Finasteride-associated male infertility

Chiba, Koji; Yamaguchi, Kensei; Li, Fuping; Ando, Motomi; Fujisawa, Masato

doi:10.1016/j.fertnstert.2010.12.001

Cited by 51 publications

(39 citation statements)

References 14 publications

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“…Throughout this period, spermatozoa production is limited because of massive cell apoptosis [3], and in this way the proper number of SSCs and SCs [4,5] for sperm production in adult gonads is established [6]. Moreover, at about the 15 th to 18 th postnatal day, the physiological blood-testis barrier is created, the lumen of the seminiferous cords open, and the Sertoli cells undertake their secretory function [6,7]. The morphology and function of the testis is under the control of hypothalamic-pituitary-gonad axis and locally produced steroid hormones such as testosterone (T) and dihydrotestosterone (DHT), which is much more biologically active than T [8].…”

Section: Introductionmentioning

confidence: 99%

“…However, many studies have documented contrary findings [15,16]. In patients administered finasteride, a decrease in semen parameters [17][18][19], difficulties in fertilization [18], sexual dysfunction such as low libido, and problems with erection and orgasm are observed [20]. Some of these symptoms persist for many months after administration of the drug has ceased [20].…”

Section: Introductionmentioning

confidence: 99%

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Androgen levels and apoptosis in the testis during postnatal development of finasteride-treated male rat offspring

Kolasa

Misiakiewicz-Has

Baranowska-Bosiacka

et al. 2015

Folia Histochem Cytobiol.

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Introduction. The hormone-dependent events that occur throughout the first wave of spermatogenesis, such as the establishment of the number of Sertoli cells (SCs) and spermatogonial stem cells (SSCs) within the seminiferous cords and the setting up of the blood-testis barrier, are important for adult male fertility. Any changes in the T/DHT ratio can result in male subfertility or even infertility. In this study we aimed to evaluate effects of paternal exposure to 5-alpha reductase type 2 inhibitor, finasteride on litter size, androgen levels and germ cell apoptosis in male offspring during postnatal development. Material and methods. The subjects of the study were 7, 14, 21/22, 28, and 90-day-old Wistar male rats (F1:Fin) born from females fertilized by finasteride-treated rats. Offspring born from untreated parental animals were used as a control group (F1:Control). Animals and the collected testes were weighed, blood and intratesticular levels of T and DHT were measured by ELISA, and the apoptotic index of testicular cells was evaluated by TUNEL technique. Results. We observed difficulties in obtaining male newborns from female rats fertilized by finasteride-treated male rats. In the F1:Fin rats, changes in the body and testes weights occurred, and a lower number of apoptotic cells was found during postnatal maturation of the seminiferous epithelium. Changes in androgen concentrations during the first spermatogenesis wave and adult life were also evident. Conclusion. Finasteride treatment of male adult rats may not only cause a decrease in the fertility of parental rats, but also could lead to incorrect, androgen-sensitive course of spermatogenesis in their offspring.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Androgen levels and apoptosis in the testis during postnatal development of finasteride-treated male rat offspring

Kolasa

Misiakiewicz-Has

Baranowska-Bosiacka

et al. 2015

Folia Histochem Cytobiol.

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“…There is mounting evidence to suggest that certain individuals may be more sensitive to the fertility effects of 5α-reductase inhibition and that finasteride use leads to infertility in some men. [3][4][5][6] The largest published series has shown that for men with infertility who are taking finasteride, sperm counts increased 11-fold once the finasteride was discontinued. 3 While Samplaski et al recommended that infertile men discontinue finasteride use, many of these men will be unwilling to take this advice.…”

Section: Discussionmentioning

confidence: 99%

“…2 There are now a number of studies documenting that finasteride, even at the low dose of 1mg, may have an adverse effect on fertility for some men. [3][4][5][6] In the largest study, Samplaski et al reported that sperm counts improved over 11-fold once the men had stopped the finasteride, but most of the men did not recover to normal sperm parameters. 3 Presently, if men using finasteride are subfertile, the recommendation is to stop the finasteride and wait for a recovery of spermatogenesis.…”

Section: Introductionmentioning

confidence: 99%

Clomiphene citrate rescue of spermatogenesis in men with infertility while remaining on finasteride: A case report

Forbes

Jarvi³

2017

CUAJ

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Finasteride is a selective inhibitor of type-2 5-alpha reductase enzyme, preventing the conversion of testosterone to dihydrotestosterone (DHT). Finasteride is used as an oral drug for the treatment of benign prostatic hyperplasia at the 5 mg/day dose and is also used for the treatment of androgenic alopecia, or male pattern hair loss, at a dosage of 1 mg orally. There are now a number of studies documenting that finasteride, even at the low dose of 1 mg, may have an adverse effect on fertility for some men.In the largest study, Samplaski et al reported that sperm counts improved over 11-fold once the men had stopped the finasteride, but most of the men did not recover to normal sperm parameters. Presently, if men using finasteride are subfertile, the recommendation is to stop the finasteride and wait for a recovery of spermatogenesis. There has been no report of the use of any hormone therapy, such as clomiphene citrate, gonadotropin, or aromatase inhibitors, to treat subfertile men on finasteride. This is the first case report of the use of clomiphene citrate to improve fertilty for a man on finasteride.

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“…A common finding in these case reports was the significant improvement in semen concentration following cessation of the drug. The improvements were significant enough to allow subjects to continue with less-invasive fertility therapy [3,4]. Although there have been studies with seemingly meaningful correlations, the lack of an overall understanding of fetal safety with paternal exposure to finasteride renders no definitive advice for patients.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy Outcomes with Paternal Exposure to Finasteride, a Synthetic 5-Alpha-Reductase Inhibitor: A Case Series

Kh¹,

Shin²,

Hong³

et al. 2015

J Clin Toxicol

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Finasteride (a synthetic 5-alpha-reductase inhibitor) is used for the treatment of male pattern baldness and benign prostatic hyperplasia. There have been few reports on pregnancy outcomes after paternal exposure to finasteride either prior to or during pregnancy. Nineteen cases with documented paternal exposure to finasteride either prior to or during pregnancy were identified through the Korean Motherisk program. Detailed patient histories were obtained and each patient was followed from pregnancy through abortion or delivery. Of the 19 patients, 13 (68.4%) gave birth to normal full-term babies. The other six cases (31.6%) resulted in either spontaneous (n=3) or artificial (n=3) abortions. These results are consistent with previous animal studies demonstrating an increase in adverse outcomes with paternal exposure to finasteride.

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Finasteride-associated male infertility

Cited by 51 publications

References 14 publications

Androgen levels and apoptosis in the testis during postnatal development of finasteride-treated male rat offspring

Androgen levels and apoptosis in the testis during postnatal development of finasteride-treated male rat offspring

Clomiphene citrate rescue of spermatogenesis in men with infertility while remaining on finasteride: A case report

Pregnancy Outcomes with Paternal Exposure to Finasteride, a Synthetic 5-Alpha-Reductase Inhibitor: A Case Series

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