title: Are proton-pump inhibitors harmful for the semen quality of men in couples who are planning pregnancy?
abstract: OBJECTIVE
  To determine associations between proton-pump inhibitor (PPI) use and semen parameters in young men of couples who are planning pregnancy.
  
  
  METHODS
  Case-control study of a population-based registry.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  General practitioner patients comprising 2,473 men from couples planning pregnancy with a recorded semen analysis: 241 with a low total motile sperm count (TMSC ≤1) and 714 with TMSC >1 as matched controls.
  
  
  METHODS
  None.
  
  
  METHODS
  Exposure to PPI; PPI dosage.
  
  
  RESULTS
  The study of data from between 1996 and 2013 from the Integrated Primary Care Information database in the Netherlands, which incorporates the medical records of 1.5 million patients from 720 general practitioners, found that the use of PPIs in the period between 12 and 6 months before semen analysis was associated with a threefold higher risk of low TMSC (odds ratio 2.96; 95% confidence interval 1.26-6.97) adjusted for age and other medication. Use of PPIs during the 6 months immediately before the semen analysis was not statistically significantly associated with low TMSC.
  
  
  CONCLUSIONS
  The use of PPIs in the period 12 to 6 months preceding semen analysis is associated with a threefold higher risk of low TMSC, which suggests that a long-term increase in gastric pH results in a decline of sperm quality. This finding emphasizes the need for more preconceptional research and counseling on the potential effects of medication use on semen quality.
authors.affiliation: Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Huijgen
authors.affiliation: Department of Medical Informatics, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
authors.forename: Maria A J
authors.initials: MA
authors.lastname: de Ridder
authors.affiliation: Department of Medical Informatics, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
authors.forename: Katia M
authors.initials: KM
authors.lastname: Verhamme
authors.affiliation: Department of Urology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
authors.forename: Gert R
authors.initials: GR
authors.lastname: Dohle
authors.affiliation: Department of Medical Informatics, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Vanrolleghem
authors.affiliation: Department of Medical Informatics, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
authors.forename: Miriam C J M
authors.initials: MC
authors.lastname: Sturkenboom
authors.affiliation: Department of Obstetrics and Gynaecology, Division of Reproductive Medicine, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
authors.forename: Joop S E
authors.initials: JS
authors.lastname: Laven
authors.affiliation: Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands; Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. Electronic address: r.steegers@erasmusmc.nl.
authors.forename: Régine P M
authors.initials: RP
authors.lastname: Steegers-Theunissen
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D005298:Fertility / Q000187:drug effects*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009426:Netherlands; D016017:Odds Ratio; D011247:Pregnancy; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012661:Semen / Q000187:drug effects*; D013076:Sperm Count; D013081:Sperm Motility / Q000187:drug effects*; D013094:Spermatozoa / Q000187:drug effects* / Q000473:pathology; D013997:Time Factors
chemical_list: D054328:Proton Pump Inhibitors
keywords: Adverse drug reaction; fertility; proton-pump inhibitors; semen quality