Can certain medications affect fertility?

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Dr Asha S Vijay
Can certain medications affect fertility?

Motherhood is an incredible experience, and every woman is keen on becoming a mother and experiencing the joy of carrying a life within. Some women have problems becoming a mother, which may result from various reasons affecting her or her partner. Infertility is when a woman cannot bear a baby after one year of unprotected sex. Different conditions may cause infertility. A typical understanding of infertility is that it is only because of reproductive, genetic, morphological, anatomical, or general health conditions. Little is known that medications impact a more significant part of it, and it might be one of the leading causes of infertility. For a woman, irregular menstrual cycle, age, impaired ovarian function, blocked fallopian tubes, or problems in the uterus are responsible for one not getting pregnant. For a man, infertility is primarily because of the quality and quantity of the sperms, and hormonal problems may cause infertility. Both men and women are affected by certain medications, while some drugs affect only women or only men. The medications that cause infertility could also be prescription drugs or over-the-counter drugs. When a couple is planning a family, it’s essential to watch out for the kind of medicines and drugs they take because it might hurt their fertility.

Fertility can be affected by medications in many ways.

Medicines can alter a woman’s ovulation and endometrial or uterine receptivity to pregnancy. Medication may very well affect a woman’s ability to ovulate by affecting the production of FSH (Follicular Stimulating Hormone) or LH (Luteinizing Hormone) by the pituitary. Suppose one is taking medication like antidepressants or antipsychotics; they must be careful because they can interfere with the hormonal regulation of one’s ovulation and also elevate associated hormone levels like prolactin. Ovulation and fertility may be affected by medications that raise the prolactin levels – chlorpromazine, haloperidol, risperidone. Cyclophosphamide used for cancer and as an immunosuppressant can be toxic to the male and female reproductive system by interfering in oogenesis and spermatogenesis. For men, testosterone treatment, anabolic steroids, narcotic painkillers, SSRI antidepressants can affect fertility by affecting the quality and quantity of sperms.

Some of the medications that one should consider replacing after consulting a doctor that can impact infertility are

• Anabolic steroids/testosterone therapy: Anabolic steroids used to counter muscle loss can make a man permanently sterile by reducing the quality and quantity of sperms

• Antidepressants: Some antidepressants, like Prozac, Paxil, and Zoloft, can impact a male’s sexual drive, his ability to get an erection, and damage the sperm quality. These drugs have side effects like loss of libido, lowered sperm count, male erectile dysfunction, and menstrual irregularities. They also raise the prolactin levels in women and disrupt ovulation.

• Antifungal medications: Antifungal medications, like ketoconazole, can restrain the production of testosterone hormone, lower the sperm count, and have adverse effects on sperm motility.

• Blood pressure medications: Calcium channel blockers, like Procardia (nifedipine), used to treat high blood pressure, increase the risk of lower sperm count.

• Chemotherapy drugs: Chemotherapy may interfere with fertility in men and women. Chemotherapy can cause nausea, and hair loss may also decrease libido. Chemotherapy drugs like cyclophosphamide and methotrexate lower the sperm count in males. Cyclophosphamide, also called Cytoxan, is a medication administered to cancer patients and used in autoimmune diseases that may cause fertility issues like amenorrhea and decrease estrogen levels and other hormonal levels in women. In men, the drug may cause low sperm count impaired sperm motility, and there are cases when the sperm doesn’t develop properly. The cyclophosphamides can also decrease libido.

• Epilepsy drugs: Common drugs such as carbamazepine and valproate used to treat epilepsy can affect the sperm count, morphology, and motility of the sperm.

• Painkillers: The pain killers containing ibuprofen can reduce male fertility. Painkillers are known to delay ovulation. Using prescription anti-inflammatories for conditions like arthritis or rheumatism may temporarily interfere with ovulation. Periods can be disrupted or stopped by drugs that affect the pituitary gland. Talk to your doctor first about lowering your dose or switching to another medication.

• Propecia: Propecia, a drug commonly used for hair loss, impacts the male reproductive hormones to such an extent that it can weaken the production and functioning of sperms which may have adverse effects in men who have extremely low sperm counts.

• Sulfasalazine: Sulfasalazine which is commonly used to treat ulcerative colitis (a type of bowel disease), IBS (Irritable bowel syndrome), can affect the total sperm count, motility, and cause functional azoospermia.

• Urinary function drugs: These drugs, such as Nitrofurantoin, are also known to lower the sperm count.

If one is on specific medication, it’s recommended to wait three months before attempting conception. It may also make one’s body a month or two to get back to its optimal fertility after stopping some types of birth control pills. This may be because the ovaries are recovering after an extended suppression time. Once a medicine is destroyed, it takes a while for one’s body to recover, though the exact span varies from drug to drug. Average egg production for months can be affected by some medications. Generally, most over-the-counter medications don’t interfere with fertility, but it’s always good to ascertain first with the doctor. Consultation with the doctor is necessary when it involves medicine intake. Suppose one is looking forward to planning a baby sooner or later. In that case, one needs to approach an established clinic or fertility centre to seek advice and get the best treatment that enhances success.

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