title: Finasteride use in the male infertility population: effects on semen and hormone parameters.
abstract: OBJECTIVE
  To determine the degree of improvement in semen parameters after finasteride discontinuation.
  
  
  METHODS
  A prospective database of men presenting for a fertility evaluation was analyzed for semen and hormone parameters before and after discontinuation of finasteride.
  
  
  METHODS
  A male infertility specialty clinic.
  
  
  METHODS
  Men presenting for fertility evaluation from 2008-2012 on finasteride.
  
  
  METHODS
  None.
  
  
  METHODS
  Semen and hormone parameters before and after discontinuation of finasteride.
  
  
  RESULTS
  At presentation, 27 (0.6%) of 4,400 men on finasteride. The mean duration of treatment with finasteride was 57.4 months, and mean dose was 1.04 mg/day. There was an average 11.6-fold increase in sperm counts after finasteride discontinuation. Of the men with severe oligospermia (<5 M/mL), 57% had counts increase to >15 M/mL after finasteride cessation. No man had a decrease in sperm count. There was no change in hormone parameters, sperm motility, or sperm morphology.
  
  
  CONCLUSIONS
  Finasteride, even at low doses, may cause reduced sperm counts in some men. In this population, counts improved dramatically for the majority of men after finasteride discontinuation. The hormone parameters, sperm motility, and sperm morphology were unchanged after cessation. Finasteride should be discontinued in subfertile men with oligospermia, and used with caution in men who desire fertility.
authors.affiliation: Division of Urology, Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Samplaski
authors.forename: Kirk
authors.initials: K
authors.lastname: Lo
authors.forename: Ethan
authors.initials: E
authors.lastname: Grober
authors.forename: Keith
authors.initials: K
authors.lastname: Jarvi
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D000328:Adult; D053713:Azoospermia / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D016208:Databases, Factual; D005299:Fertility Agents / Q000627:therapeutic use; D018120:Finasteride / Q000627:therapeutic use*; D042341:Gonadal Hormones / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D055101:Semen Analysis / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D058891:5-alpha Reductase Inhibitors; D005299:Fertility Agents; D042341:Gonadal Hormones; D018120:Finasteride
keywords: 5α-reductase; Azoospermia; fertility; finasteride; oligospermia; semen; spermatogenesis