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When sperm counts are significantly low, intracytoplasmic sperm injection (ICSI) and assisted reproductive technologies (ART) should be considered as a first treatment option

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Regulatory Framework: Key FDA Guidance Documents for Nasal Sprays The foundation of nasal spray testing requirements in the United States is established by two primary FDA guidance documents, both from the Center for Drug Evaluation and Research (CDER): FDA CDER 2002 Nasal Spray and Inhalation Solution, Suspension and Spray Drug Products Chemistry, Manufacturing and Controls Documentation (CMC Guidance): Defines the CMC documentation requirements for new drug applications (NDAs) and abbreviated new drug applications (ANDAs) involving nasal spray and inhalation drug products

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