RA-2 13-cis Retinoic Acid (Isotretinoin)

Inclusion Criteria: * Subjects will be infertile men (no pregnancy with partner with normal cycles and normal hysterosalpingogram despite \>1 year of unprotected intercourse). * Abnormal sperm analyses with a total, motile sperm count of less than 10 million sperm as assessed by semen analysis on two occasions separated by one week. * In the opinion of the investigator, is able to comply with the protocol, understand and sign an informed consent and HIPAA (Health Insurance Portability and Accountability Act ) form. Exclusion Criteria: * Men participating in another clinical trial * Men not living in the catchment area of the clinic * Clinically significant abnormal findings at screening * Known genetic infertility (e.g. Klinefelter syndrome or Y-chromosome microdeletions), * Hypogonadotropic hypogonadism (that might respond to gonadotropin injections), * The use of anabolic steroids, illicit drugs, or the consumption of more than 4 alcoholic beverages daily * Severe mental health problems requiring medications * Current therapy with retinoic acid (e.g. Accutane) or vitamin A. * Score of greater than 15 on the Patient health questionnaire (PHQ9). * Abnormal serum chemistry values according to local laboratory normal values which indicate liver or kidney dysfunction. Other abnormal lab values may also be exclusionary, at the discretion of the investigator * Men with a personal history of serious psychiatric disorders * Men currently receiving tetracycline containing medications * Men currently receiving phenytoin * Men with a history of inflammatory bowel disease * Men with a history of bone disease * Men who have used isotretinoin within eight weeks of the start of dosing * Men with elevated serum triglycerides