What medications affect fertility?

Varvara February 02 2022

It is extremely common for doctors to prescribe drugs to patients. These medications are available by prescription only and can be life-saving when used appropriately. Unfortunately, the side effects of the medications are typically unknown. Some medications affect fertility in both men and women, others affect fertility in women only, while others affect sperm counts only.

There are medications that may affect your fertility. These medications may be prescribed by your doctor to treat another medical condition. If you are planning a pregnancy, it is important to tell your doctor about all the prescription drugs you take at each visit. Your doctor will work with you to minimize the risks of taking medications during pregnancy.

It is possible that certain medications can affect fertility. A medication could decrease your ability to have children by causing problems in sperm production or ovulation, increasing the risk of miscarriage, birth defects, etc. However, most drugs are not known to cause infertility when used effectively. It is important that any woman who is planning a pregnancy talk to their doctor about what they are taking before trying to conceive. Your doctor can help you make an informed decision about continuing medication use during pregnancy and breastfeeding.

If you are already pregnant when you start using a particular drug, it is also important for your doctor to know in case there may be the harm in taking the medication at that stage.

The following medications may affect fertility:

  1. Cancer medications: There are certain cancer treatments that can damage sperm and eggs, which can affect future fertility potential. Some doctors recommend limiting the time between the end of cancer treatment and when you start trying to conceive. If you are planning on starting a family in the near future, some oncologists will freeze your semen or eggs before beginning chemotherapy or radiation therapy, so that they can be used at a later date if desired.
  2.  Blood pressure medications: Using beta-blockers (Acebutolol, Atenolol), calcium channel blockers (Nifedipine), ACE inhibitors (Benazepril, Captopril), or Aldosterone receptor antagonists (Eplerenone) can decrease fertility potential. Be sure to tell your doctor if you are trying to conceive before taking these medications.
  3.  Diabetes medications: Some diabetes medications, including insulin or glyburide, can cause changes in menstrual cycle timing. These changes may affect the timing of sexual intercourse relative to ovulation and therefore affect fertility potential. If you are planning on getting pregnant soon, it is best not to take these drugs before trying due to their effects on ovulation timing.
  4.  Prostate cancer medications: Using anti-androgens such as flutamide or bicalutamide can decrease testosterone production which results in decreased sperm count so they are not advised if you are trying to conceive anytime soon.
  5.  Blood thinners: Taking blood-thinning medications such as warfarin can increase your risk of miscarriage or birth defects in the unborn baby, so you should talk with your doctor before trying to conceive.
  6.  Arthritis medications: Using over-the-counter pain relievers such as acetaminophen (Tylenol, Panadol), aspirin (Bufferin, Bayer), ibuprofen (Advil, Motrin IB), naproxen (Aleve, Naprosyn), or other prescription medicines to reduce fever or treat pain may affect fertility potential.
  7. Steroids: Taking corticosteroids such as prednisone, or inhaled corticosteroid medications to decrease inflammation in the body may affect fertility potential.
  8. Anti-depressants: Using tricyclic antidepressants such as desipramine (Norpramin), imipramine (Tofranil), and others can decrease fertility potential.
  9. Antibiotics: Using antibiotics such as metronidazole (Flagyl), tinidazole (Fasigyn) and others can decrease fertility potential.
  10. Anti-seizure medications: Using valproic acid or sodium valproate may affect the development of an unborn baby's major organs, particularly the brain and spinal cord. If you are planning on getting pregnant soon, talk with your doctor about alternative medication options.
  11. Anticoagulants: Taking anticoagulants such as heparin or warfarin may cause problems during pregnancy for both mother and unborn baby. You should not conceive while taking these drugs because of the risk of birth defects.
  12. Migraine medications: Taking migraine headache medications such as topiramate (Topamax), valproic acid, and others may affect fertility potential and should not be used if you are planning on getting pregnant soon.
