructive azoospermia. This drug is typically a last resort treatment because it requires two to three injections per week, which most patients would rather avoid.
Antibiotic treatment might cure an infection of the reproductive tract, but does not always restore fertility. Medication can also help improve fertility in conditions such as erectile dysfunction or premature ejaculation. The 5 most reported prescription medications among men in couples trying to get pregnant were lisinopril (2.0%), mometasone (2.0%), fexofenadine (1.8%), atorvastatin (1.6%), and montelukast (1.6%). The most reported supplements were fish oil (13.2%, 9.4%).
