Infertility and Teratogenicity After Paternal Exposure to Systemic Dermatologic Medications: A Systematic Review

In 2019, a systematic review was conducted to evaluate the impact of systemic dermatologic medications on male fertility and the risk of causing birth defects (teratogenicity) following paternal exposure. Out of 1,032 studies, 19 met the inclusion criteria. The review found that 6 out of 13 medications had evidence of negative effects on male fertility, specifically colchicine, cyclophosphamide, doxycycline, finasteride, tetracycline, and thalidomide. However, for other medications like acitretin, isotretinoin, and systemic corticosteroids, no impairment in semen parameters was observed, and isotretinoin might even improve sperm motility. No studies confirmed teratogenic effects following paternal exposure to isotretinoin, thalidomide, or methotrexate, and postmarketing data suggested such effects are unlikely. The review emphasized the need for more research, particularly on the potential for medications to be excreted in semen and the implications for offspring, as well as the importance of discussing fertility preservation and treatment options with patients.