SynthesisInternational urology and nephrology2026
Could isotretinoin be a new therapeutic frontier for male infertility? A systematic review and meta-analysis.
Synthesis in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Micro-TESE in Non-Obstructive Azoospermia: Phenotype-Guided Hormonal Optimization and Testosterone Response-Prognostic Biomarker or Therapeutic Target?Journal of clinical medicine · 2026Review
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeRetinoic acid is essential for spermatogonial differentiation and meiotic initiation, providing a biologically plausible rationale for exploring retinoid-based therapies in the context of male infertility. Isotretinoin is widely prescribed for acne. However, it has historically raised concerns about potential sexual adverse effects. We aim to synthesize contemporary available clinical evidence on isotretinoin and clarify whether it poses reproductive risks or may hold any potential therapeutic relevance in men across both dermatologic and infertility settings.
methodsFollowing PRISMA guidelines, we systematically searched MEDLINE/PubMed, Scopus, and Web of Science from inception to November 2025 for original articles investigating the effects of isotretinoin on semen parameters, reproductive hormones, sexual function, or fertility outcomes. A narrative synthesis was conducted in conjunction with a random-effects meta-analysis for semen parameters when means and standard deviations were available.
resultsSix clinical studies involving 225 men were included: three dermatologic cohorts (n = 167) with normal baseline fertility, treated with standard isotretinoin regimens for acne, and three infertility cohorts (n = 58), receiving low-dose isotretinoin for oligoasthenozoospermia, cryptozoospermia, or non-obstructive azoospermia. In dermatologic populations, random-effects meta-analysis showed small but statistically significant increases in sperm concentration (Mean Difference [MD] + 1.77 million/mL, p = 0.028) and vitality (MD + 3.74%, p = 0.009), with non-significant positive trends for progressive motility (MD + 4.12%) and normal morphology (MD + 1.13%). In infertility settings, sperm concentration increased by approximately + 1.3 million/mL, progressive motility improved by + 3%, and normal morphology remained stable in oligoasthenozoospermic men. In comparison, de novo sperm appeared in 37-44% of azoospermic or cryptozoospermic men, enabling pregnancies across three studies (both spontaneous and with assisted reproductive technology). No study reported impaired fertility or treatment-emergent sexual dysfunction. Overall, the certainty of evidence was low to moderate.
conclusionCurrent clinical data do not support reproductive harm from isotretinoin. Instead, isotretinoin may enhance semen quality in healthy men and promote clinically meaningful spermatogenic recovery in selected infertility contexts. Controlled trials are needed to define therapeutic efficacy, identify responders, and clarify its role in male infertility management.
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