Could isotretinoin be a new therapeutic frontier for male infertility? A systematic review and meta-analysis - PubMed

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Isotretinoin, commonly used for acne, is being investigated for its potential role in male infertility due to retinoic acid's importance in spermatogenesis.
A systematic review and meta-analysis of six clinical studies involving 225 men found isotretinoin may improve semen parameters in both healthy men and those with infertility issues.
In dermatologic populations, isotretinoin showed small but significant increases in sperm concentration and vitality, with positive trends in motility and morphology.
In infertility settings, isotretinoin led to improvements in sperm concentration and motility, with de novo sperm appearing in 37-44% of azoospermic or cryptozoospermic men, enabling pregnancies.
No studies reported impaired fertility or sexual dysfunction from isotretinoin use, suggesting it may be safe and potentially beneficial for male reproductive health.
The evidence quality was low to moderate, indicating a need for controlled trials to confirm therapeutic efficacy and identify which patients may benefit most.

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