Controversial acne drug could increase sperm count in infertile men: study

A drug once known for zapping zits might now help men who’ve been shooting blanks.

In a small study, the medication jumpstarted sperm production in severely infertile patients, opening a new door to biological fatherhood.

“For some men, many of whom have no options for treatment, this could be a game changer,” said Dr. Stephanie Page, a professor of medicine at the University of Washington, who was not involved in the research.

Normally, semen is packed with millions of sperm — but men with cryptozoospermia have barely any swimmers, and those with azoospermia have none at all.

Their best shot at fathering a biological child has long involved invasive surgery to extract any sperm hidden within the testicles.

But the procedure isn’t guaranteed. Success rates range from 40% to 60%, and the risks include pain, bleeding, infection and rare but lasting damage to the testes, according to the Cleveland Clinic.

Now, a decades-old medication may help rewrite the playbook.

In a recent study, researchers recruited 26 men with azoospermia and 4 with cryptozoospermia — 90% of whom had previously undergone unsuccessful testicular sperm retrieval procedures.

They were given 20 mg of isotretinoin, better known as Accutane, twice daily for six months.

By the end, 11 participants — all four men with cryptozoospermia and seven with azoospermia — began producing sperm that swam efficiently in their ejaculate.

In fact, 82% saw sperm appear within just three months.

Better yet, the sperm worked. Men who underwent IVF with the new sperm produced healthy embryos and multiple pregnancies, with at least one live birth recorded so far.

“Avoiding surgical procedures to get sperm for sterile men opens up new, less invasive paths to family building,” Page said.

But even those who still needed surgery fared better after taking the acne-fighting drug. Their procedures took an average of just 63 minutes, down from 105 minutes before treatment.

“This pill has done something that little else has ever accomplished in the world of male infertility,” Dr. Paul Turek, a male infertility specialist who co-authored the study, wrote in a blog post. 

Isotretinoin is a powerful vitamin A derivative commonly used to treat stubborn acne. It mimics retinoic acid — a molecule essential for sperm development that past studies have shown infertile men often lack in their testes.

By acting as a substitute for retinoic acid, researchers hoped the drug could jumpstart sperm production in these men. And it appears they were right.

“I would call this little-pill-that-could nothing short of a ‘babymaker’ for some couples,” Turek wrote.

But it wasn’t all smooth sailing. All of the participants dealt with dry skin and chapped lips while taking the drug, according to researchers.

Four broke out in rashes, 14 got irritable and five saw their cholesterol and triglyceride levels change.

Still, none of them quit the treatment over the side effects.

And while isotretinoin can cause serious birth defects if taken by pregnant women, “in men, the situation is different,” Dr. Justin Houman, a urologist not involved in the study, told Live Science.

The drug doesn’t appear to harm sperm DNA or pose risks to reproductive partners or babies conceived with it, he explained.

“In fact, this new research suggests it may have a paradoxical benefit by enhancing sperm production in certain men,” Houman said. 

But he cautioned the study is small and early, saying it “requires replication in larger, randomized trials before we can consider it a true breakthrough.”

In the future, scientists hope to identify which men will benefit most from isotretinoin and determine if it can improve sperm quality and overall fertility.

As part of that research, doctors at the The Turek Clinic are now offering a six-month program based on the study to help qualified men chase biological fatherhood under expert care.