In most cases, the cause of male infertility is unknown. Sperm parameters have been shown to sometimes improve using certain hormonal medications, ie. gonadotropins (FSH, LH, hCG), aromatase inhibitors (letrozol or anastrozole) or selective estrogen receptor modulators (clomiphene citrate or tamoxifen). Testicular and hypophyseal function should be assessed by measuring serum hormone levels to identify the men that benefit most from the medical treatment.
Hormonally treatable conditions include:
The medication may be administered orally or as subcutaneous injections. Due to the long process of spermatogenesis, the effect of the medication on the sperm parameters will take at least 4 to 6 months to show. The treatment will also be monitored following serum testosterone and LH levels.
It should be noted that testosterone and anabolic androgens are highly detrimental on sperm production, and all of these products should be discontinued when trying to achieve a pregnancy!