TLDR Finasteride use may cause sperm damage and infertility, stopping it can improve sperm health.
This case report describes a 48-year-old man who had been taking low-dose finasteride for androgenic hair loss and was experiencing secondary infertility with his wife. The patient had normal semen parameters but an elevated sperm DNA fragmentation index (DFI). After discontinuing finasteride, the patient's DFI decreased significantly within three months, suggesting a causal link between finasteride and sperm DNA damage. The authors suggest that in infertile men using finasteride, sperm DFI should be measured in addition to semen parameters, and a trial of discontinuation of finasteride may be warranted.
49 citations
,
December 2007 in “Fertility and Sterility” Stopping finasteride improved sperm counts in two men, reducing the need for fertility treatments.
195 citations
,
February 2007 in “The Journal of Clinical Endocrinology and Metabolism” Dutasteride and finasteride may reduce sperm count and volume but don't affect movement or shape; effects are reversible after stopping.
34 citations
,
January 2004 in “Revista do Hospital das Clínicas” Finasteride may worsen infertility in men with existing issues, but stopping it can improve sperm health.
March 2013 in “Reactions Weekly” A man's fertility improved after he stopped taking finasteride but worsened again when he restarted the medication.
15 citations
,
October 2012 in “International Urology and Nephrology” Low-dose finasteride may cause fertility issues, but stopping it can improve sperm quality and lead to pregnancy.
33 citations
,
April 2015 in “Current Opinion in Endocrinology, Diabetes and Obesity” 5α reductase inhibitors treat hair loss but may cause sexual side effects and risks.
35 citations
,
April 2013 in “Sexual medicine reviews” 5-alpha reductase inhibitors slightly increase the risk of sexual and mood side effects, and breast growth in men.
54 citations
,
September 2013 in “Fertility and Sterility” Finasteride can reduce fertility in some men, but stopping it increases sperm count.
