Medications, drugs, and other exposures can affect male fertility by directly affecting sperm production, or by indirectly altering hormonal balance or sexual function. This information is mainly derived from human observational studies and controlled animal studies, much of which is done for FDA approval. Most drug exposures are reversible after short-term use, except for cancer chemotherapy the effects of which can be permanent. Many drug exposures that appear to have no effect on basic semen parameters may in fact still affect sperm quality and fertility through more subtle mechanisms such as damage to sperm DNA. In the future, stem cell-based, in vitro diagnostic model systems that mimic human spermatogenesis have the most potential to further define drug-, medication-, and exposure-related reproductive toxicity.
Semin Reprod Med. 2013;31(4):286-292. © 2013 Thieme Medical Publishers