What medicine can cause infertility, but does not affect its use

There are currently no medications that specifically cause azoospermia without affecting sexual function. Azoospermia is usually related to testicular spermatogenic dysfunction or vas deferens obstruction, while sexual function is mainly regulated by androgens and the nervous system, and the two mechanisms are different. Some drugs may indirectly affect sperm production by inhibiting the spermatogenesis process or interfering with hormone levels, but are often accompanied by side effects such as decreased sexual desire or erectile dysfunction.

1. Hormone drugs

Long-term use of androgen preparations such as testosterone propionate injection may inhibit pituitary gonadotropin secretion through negative feedback, leading to stagnation of testicular spermatogenesis. Estrogen drugs such as diethylstilbestrol tablets also interfere with the hypothalamic-pituitary-testicular axis, but may cause feminizing manifestations such as gynecomastia. There are individual differences in the impact of these drugs on sexual function, and some patients may experience a decrease in sexual desire.

2. Chemotherapy drugs

Alkylating antineoplastic drugs such as cyclophosphamide tablets can destroy rapidly dividing spermatogenic cells, and their use in large doses may cause irreversible azoospermia. Some patients can still maintain normal erectile function after chemotherapy, but the drug will also damage testicular interstitial cells, which may be accompanied by a decrease in testosterone levels. When chemotherapy is combined with radiotherapy, the damage to spermatogenic function is more significant.

3. Immunosuppressants

Immunosuppressive drugs used for organ transplantation, such as tacrolimus capsules, may affect spermatogenesis by inhibiting Sertoli cell function. Clinical observations have found that some patients develop oligozoospermia rather than complete azoospermia. This type of drug has less interference with the gonadal axis and the sexual function of most patients is not affected. However, it should be noted that its nephrotoxicity may indirectly lead to sexual dysfunction.

4. Anti-parasitic drugs

Gossypol has been studied as a male contraceptive, which can selectively inhibit the seminiferous epithelium and cause azoospermia. Most people's sperm count can be restored after stopping the drug. This drug does not affect serum testosterone levels and theoretically has no direct impact on sexual function. However, it has not been clinically promoted due to serious side effects such as hypokalemia. Current antibacterial drugs such as nitrofurantoin enteric-coated tablets may also temporarily inhibit sperm motility.

5. Psychotropic drugs

Selective serotonin reuptake inhibitors such as fluoxetine may interfere with the spermatogenesis process by increasing prolactin levels, but more commonly cause delayed ejaculation or orgasmic dysfunction. The blocking effect of antipsychotic drugs such as risperidone tablets on dopamine receptors may affect sexual function and spermatogenic function at the same time, making it difficult to achieve a single effect.

Any drugs that may affect reproductive function must be used under the guidance of a doctor. If semen abnormalities occur, semen analysis and reproductive hormone testing should be performed promptly. Maintaining moderate exercise, avoiding high temperature environments, and supplementing with nutrients such as zinc and vitamin E can help maintain reproductive health. If you need to preserve your fertility, you can consult a reproductive medicine expert about sperm cryopreservation before taking medication.