Can taking prescription medicines affect male fertility?

By The Examen Team


An emerging area of interest amongst men struggling with infertility is whether common prescription medicines can impact their fertility. Although male fertility issues are often under-investigated, it is becoming increasingly recognised that lifestyle factors and overall health can impact a man’s likelihood of getting his partner pregnant and having a baby. Advanced age, being overweight, high alcohol consumption, smoking and recreational drug use can all adversely affect sperm health[1]. Most of these factors can be reversed by lifestyle changes, with a wide range of support services available to help make these simple changes. But less attention has been paid to how illness and the use of prescription drugs can influence male fertility.

Prescription medicines are vital to address a range of health issues – but unfortunately many of them can adversely influence fertility themselves. There is a wide range of medicines with varying dosing regimens to treat each illness, so doctors can often tailor prescriptions to prevent any  unwanted side-effects for your fertility.

Which illnesses and medications can affect fertility?

Illnesses and their associated medicines can affect sperm production, their maturation, their motility and even their shape. They can also damage the quality of sperm DNA.

There is an extensive list of medicines and conditions that may negatively impact male fertility including:

Many health conditions and their associated medicines affect individuals for a short period of time, and successful pregnancy can be achieved if a man’s medicines are altered. However, for patients  using prescription medicines for long-term or chronic conditions it is important to discuss your fertility goals with your doctor who may be able to adapt your treatment plan to suit. For example, we know that cystic fibrosis, along with other prevalent conditions such as diabetes, can adversely affect male fertility [2,3]. Likewise, some of the treatments used for common conditions such as asthma and inflammatory bowel disease are associated with male fertility issues [4, 5].

Furthermore, with mental health conditions now affecting more people than ever, more men are seeking medical treatments. Although some antidepressant medication can negatively impact male fertility [6,7,8], fertility risks must be balanced with the health improvements these medications deliver. Your doctor can advise you on whether it is possible to change to a different medication or use an alternative strategy such as CBT or talking therapy, while trying for a baby.

New sperm

The good news is that many of these types of unwanted side effects can be reversible. Men produce new sperm continually, with sperm completely replaced after three months. So, if your doctor confirms that your medicine can be safely stopped or changed, even for a short while, this can allow sperm quality to improve quite quickly. For example, a scientific analysis of a group of men with fertility issues demonstrated that among those that were allowed to safely stop or switch medication, there was a 93% improvement in semen quality and an 85% improvement in conception rate [4]. The improvement in sperm quality may not be immediate, it can sometimes take 6-12 months for sperm to return to normal.

If you’re trying to become a dad without success, book an appointment with your family doctor to discuss your fertility. Don’t stop taking your medicines!

Only by discussing your overall health and your ambition to become a dad with your doctor can you be guided towards the best next steps for your own fertility journey.

References/ further reading:

  1. Montagnoli C, Ruggeri S, Cinelli G, Tozzi AE, Bovo C, Bortolus R, Zanconato G. Anything New about Paternal Contribution to Reproductive Outcomes? A Review of the Evidence. World J Mens Health. 2021 Oct;39(4):626-644. doi: 10.5534/wjmh.200147. Epub 2021 Jan 8. PMID: 33474842; PMCID: PMC8443996.
  2. Eisenberg ML, Sundaram R, Maisog J, Buck Louis GM. Diabetes, medical comorbidities and couple fecundity. Hum Reprod 2016;31:2369-76
  3. World Health Organization. Genes and human diseases [Internet]. Geneva: World Health Organization; c2020 [cited 2020 May 6]. Available from: public/geneticdiseases/en/.
  4. Hayashi T, Miyata A, Yamada T. The impact of commonly prescribed drugs on male fertility. Hum Fertil (Camb) 2008;11:191-6.
  5. Ananthakrishnan AN, Martin C, Kane S, Sandler RS, Long MD. Paternal disease activity is associated with difficulty in conception among men with inflammatory bowel diseases. Clin Gastroenterol Hepatol 2019;17:203-4.
  6. Evans-Hoeker EA, Eisenberg E, Diamond MP, Legro RS, Alvero R, Coutifaris C, et al. Major depression, antidepressant use, and male and female fertility. Fertil Steril 2018;109:879- 87.
  7. Tanrikut C, Feldman AS, Altemus M, Paduch DA, Schlegel PN. Adverse effect of paroxetine on sperm. Fertil Steril 2010;94:1021-6.
  8. Chen D, Zhang JP, Jiang L, Liu H, Shu L, Zhang Q, et al. Factors that influence in vitro fertilization treatment outcomes of Chinese men: a cross-sectional study. Appl Nurs Res 2016;32:222-6

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