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Regulatory factors also come into play

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At both exposure levels, sperm motility and sperm count were decreased and the sperm drive range was increased, but there was no increase in effect with increase in dose

The National Association of Boards of Pharmacy has explained that illegal actors are taking advantage of high demand and short supply [of incretin medications] in order to sell substandard and falsified versions of these products to patients around the world. Their unlawful actions put patients at risk. Compounded products may be legal in limited circumstances to address specific patient needs, but they are not FDA-approved and lack the same safety, quality, and efficacy protections as FDA-approved medicines