  13. Heartburn or ulcer medications: Heartburn and ulcer medications such as omeprazole, esomeprazole (Nexium), lansoprazole (Prevacid), and others can decrease fertility potential. There is also a small chance that taking proton pump inhibitors during early pregnancy could cause problems for your baby developing in the uterus.
  14. Allergy medications: Using over-the-counter antihistamines such as diphenhydramine (Benadryl), and chlorpheniramine (Chlor-Trimeton) can decrease fertility potential.
  15. Asthma medications: Using asthma medicines, particularly inhaled steroids, can increase the risk of miscarriage or birth defects so you should talk with your doctor before trying to conceive if you are taking these medicines during treatment for asthma. NOTE: Allergy medications are riskier than asthma medications because allergy medication affects the fertility potential of both men and women. Asthma medications only affect women's fertility potential.
  16. Muscle relaxants or anti-seizure medications: Using muscle relaxants such as tizanidine (Zanaflex), baclofen (Lioresal), diazepam (Valium, Diastat), methocarbamol (Soma), or other anti-seizure medications may affect fertility potential so it is best not to conceive while taking these drugs.
  17. Prescription weight loss medication: Taking prescription weight loss medication such as phentermine, sibutramine, fluoxetine (Prozac, Sarafem), and topiramate (Topamax) can decrease fertility potential.
  18. Cholesterol-lowering medications: Using statin cholesterol-lowering medications such as atorvastatin (Lipitor), lovastatin (Mevacor), simvastatin (Zocor, Vytorin) and others may affect fertility potential so it is best not to conceive while taking these drugs.
  19. Hydrochlorothiazide: Using hydrochlorothiazide may increase your risk of cardiovascular problems during pregnancy and should not be used if you are planning on getting pregnant soon.
  20. Aspirin: Taking aspirin in the third trimester of pregnancy increases the risk of bleeding in the fetus when labor begins. If you are planning on getting pregnant soon, talk with your doctor before taking any medicine containing aspirin.
  21. Lithium: Using lithium may cause birth defects so you should not conceive while taking this medication.
  22. Corticotropin or ACTH: Taking corticotropin or adrenocorticotropic (ACTH) hormone to treat various ailments such as arthritis and skin conditions can decrease fertility potential and may affect the unborn baby's development in the uterus.
  23. Doxycycline: Using doxycycline may be linked to a higher incidence of certain eye problems among children born to women using the medication during pregnancy (40).
  24. Minoxidil: Topical minoxidil (Rogaine) is usually applied directly to the scalp twice daily so it does not affect fertility potential. If you are taking oral minoxidil for the treatment of high blood pressure, talk with your doctor before trying to conceive because this medication may reduce fertility potential.
  25. Gold injections: Taking gold injections such as aurothioglucose (Solganal), may decrease fertility and should not be used if you are planning on getting pregnant soon.
  26. Prolonged corticosteroid therapy: Using prolonged corticosteroids such as betamethasone (Diprolene cream or Diprolene AF ointment), dexamethasone (Decadron), hydrocortisone, and triamcinolone (Aristocort) may decrease fertility and affect the unborn baby's development in the uterus.
  27. Cancer: Women with cancer should not become pregnant during treatment because chemotherapy drugs could harm the fetus. Discuss your specific case with your doctor to determine if you can try to conceive or you need to delay pregnancy until after treatment is over. Women who are undergoing radiation therapy to treat cancer of the reproductive system may be at higher risk for infertility following treatment however, there have been reports of women becoming pregnant soon after completing their course of radiation therapy.

What medications affect fertility in men?

Medications taken by a father-to-be can also affect the unborn baby's development. Some medications that are safe for the mother may be harmful to the fetus so you should talk with your doctor about possible effects on your developing baby if either of you are taking medication. According to one study, more than 15% of men have used some form of medication during their lifetime which could potentially impact fertility potential. The study also stated that men are more likely to use medication whose effects on fertility potential have not been well studied. Medications that may reduce fertility in men include:

