Study – Sperm Count and Finasteride
Snippet from the abstract:
OBJECTIVE: To determine the degree of improvement in semen parameters after finasteride discontinuation.
DESIGN: A prospective database of men presenting for a fertility evaluation was analyzed for semen and hormone parameters before and after discontinuation of finasteride.
SETTING: A male infertility specialty clinic.
PATIENT(S): Men presenting for fertility evaluation from 2008-2012 on finasteride.
Read the rest — Finasteride use in the male infertility population: effects on semen and hormone parameters.
In a study of 4400 men over a 57.4 month time span, sperm counts were performed after finasteride was discontinued. There was an 11.6-fold increase in sperm count on the discontinued use of finasteride (Propecia at the 1mg dose), suggesting that the drug brought down the sperm count in most men.
In men with severe oligospermia (low sperm count), the counts went up when the drug was stopped. No men had decreases in sperm count in the study. This suggests that individuals on finasteride who are interested in having children, should be aware that there is a risk of reduced sperm counts on the drug.
I don’t agree with this. I’ve been on propecia for nearly 10 years and I can still shoot peter north style loads…
Hi Dr. Rassman,
With respect, the increase was 11.6-fold, i.e. 1060%, not 11.6%.
As an aside, have any of your patients come back to you to report on children they had who were born with or who later presented with health issues that your patients thought might be linked to their use of finasteride? I know there’d be no way to show causality, I’m just wondering if it’s happened. Personally I don’t care as much about infertility as I do about having a child who has health issues as a result of my finasteride usage. I’m having conscience-pangs just thinking about it. Could finasteride exert some kind of deleterious effect on the genetic content inside sperm whereby the sperm _does_ manage to fertilize the egg but where genetic abnormalities are passed on to the child? As usual, I suppose the answer is that nobody knows for sure.
Regards,
Chris
Chris – I edited the post to correct the error. Thanks for pointing that out. I’ll send Dr Rassman your question.
To be clear this retrospective study was of 24 men on finasteride out of 4,400 seeking fertility treatment. It is important to note that this was a group of men who were already having difficulty conceiving & were thus seeking fertility treatment. Further, 11 of the 24 subjects had other pre-existing health related impediments to fertility unrelated to finasteride use. 14 of the 24 men had semen analysis conducted on both before and after their finasteride discontinuation. The 11.6-fold increase was only found in the men with severe oligospermia. The average increase from the 24 men was actually fourfold (an average which also includes the oligospermia sufferers in the mix). Here is a link providing a more detailed synopsis https://www.medpagetoday.com/Endocrinology/Infertility/41424
Reduction in sperm counts can be triggered by a lot of hormonal changes in men. As well as reducing DHT with finasteride, use of anabolic steroids causes temporary infertility (and has been used as a male contraceptive in some trials). In all the studies I’ve seen the reduction in sperm production and motility is not related to sperm quality or viability. We are talking about a reduction in production not damage of the sperm produced.
Another point is that only 27 of the 4400 were on finasteride, i.e. this was a study of 27 men, not 4400.