Widely used acne acne can be used to treat infertility in men. This is a small research tip.
For men with infertile disease caused by very low sperm counts or complete lack of sperm, the only medical option is to collect sperm directly from the testes and undergo surgery to use in vitro fertilization (IVF). However, this is an important procedure with discomfort. Potential risks such as infection. And a long recovery period. Furthermore, surgery only brings sperm about half the time.
Currently, researchers are exploring alternatives. Isotretinoin, known as Accutane, is well known as a drug that has been used for decades to treat severe acne. A small study published in the Journal of Assist’s Reproduction and Genetics in July stimulated sperm production in some males who had no or very little sperm ejaculation at baseline.
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“The idea that well-studied drugs can stimulate spermatogenesis. [sperm production] In men with severely impaired sperm production, it is exciting as it opens the door to non-surgical options for men who may require invasive testicular sperm recovery.
“That being said, this study is small and preliminary and requires replicating in a larger randomized trial before it can be considered a true breakthrough,” he warned.
Dr. Brian Levine, founding partner and director of practice at CCRM Fertility in New York, who was not involved in the study, also expressed careful optimism about the findings.
“The prospect of helping patients avoid pain, recovery time and emotional stress from surgery is a real source of excitement for me and my colleagues,” he told Live Science in an email. But “this is not all treatments and there’s far more to do,” he said.
Related: Humans undergo a stem cell transplant that produces sperm in the first step
So, how can skin medication help men produce sperm?
Previous studies have found that infertile men often have low levels of retinoic acid within the testes. This molecule, a derivative of vitamin A, is essential for the normal development of sperm cells. It regulates the development of immature germ cells into mature sperm cells and promotes the release of mature sperm to the seminal factors within the testis. This link has led scientists to test isotretinoin, a compound that mimics natural retinoic acid, as a potential way to jump sperm production.
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In this study, the researchers enrolled 26 men with obstructive, non-obstructive pregnancies. This is four men with spermless condition in ejaculation due to sperm production problems – and cryptogenic juvenile disease with very few ejaculation numbers.
All participants received 20 milligrams of isotretinoin twice a day for at least 6 months. Their blood levels, hormone levels, and semen were closely monitored at several time points during the study.
Of the 30 men in the study, 11 began to produce motile sperm (swimming sperm) during ejaculation. This allowed these men and their partners to begin IVF without the need for surgical sperm collection. This treatment response group included a man with all four men with cryptozos phytopathy and seven men who had previously shown no sperm to ejaculate.
For the remaining men who still lacked sperm in ejaculation after treatment, doctors had to use surgery to collect IVF sperm. However, after isotretinoin, the procedure took an average of 63 minutes, compared to 105 minutes before treatment. (The report did not point out exactly why surgery became more efficient after Accutane.)
At the time the study was published, nine IVF cycles in which sperm was collected after isotretinoin treatment were carried out, leading to multiple healthy embryos, several ongoing pregnancies, and one production birth, the researchers reported.
However, the treatment had no side effects. All 30 men reported developing dry skin and cracked lips, with about half of them feeling irritated after treatment. Others also had rashes and elevated cholesterol and triglyceride levels. Isotretinoin allows these levels and liver function, so patients will need regular blood tests during treatment, Houman said. When people take Accutane for acne, doctors recommend regular blood tests, but they disagree with how often these tests are done.
“The important thing is that we still don’t know the optimal dose, duration, or long-term safety of isotretinoin in men seeking fertility,” he said. “Another drawback is that the response rate is unknown and many men may not benefit at all.”
Until data from large studies become available, isotretinoin should not be used to treat men infertility outside of clinical trials, Houman warned.
In women, isotretinoin can be safely taken outside of pregnancy, but it is considered extremely dangerous during pregnancy as it can cause severe birth defects. Because this risk is so important, this medication has black box warnings and strict birth control requirements to adhere to when taking the medication.
“For men, things are different,” Houman said. This drug does not appear to damage sperm DNA or pose a risk to reproductive partners or the resulting child. “In fact, this new study suggests that it could provide paradoxical benefits by enhancing sperm production in certain men,” he said, highlighting “a very different biological context” between male and female reproductive systems.
Looking ahead, researchers want to know which male infertile patients are most likely to benefit from isotretinoin. How to fine-tune the timing and dosage of treatment. And whether the drug can improve sperm quality and fertility outcomes.
The possibility that a simple course of oral medication can restore sperm production in some men “represents a monumental change in how we approach male infertility,” Levine said. “It offers a new layer of hope, not just hope to find sperm, but also hope to restore natural biological functions.”
This article is for informational purposes only and is not intended to provide medical advice.
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