  1. Diabetes medications: Using insulin or other diabetes medications may reduce male fertility potential.
  2. Corticosteroids: Taking corticosteroids such as prednisone, methylprednisolone (Medrol), dexamethasone, betamethasone, and triamcinolone (Aristocort), can decrease sperm production so it is best not to conceive while taking these drugs.
  3. Cholesterol-lowering medications: Using statin cholesterol-lowering medications such as atorvastatin (Lipitor), lovastatin (Mevacor), simvastatin (Zocor, Vytorin), and others may affect fertility potential so it is best not to conceive while taking these drugs.
  4. Cancer: Men with cancer should not try to conceive until after treatment is over because chemotherapy drugs could affect sperm production. Discuss your specific case with your doctor to determine if you can start trying to conceive or you need to delay pregnancy until after treatment is over.
  5. High blood pressure medications: Taking high blood pressure drugs such as diuretics, ACE inhibitors, and beta-blockers may affect fertility potential.
  6. Acyclovir: Using acyclovir (Zovirax), an antiviral agent used to treat herpes infections, can decrease sperm production so it is best not to conceive while taking this drug.
  7. Hydrochlorothiazide: Taking hydrochlorothiazide may increase your risk of cardiovascular problems during pregnancy and should not be used if you are planning on getting pregnant soon.
  8. Aspirin: Taking aspirin in the third trimester of pregnancy increases the risk of bleeding in the fetus when labor begins. If you planning on getting pregnant soon, talk with your doctor before you take aspirin.

What medications affect fertility in both men and women?

  1. Chemotherapy: People undergoing cancer treatment with chemotherapy should not become pregnant until after treatment is complete because the drugs can affect sperm and egg production and embryo development. Discuss your specific case with your doctor to determine if you can try to conceive or you need to delay pregnancy until after treatment is over.
  2. Radiation therapy: People undergoing radiation therapy for cancer may be at risk for reduced fertility following treatment however, there have been reports of women becoming pregnant soon after completing their course of radiation therapy.
  3. Lupus medications: Using lupus medications such as hydroxychloroquine (Plaquenil), chloroquine (Aralen), methotrexate, and other disease-modifying antirheumatic drugs, can decrease fertility so it is best not to conceive while taking these drugs.
  4. Arthritis medications: Using arthritis medications such as celecoxib (Celebrex), etodolac (Lodine), indomethacin (Indocin) and others may affect fertility potential so it is best not to conceive while taking these drugs.
  5. Ulcer medications: People using non-steroidal anti-inflammatory medications for stomach ulcers, such as diclofenac, naproxen or ibuprofen should not become pregnant because these drugs can cause miscarriages or birth defects.
  6. Narcotics: Narcotic analgesics including morphine, codeine and methadone are associated with an increased risk for miscarriage and birth defects.
  7. Clozapine: Women taking clozapine (Clozaril) to treat schizophrenia should stop taking this drug if they are trying to get pregnant because it could cause problems with the baby's development.
  8. Birth control pills: Using oral contraceptives while you are trying to conceive can reduce fertility by delaying ovulation so it is best not to get pregnant while on the pill. The hormones in birth control pills may also affect sperm production so men should wait 6 months after stopping oral contraceptives before starting a family.
  9. Smokers: If you smoke, quitting smoking before conceiving will improve your chances of having a healthy pregnancy and baby. Smoking during pregnancy can lead to miscarriages, preterm labor and stillbirth.
  10. Narcotic pain relievers: Using narcotic analgesics such as morphine, codeine, fentanyl (Duragesic), pentazocine (Talwin), propoxyphene (Darvocet-N 100), dezocine (Dalgan) or others may affect fertility potential so it is best not to conceive while taking these drugs.
  11. Alcohol: Heavy alcohol use can interfere with ovulation which can make conceiving difficult. It's also one of the biggest risk factors for birth defects in babies so if you are trying to get pregnant or are already pregnant, do not drink any alcohol during this time.
  12.  Diabetes medications: Taking diabetes medications such as insulin, glyburide (Diabeta, Glynase), and glipizide before you get pregnant might increase the risk of miscarriage. Men who have type I or II diabetes should discuss their treatment options with a doctor so they can minimize the possible effects on fertility before getting a lady pregnant.

Conclusion:

There are a variety of medications that affect fertility. Discuss specific concerns with your doctor before attempting to conceive. While some medications have the potential to affect fertility, it is important to note that most often they do not interfere with sexual intercourse or prevent pregnancy. Talk to your doctor for specific questions about medications you are taking and how they might affect your upcoming pregnancy.