title: Effects of medical therapy, alcohol, smoking, and endocrine disruptors on male infertility.
abstract: Infertility affects up to 15% of the sexually active population, and in 50% of cases, a male factor is involved, either as a primary problem or in combination with a problem in the female partner. Because many commonly encountered drugs and medications can have a detrimental effect on male fertility, the medical evaluation should include a discussion regarding the use of recreational and illicit drugs, medications, and other substances that may impair fertility. With the knowledge of which drugs and medications may be detrimental to fertility, it may be possible to modify medication regimens or convince a patient to modify habits to decrease adverse effects on fertility and improve the chances of achieving a successful pregnancy. Concern is growing that male sexual development and reproduction have changed for the worse over the past 30 to 50 years. Although some reports find no changes, others suggest that sperm counts appear to be decreasing and that the incidence of developmental abnormalities such as hypospadias and cryptorchidism appears to be increasing, as is the incidence of testicular cancer. These concerns center around the possibility that our environment is contaminated with chemicals--both natural and synthetic--that can interact with the endocrine system.
authors.affiliation: Department of Urology, Hospital das Clínicas, Faculty of Medicine, University os São PAulo, São Paulo, SP, Brazil. fabio@conception-rs.com.br
authors.forename: Fábio Firmbach
authors.initials: FF
authors.lastname: Pasqualotto
authors.forename: Antônio Marmo
authors.initials: AM
authors.lastname: Lucon
authors.forename: Bernardo Passos
authors.initials: BP
authors.lastname: Sobreiro
authors.forename: Eleonora Bedin
authors.initials: EB
authors.lastname: Pasqualotto
authors.forename: Sami
authors.initials: S
authors.lastname: Arap
mesh_terms: D000437:Alcoholism / Q000150:complications; D000959:Antihypertensive Agents / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000009:adverse effects; D004703:Endocrine System / Q000187:drug effects; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects; D007248:Infertility, Male / Q000209:etiology*; D008297:Male; D012907:Smoking / Q000009:adverse effects; D013736:Testicular Neoplasms / Q000150:complications; D013737:Testis / Q000002:abnormalities; D014564:Urogenital Abnormalities / Q000150:complications
chemical_list: D000959:Antihypertensive Agents; D014150:Antipsychotic Agents; D013287:Illicit Drugs