Pharmacological therapies for male infertility

Male factor infertility is a multifaceted problem that affects approximately 50% of couples experiencing infertility. Causes of male infertility include endocrine disturbances, gonadotoxins, genetic abnormalities, varicocele, malignancies, infections, congenital or acquired urogenital abnormalities, iatrogenic factors, immunological factors, genetic causes, and idiopathic reasons. There are a variety of treatment options for male infertility, depending on the underlying cause(s), including surgical treatments, medical/hormonal therapies, and assisted reproductive techniques, which can be combined with surgical sperm retrieval if necessary. In this review article, the pharmacological therapies for male infertility are grouped based on the underlying causes of male infertility. Some of these therapies are targeted and specific, while others are used empirically to treat idiopathic male infertility. These include treatments to optimize infertility in patients who have hypogonadism, ejaculatory dysfunction, infections, or idiopathic male infertility. Finally, we provide an overview of the future directions of pharmacological therapies for male infertility. Significance Statement: Male infertility is a significant worldwide problem. Detailed knowledge of the pharmacological therapies available will ensure the prescription of appropriate therapy and avoidance of unnecessary or harmful treatments.