Hormone Treatment for Men’s Infertility
Not just a woman’s problem
When people think of infertility, it is generally assumed that it is the woman that has the problem conceiving. However, research reveals that male infertility represents 1 out of every 3 cases of infertility. Although it can be a difficult diagnosis for many to accept, it can provide a starting point for alternative treatment options. Luckily male hormone replacement therapy is among the many new treatment advances now available.
Each time a man ejaculates, millions of sperm are released. However, this can only appropriately occur if the levels of testosterone and other hormones are balanced. The precise timing of hormone release is controlled by signals from the brain. Before the age of 35, couples are encouraged to seek help if they are unable to conceive within a year of actively trying. Earlier evaluation should be undertaken based on medical history and physical findings, or if the woman is over the age of 35.
The treatment for male infertility depends upon the underlying cause. Surgery may be required in the case of obstructions; however, in the case of hormone-related infertility, treatment with human chorionic gonadotropin (hCG), recombinant human follicle stimulating hormone (rhFSH), also called gonadotropin treatment, may be required. This boost in hormones may restore fertility to men who would otherwise be unable to father a child.
Why do hormones work?
Problems in the hypothalamus and pituitary gland (parts of the brain that regulate hormone production) contribute to a small percentage of male infertility. In those cases, human chorionic gonadotropin (hCG) and/or recombinant human follicle stimulating hormone (rhFSH) are often prescribed to improve sperm production and regulate testosterone secretion.
Gonadotropin treatment starts with injections of hCG three times per week (or sometimes every other day, depending on the severity of the condition). Testosterone is monitored in the blood and the dose of medication is adjusted as needed. In the absence of sperm cells after six months of treatment, recombinant human follicle stimulating hormone (rhFSH) is added in the form of an injection.
This has been shown to be a highly successful way to get men with hormone-related infertility to produce viable sperm. Up to 2 years of treatment is often required to establish normal fertility. Medication costs can be high and unfortunately, most insurance companies do not pay for gonadotropin therapy. Be sure to seek out the advice of a fertility specialist before initiating any treatment.
Treatment for low sperm count
Low sperm count may also be improved with gonadotropin treatment. This will allow more sperm to be released and the quality of sperm to improve, raising the chances of conception.
Medication that can affect fertility
One thing you should bear in mind when considering male infertility is medication you may already be taking. A common misconception is that over-the-counter medications are not worth mentioning. Testosterone and other steroids, which are sometimes used for weight training and bodybuilding, are often not discussed with your doctor. However, these can significantly impair sperm production. Lack of full disclosure can result in men undergoing invasive procedures that they otherwise would not need if had they mentioned this during their initial consultation.
It is also important to maintain a healthy lifestyle. Sleep, diet, exercise, weight and even stress management may impact fertility potential.
By Joelle Taylor, MD