Effects of systemic dermatological treatments on male fertility: Review; [Dermatolojide kullanilan sistemik tedavilerin erkek üremesi üzerine etkileri]
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Date
2010
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Abstract
Various systemic drugs that may damage spermatocytes temporarily or permanently are now commonly used. These are generally cytotoxic, immunosupressive, immunomodulatory and biologic drugs which may have gametotoxic adverse effects. Controlled studies upon male fertility, including the risk of congenital abnormalities are not available; any observed effects are presented as anecdotal evidence. Cyclosporin and methotrexate are the most well-known and frequently used ones. Their effects on spermatogenezis have been reported in several studies. According to the presented data, biologics and retinoids do not have reproductive safety risk. On the contrary, it was found that biologics increase sperm functions by inhibiting TNF-α in vitro studies. The effects of these drugs on male productive system are dependent on therapy period, treatment protocol and the spermatogenetic status of patient before the treatment. Sperm concentration starts to drop about after 2 weeks and reaches a maximum state after 2-3 months. About half of the patients experience a return of sperm production after 12-36 months, independent from dose or therapeutic agent. One year after treatment the drug is completely washed out from the body and there is no increased risk of fathering a malformed child in the first generation. The patients who have to use the drugs that may affect the spermatogenesis negatively should be informed about the risk of decreased fertility, the time to gain the fertility again and cryopreservation. In case of a decrease or loss in fertility, sperm cryopreservation may be an alternative for fertilization. Copyright © 2010 by Türkiye Klinikleri.