Men wanting to be a father should be aware of medications and supplements that can negatively impact sperm

If you are a man trying to father a baby, most medicines are safe for you to take. But, you should also be aware that there are many drugs (prescription, over the counter, or even illicit) that can significantly affect your ability to get a woman pregnant. Many of these medications are taken for common problems, such as hypertension or low-T. In particular, men should be wary of medications and supplements that can negatively affect sperm.

Sperm cells are known to be especially sensitive to many drugs. Some drugs can reduce sperm count (the number of sperm), sperm motility (ability to move), or sperm morphology (shape). Other medicines and supplements may affect the hormones that are involved in sexual and reproductive function. The side-effects from these can be in the form of erectile dysfunction or low libido.

The list is long on medications that can affect male fertility 

While the following list of medications and supplements that can negatively affect sperm seems long, in most cases, sperm quality and production can rebound when you stop taking many of these. On average, it takes 50–60 days for sperm to develop in the testicles, so giving your body 2-3 months to produce a new crop of sperm without the side-effects of a drug may be all you need to make a baby. Be sure to first talk with your prescribing doctor before stopping or altering any medications you take.

Medications and supplements that can negatively affect sperm include:

• Testosterone Replacement Therapy – Many men are often surprised to find that the testosterone their doctor prescribed to make them feel, well, more manly, has the opposite effect on their fertility. Despite its positive effects on sexual function, testosterone replacement therapy inhibits the production of follicle stimulating hormone and luteinizing hormone in men. These hormones are vital for sperm production. Testosterone therapy comes in many forms, such as gels, patches, injections, and pellets under brand names like Androgel, Fortesta, and Axiron. Sperm production will typically bounce back to normal in a few months after stopping testosterone replacement.
• Long-term Anabolic Steroid Use – Anabolic steroids harm male fertility the same way testosterone does by interfering with the hormone signals that are needed to produce sperm. The good news is that sperm production resumes after steroids are stopped. 
• Antidepressants – Tricyclic antidepressants and selective serotonin reuptake inhibitors used for depression can also cause sexual dysfunction, such as lowered desire or arousal, delayed orgasm, and anejaculation. They may also cause lower sperm counts. Some of these are citalopram, fluoxetine, venlafaxine, paroxetine, sertraline, nortriptyline, and imipramine. If you are trying to conceive and taking one of these medications, talk to your prescribing doctor to find other medications to treat your depression. Be sure to talk with your doctor before you stop taking any prescription antidepressant medications. 
• Cancer Medications – Many chemotherapy drugs damage the cells that produce sperm and may cause azoospermia (no sperm in ejaculate) right after treatment. A man may or may not regain the ability to make sperm after having chemotherapy. This will depend on which chemotherapy drug is used, what dose was given, and how long treatment lasts. We recommend that men who hope to have children try to cryopreserve their sperm before beginning chemotherapy, if possible. With this technique, sperm are frozen for later use with in vitro fertilization or intrauterine insemination. 
• Antibiotic Medications and Certain Anti-Fungals – Some studies show that antibiotics such as nitrofurantoin and erythromycin have been shown to block sperm production. While antibiotics taken for a short time are safe, long-term use can likely affect a man’s fertility. Ketoconazole, an antifungal antibiotic, interferes with testosterone and sperm production.
• Opiates – Opiates, whether prescribed legally for pain or taken recreationally, can decrease sperm motility, even at low doses. Higher doses of opiates can cause erectile dysfunction, low libido, and low sperm production. 
• Marijuana, THC and Cocaine – While more research is needed, marijuana and THC use by men has been shown to have a detrimental impact on male sperm. Cocaine has been found to alter the cell cycle and cell division, induce cell death, and alter sperm motility. 
• High Blood Pressure Medications – Calcium channel blockers, such as amlodipine and diltiazem, used to treat high blood pressure and heart problems may decrease sperm count and motility. Other treatments may be available to treat your high blood pressure, and a conversation with your cardiologist may help you decide on an alternative.

Bring a list of your medications to your fertility consult

During your fertility consultation, be sure to bring a list all medications and supplements that you take. Your fertility physician will be able to give you advice on medications and supplements that negatively affect sperm or sexual function. After discussing your medical history and the medications and supplements you take, you will arrange to provide a semen sample at our lab. A semen analysis will be able to determine if your sperm are healthy and if you need to make any temporary changes in the medications and supplements you take.

If you’re concerned about your fertility and thinking your medication may be affecting it, it’s best to consult with a healthcare professional before making any changes to your medication regimen. Be sure to talk with your doctor before stopping or altering any medications. Not taking a medication needed for a health problem or even abruptly stopping a medication can have serious health risks. Many times, an alternative medication or therapy can be used during the time you are trying to conceive.