Hormonal therapy in male infertility

What hormonal therapy is used in male infertility?

Testosterone is a very important fertility and sex hormone in men. It must be in normal range for better fertility outcomes. The normal range of testosterone is still controversial and differs from lab-to-lab and equipment-to equipment.

Adequate levels of endogenous testosterone (produced by the body) help in sperm production whereas exogenous testosterone (in the form of testosterone tablets or injections) suppresses sperm production due to negative feedback inhibition. Hence testosterone tablets or injections should not be taken by couples planning to have kids. Instead, we need to indirectly increase the testosterone levels using other form of medications such as clomiphene, anastrozole, letrozole, HCG injections and HMG Injections if there is low testosterone.

Hormonal therapy in male infertility

Is clomiphene used by men with infertility?

Yes, clomiphene is used by men to improve testosterone levels (Wheeler KM. Sex Med Rev 2019). Clomiphene is an oral tablet which was first introduced in women with infertility issues. Subsequently it is being used by andrologists since last 30-40 years to treat men with low testosterone levels and infertility.

How is clomiphene taken by men?

It is a tablet taken by mouth daily or on alternate days or twice a week depending on the testosterone levels. Your andrologist will decide the appropriate regimen.

Can hormone therapy increase sperm counts?

Hormone therapy can be given when the testosterone levels are very low. In such a scenario, hormonal therapy may improve sperms counts thereby increasing fertility rates.

Are HCG and HMG injections painful in men?

HCG and HMG injections are usually given twice or thrice a week under the skin (subcutaneous) or into the muscle (intramuscular). These injections do not cause any additional pain compared to a TT injection which you would have taken after a fall or rusted metal injury. HCG and HMG injections are given to improve testosterone levels in men and best results are seen in a case of hypogonadotropic hypogonadism.

How long is the hormonal therapy in male infertility?

The duration of hormonal therapy is usually around 3-4 months in men but may vary depending on the cause and simultaneous assisted reproductive techniques.

Who is the best doctor for hormonal therapy in male infertility?

Dr Pramod Krishnappa is the best andrologist dealing with Men’s’ Sexual Health and Male Fertility. He has been trained extensively in high volume Andrology centres in Madrid (Spain), Belgrade, Budapest, Chicago, and New York.

Dr Pramod Krishnappa has done male infertility fellowship under Prof Dr Craig Niederberger at the University of Illinois at Chicago (UIC), who is one of the first centers in the USA to start hormonal therapy in male infertility.

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